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Pulmonology > Approach to Pulm > Flashcards

Approach to Pulm Flashcards

1
Q

The carina bifurcates at what spinous level?

A

T4-T5

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1
Q

Describe Cheyne-Stokes Respirations and what conditions you might see them in.

A

Crescendo/decrescendo respirations with pauses of apnea. Could be caused by a stroke/brain injury. Common condition

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1
Q

Describe Wheezes and what conditions you might hear them in?

A

Inspiratory and expiratory High pitched and musical in quality (narrowed airway) Might see in Asthma, brochospasm

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3
Q

What condition might cause rusty colored sputum?

A

Pneumococcal pneumonia

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4
Q

A line drawn between the inferior lungs crosses what spinous process?

A

T10

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4
Q

A flat/dull percussion sound generally indicates what pathology?

A

Pleural Effusion or Lobular Pneumonia

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4
Q

What are pulmonary angiograms useful in detecting in the lungs?

A

Definitive diagnosis for pulmonary embolism.

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5
Q

What constitutes a good sputum sample?

A

Contamination = 10-25 squamous epithelial cells (inadequate) Alveolar macrophages 1 dominant pathogen

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7
Q

Where is the sternal angle (angle of Louis) located?

A

Approx 5 cm inferior to jugular notch T4 Level Posteriorly Second costal cartilage/space anteriorly

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7
Q

What conditions might you hear fine crackles in?

A

Fine (rubbing of hair) - diffuse interstitial disease, fibrosis, atelectasis, pneumonia, CHF

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7
Q

What are ultrasounds useful in detecting in the lungs?

A

Small amounts of pleural fluid, walled off compartments (loculations) within pleural effusions, distinguishing between pleural thickening

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8
Q

A hyperresonant percussion sound generally indicates what lung conditions?

A

Emphysema or Pneumothorax

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9
Q

Describe Crackles in the lungs.

A

On inspiration. High pitch and discontinuous

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10
Q

What space do you put a chest tube in?

A

4th Intercostal

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10
Q

A sudden onset of hemoptysis can be indicative of what condition?

A

Pulmonary Embolus

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11
Q

What area of the back does the scapula span?

A

2-7th rib

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12
Q

What is a VQ scan?

A

A scan that evaluates both airflow and blood flow in the lungs. Done by breathing in radioactive xenon.

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13
Q

Which lung lobes are more prominent anteriorly?

A

The upper lobes

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14
Q

What intercostal space is the nipple located at in men?

A

4th

16
Q

What level is the xyphoid at?

A

T10

18
Q

What pathogens might cause foul smelling sputum?

A

anaerobes

19
Q

Describe Rhonchi and what conditions you might hear them in.

A

Snoring or gurgling quality. Pneumonia, Consolidation

20
Q

What landmark lies at T3?

A

Jugular notch

20
Q

What are CTs good for when viewing the lungs?

A

Viewing lung tumors, mediastinal masses, soft tissue disorders

21
Q

What condition might cause purulent pus (yellow, green) sputum?

A

Acute/Chronic bronchitis (yellow to brown associated with G- bacteria)

22
Q

A line drawn between the inferior angle of the scapula crosses what vertebral bodies?

A

T7-T8

24
Q

What is the Pulmonary Embolus triad?

A

hemoptysis, dyspnea, chest pain

25
Q

What condition might cause bloody sputum?

A

Tuberculosis

26
Q

Describe Kussmaul’s respirations and what condition you might see them in.

A

Fast breathing, full tidal volume, metabolic acidosis (DKA)

27
Q

Describe a mediastinal crunch and what conditions you might hear them in.

A

Precordial crackles synchronous with heart beat. Pneumomediastinum, called Hamman’s sign

29
Q

A slightly blood tinged sputum (hemoptysis) might be indicative of what conditions?

A

Sinusitis, bronchitis, pneumonia. non-emergent

30
Q

Describe Ataxic (Biot’s) Respirations and what conditions you might see them in.

A

Fast breathing, full tidal volume, with apnea between episodes. Could be caused by a medullary lesion.

31
Q

Persistent hemoptysis can be indicative of what conditions?

A

Tuberculosis Cancer

31
Q

What procedures can be done through a bronchoscope?

A

Direct visualization of airways Collection of various samples Brushings, transbronchial needle aspiration, endobronchial biopsy, transbronchial biopsy

32
Q

A healthy/resonant percussion sound generally indicates what lung conditions?

A

Normal lungs or Bronchitis

33
Q

What conditions might you hear course crackles in?

A

Course (blowing bubbles in water) - severe COPD Louder, lower in pitch, not quite as brief

34
Q

What might heavy hemoptysis be indicative of?

A

Vascular origin

35
Q

When is a VQ scan useful?

A

Decreased perfusion and normal ventilation = PE Blood clots is suspected in areas that have good airflow but poor blood flow.

37
Q

Describe Apneustic respirations and what conditions you might see them in.

A

steady respirations with normal inspirations, but shallow expirations. Could be caused by midbrain/pons lesions, CHF, renal failure, or sleeping (child/elder)

40
Q

Which lung lobes are more prominent posteriorly?

A

The lower lobes

41
Q

What sounds might be abnormal with consolidation?

A

Bronchophony - 99 Egophony - ee Whispered pectoriloquy - 99 whispered

42
Q

What is the x-ray pneumonic?

A

A - Airway, Adenopathy B - Bones, Breast C - Cardiac Shadow D - Diaphragm E - Everything else (soft tissue) F - Fields (lung, vascular)

43
Q

What condition might cause pink-tinged, foamy or frothy white sputum?

A

Pulmonary edema

44
Q

Describe Stridor and what conditions you might hear them in.

A

Inspiratory wheeze from upper airway obstruction (croup) Epiglotitis, extubation reaction. Might need to emergency crike them!

45
Q

Describe a pleural (friction) rub and what conditions you might hear them in.

A

Sound generated from inflammed pleural surfaces rubbing together. Pleuritic chest pain

Pulmonology (4 decks)

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