Arfoosh: Approach to the Patient with Respiratory Disease Flashcards
What are some unexpected locations of cough receptors that will trigger a cough reflex?
Stomach, ears (tympanic membrane, external auditory meatus), diaphragm, pericardium
Describe the cough reflex.
Receptors are stimulated –> Vagal afferents send info to Medullary Cough Center –> Activate Systemic Efferent Vagal Fibers, Phrenic, and Spinal motor nerve –> High intrathoracic pressure is generated (up to 300mmHg) against a closed glottis –> Forceful expulsion of air and secretions upon glottic opening (speed up to 500mph)
What are the differences in acute, subacute and chronic cough?
acute: 8w
What are some main causes of Chronic Cough?
- **aCe inhibitors (C for CHRONIC), i.e. lisinopril
- smoking
- Upper airway cough syndrome (rhinitis, post-infectious UACS, sinisitis, nasal sprays, pregnancy-induced rhinitis)
- Asthma
- COPD
- GERD
What is the most common reason for hemoptysis?
- **infections
What is an often underestimated cause of dyspnea?
Obesity and deconditioning
Do lungs have nerves and therefore feel pain?
Nope. If pain -> pleural or neuromuscular or cardiac
Define orthopnea, trepopnea, and platypnea.
Orthopnea: SOB when lying down
Trepopnea: SOB when lying on one side but not the other
Platypnea: (platypus feet -> your on your feet): opposite of orthopnea -seen in shunts.
What physical exam clue will you expect to see if your patient’s capillary content of reduced Hgb is >5gm/DL?
Cyanosis
In shock patients, will you expect to see central or peripheral cyanosis?
Peripheral
**Clubbing causes?
C: Cyanotic heart disease, CF
L: lung cancer, lung abscess
U: ulcerative colitis
B: bronchiectesis
I: Infective endocarditis, Idiopathic Pulmonary Fibrosis
N: Neurogenic Tumor
G: Gastrointestinal Diseases (Liver Cirrhosis, IBD)
What is the significance of increased tactile fremitus?
Increased consolidation or pneumonia
What is the significance of a finding in percussion?
If unequal sounds –> pneumothorax
