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CPD Vocab > 6 Lungs > Flashcards

6 Lungs Flashcards

0
Q 
Sputum
Clear--
Yellow--
Green--
Brown--
A

Allergy, COPD
Infxn (live neutrophils, acute bronchitis/pneumonia)
Chronic infxn (neutrophil breakdown, chronic bronchitis, bronchiectasis, CF)
Old blood (chronic bronchitis, chronic pneumonia, TB, lung cancer)

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1
Q

Cough DDX

A

URIs, rhinosinusitis, GERD, lung infxn, smoking/second hand smoke, ACE inhibitors, CF, anxiety, asthma, COPD, air pollution, CHF, cancer, postnatal drip, pulmonary edema, TB/bronchiectasis

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2
Q

Hemoptysis Ddx

A

Airway inflammation, foreign body, autoimmune, cocaine induced pulmonary hemorrhage, pulmonary embolism, coagulopathy, airway trauma, bronchiogenic carcinoma, bronchiectasis/TB, pneumonia, abcess, esophageal varices

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3
Q

2 questions to ask pt with respiratory issues…

A

Do you have a cough?

Do you have SOB?

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4
Q

Dyspnea of Cardiac origin DDX

A

CHF, ischemic heart disease, cardiomyopathy, malignant HTN, dissecting aortic aneurysm, pericardial effusion

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5
Q

Signs of cardiac originating dyspnea

A

Cheyne Stokes respiration: apnea and hyperpnea
Orthopnea: resp problems when supine (L ventricle)
Paroxysmal nocturnal dyspnea: pt awakens gasping for breath, sits up

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6
Q

Chronic productive cough DDX

A

Sinusitis, smoker, allergies, chronic irritation, TB, chronic bronchitis, later stage cancer, pulmonary edema

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7
Q

Chest pain and dyspnea DDX

A

MI, pleurisy, pneumonia, TB, cancer, pneumothorax, GERD, anxiety, panic attack

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8
Q

physical exam

A
  1. Inspection (resp rate, ss of distress, chest config, color)
  2. Palpation (areas of pain, expansion, fremitis)
  3. Percussion (resonant, flat, dull, hyperresonant, tympanic)
  4. Auscultation (normal, changes, adventitious)
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9
Q

fremitis

A

vibration transmitted through the body

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10
Q

change in breath sounds

A

absent=collapsed lung
decreased=lung displaced by air (emphysema/pneumothorax) or fluid (pleural effusion)
bronchial breathing=consolidation

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11
Q

Crackles

A

Adventitious/superimposed. popping upon inspiration. produced by passage of air through bronchi w/ secretions or that are constricted

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12
Q

Rhonchi

A

Adventitious/superimposed. low pitched wheezes originating in upper airways. clear with coughing

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13
Q

Wheezes

A

Adventitious/superimposed. high pitched, musical, or whistling sounds caused by narrowing/obstrxn of bronchi/bronchioles
Stridor when upper airway Croup

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14
Q

Pleural sounds

A

Adventitious/superimposed. pleural friction rub. pleural fluid decreased or absent, dt inflammation, leather couch

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15
Q

pleurisy

A

sharp, knife-like localized pain, pt may “splint”. concurrent with pleural sounds

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16
Q

Bronchophony

A

vocal fremitus. “99” normally indistinct. louder, clearer sounds over area of consolidation

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17
Q

Whispered Pectoriloquy

A

Pt whispers 123. “123” heard clearly over areas of consolidation

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18
Q

egophany

A

Abnormal is “ee” turns to “ay”. over areas of consolidation

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19
Q

Peak Flow Meter

A

~FEV1. monitors pulmonary fxn in pts w asthma

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20
Q

Pulse Oximetry

A

non-invasive test of oxygen saturation in arterial blood

21
Q

Pulmonary Fxn Test

A

Spirometry. assess the functional status of the lung.
results could be decreased because of obstruction (asthma, bronchitis, mucus plug, tumor, foreign body, trauma), restricted airflow (sarcoidosis, TB, pneumonia, scoliosis, pleural effusion, tumors, obesity, myasthenia gravis, MD, ALS)

22
Q

COPD

A

Excessive airway inflammation–>abnormalities that obstruct flow
Reduced expiratory flow and slow forces emptying of lungs. Minimally reversible with bronchodilators

23
Q

COPD risk factors

A

smoking/second hand smoke, pollution, childhood URIs, occupational exposure, alpha 1 antitrypsin def, asthama

24
Q

General COPD ssx

A

dyspnea (worsens with exertion), chronic productive cough, wheezing
Barrel chest, use of accessory muscles, hyperresonance, cyanosis

25
Q

Gold Scale

A 
severity of COPD. FEV1
normal: >85%
mild: >80%
moderate: 50-79%
severe: 30-49%
very severe: <30%
26
Q

Emphysema

A

permanent enlargement of alveolar ducts and air spaces distal to terminal bronchioles, loss of elastic recoil, fibrosis, scarring.
Pink puffers. cough is rare. Barrel chest, cachectic, purse-lipped breathing. sleep upright

27
Q

Hoover sign

A

lower ribs pull together with deep inhalation. sign in emphysema.

