19: Pulmonary Breath Sounds Flashcards

1
Q

three cases that may have tracheal displacement

A
  1. pneumothorax
  2. pleural effusion
  3. severe atelectasis
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2
Q

signs of respiratory distress on inspection

A
  1. accessory muscle use (SCM, scalenes)
  2. Retractions (supraclavicular retractions)
  3. inability to speak in full sentences
  4. tripod positioning
  5. abdomen paradoxical movement with breaths
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3
Q

causes of nail clubbing

A

bronchiectasis, congenital heart disease, pulmonary fibrosis, CF, lung abscess, malig

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4
Q

causes of unilateral chest expansion

A
  1. fibrosis
  2. pleural effusion
  3. lobar PNA
  4. pleural pain
  5. unilateral bronchial obstruction
  6. paralysis of hemidiaphragm
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5
Q

tactile fremitus

A

palpable vibrations from patient speaking

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6
Q

what does it mean if tactile fremitus is increased vs locally decreased vs globally decreased

A
  1. increased: consolidated tissue like PNA
  2. locally decreased: pleural effusion, pneumothorax, neoplasms
  3. globally decreased: high pitched voice, thick chest wall, obstructed bronchus, COPD, fibrosis
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7
Q

why is lack of wheezing in an asthmatic pt an ominous sign

A

could be so severe that almost no air is moving thru

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8
Q

symp levels of the lungs

A

T1-7

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9
Q

332 rule in intubation

A
  1. 3 fingers between upper/lower teeth with open mouth
  2. 3 fingers between mental angle and hyoid bone
  3. 2 fingers between floor of mandible to thyroid notch
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10
Q

LEMON airway assessment

A
  1. Look externally (trauma, big teeth, beard, large tongue)
  2. evaluate 332
  3. mallampati score >3
  4. obstruction (epiglottitis, peritonsillar abscess, trauma)
  5. neck mobility
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11
Q

indications for intubation

A
  1. respiratory failure
  2. apnea
  3. reduced consciousness GCS < 8
  4. airway injury
  5. high risk for aspiration
  6. general anesthesia
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12
Q

major contraindication of intubation

A

laryngeal fracture

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13
Q

Most common inflammatory dz of the lung + MC chronic dz in childhood in resource-rich countries

A

Asthma

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14
Q

Confirming asthma dx requires what three elements?

A
  1. Variable expiratory airflow limitation on spirometry
  2. Reversible obstruction
  3. Exclude other dxs
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15
Q

Six types of drugs used in asthma and COPD**

A
  1. SABA
  2. LABA
  3. SAMA (short acting muscarinic agents)
  4. inhaled corticosteroids
  5. Systemic corticosteroids
  6. Leukotriene R antagonist
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16
Q

COPD

A

Persistent sx and airflow limitations due to alveolar abnormalities caused by significant exposure to noxious particles

17
Q

Most reproducible and objective measurement of airflow limitation in COPD**

A

Spirometry

18
Q

How to treat acute exacerbations of COPD

A
  1. Asses O2, obtain ABGs, CO2 monitoring
  2. Intubation as needed
  3. Order CXR, CBC, CMP, cardiac profile, BNP, ECG
  4. SAMA and IV glucocorticoids
  5. Abx if increased sputum production
19
Q

Four things that cause restrictive lung disease

A
  1. ILD
  2. Chest wall issues
  3. Pleural effusion
  4. Muscle weakness (ALS, muscular dystrophy)
20
Q

Symptoms of ILD in general

A

Insidious onset, progressive dyspnea, non-productive cough

21
Q

Two most common ILDs

A
  1. IPF

2. Sarcoidosis

22
Q

Most common CT-ILD

A

Systemic sclerosis