28
Q

Chronic Bronchitis

A

mucus hyper-secretion secondary to hypertrophy of glands of bronchial mucosa, producing a cough most days of month, 3 month for a yr for 2 yrs
Blue bloaters (cyanosis, polycythemia, fluid retention)
dyspnea/wheezing

29
Q

Chronic bronchitis risk factors

A

smoking a lot, pollutants, dust, microbes.

30
Q

COPD DDX

A

central airway stenosis, bronchiectasis, heart failure, CF, constrictive bronchiolitis, bronchopulmonay mycosis

31
Q

Asthma

A

REVERSIBLE obstructive lung disorder with increased reactivity of airways

  • airway obstruction
  • inflammation
  • airway irritability
32
Q

Common triggers for attack

A

URI, allergens, meds, food, exercise, irritants, weather, stress, GERD

33
Q

Asthma PE findings

A

w attack: increased resp rate/HR, diaphoresis, use of accessory muscles, can’t.speak.in.full.sentences.
chest hyperinflation, expiratory wheezing/polyphonic
erythamatous/boggy turbinates/polyps, allergic rhinitis
skin—atopic derm, eczema, etc

34
Q

Pulsus paradoxus

A

slowing of pulse during inspiration. could be pe finding of asthmatic

35
Q

Stratus Asthmaticus

A

red flag in asthma attack

unresponsive to bronchodilation. may be fatal

36
Q

Tests for asthma

A

labs not routine.
chest radiography, sinus CT.
allergy skin testing; 24 hour gastric pH (if sxs of GERD), spirometry

37
Q

Bronchiectasis

A

ifnxs–>mucus accumulates in airways–>inflammation–>weak/dilated airway wall muscles
thickening, herniation, dilation

38
Q

Bronchiectasis etiology

A

bronchial cyst, bronchomalacia, immunodef, CF, infections (H flu, staph, klebsiella, TB), virus, fungal (pseudomonas, aspergillus)

39
Q

Bronchiectasis SSxs

A

chronic daily (productive) cough, mucipurulent/tenacious sputum

40
Q

Bronchiectasis PE

A

nonspecific. fever w acute exacerbations, wt loss, crackles, wheezes/rhonchi, cyanosis, plethora, nasal polyps,
* if advanced–cor pulmonale, peripheral edema, hepatomegaly, hypoxia

41
Q

Cystic Fibrosis

A

defect in CFTR–> deranged transport of chloride, sodium, bicarb and thick secretions in lungs.

42
Q

CF SSxs

A

lungs: persistent, productive cough; barrel chest, obstructive findings on PFTs. chronic bronchitis develops
sinuses: panopacification of paranasal sinuses, nasal polyposis, chronic rhinosinusitis
pancreas: insufficient production of digestive enzymes
distal intestinal obstructive syndrome
infertility
Musc-Skel: reduced bone density, clubbing of fingers and toes
kidney stones
salty taste on skin often first sign

43
Q

CF PE findings

A

rhinitis
pulmonary: tachypnea, wheeze/crackles, cough (usu productive), increased AP diameter, hyperresonant, respiratory distress with retractions, cyanosis
GI: abdominal distension, hepatosplenomegaly, rectal prolapse
dry skin, scoliosis, swelling of salivary ducts, cheilosis, kyphosis

44
Q

CF dx test

A

Sweat chloride test. Results confirmed with DNA genetic screen.

45
Q

CF prognosis and treatment

A

survival~37.4 years
chest percussion and postural drainage.
high cal, high protein diet, fat soluble vitamins, pancreativ enzymes, NAC, mucolytics, anti-inflammatories

46
Q

Dyspnea not of cardiac origin DDX

A

Physiologic (broken ribs, obesity, chest deformities, high altitude), restrictive lung disease, obstructive lung disease (asthma, CF, COPD, upper airway edema), pneumonia, SARS, lung ca, sarcoidosis, atelectasis
Chemical, neuromuscular (MS, ALS, myasthenia gravis), anxiety/panic attack

47
Q

Asthma ddx

A

Vocal cord paralysis, angioedema,aspiration, COPD, bronchiectasis, eosinophilic pneumonia, CHF, bronchopulmonary aspergillosis

48
Q

Wheezing DDX

A

Asthma, bronchitis, pulmonary edema, foreign object/tumor, infection (eg croup), COPD

49
Q

Classifications of asthma

A

Extrinsic: allergies
Intrinsic: infxn, irritants, emotions, cold weather

50
Q

Chest pain DDX

A

Cardiac: Angina, MI
Pulmonary pain: pleurisy, TB, cancer, atelectasis, thromboembolism, pleural effusion, pneumothorax
GI: swallowing, large meals, foods, body position, GERD
MuscSkel: fractured rib, herpes zoster
CNS: anxiety/panic attack

51
Q

Flexible bronchoscopy

A

Special test to examine airways

CPD Vocab (9 decks)

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