Clinical Signs

Question 1

What 4 things should always be looked out for in a general exam?

Answer 1

Stridor
Cyanosis
Resp distress
Nutrition

Question 2

Name 4 signs of respiratory distress.

Answer 2

At rest or with exercise
Wheeze
Stridor
Orthopnoea

Question 3

SOB means hypoxia?

Answer 3

FALSE

Question 4

Outline central cyanosis.

Answer 4

TONGUE
Peripheries are warm
Vasodilation

Question 5

Why does vasodilation occur in cyanosis?

Answer 5

There is low oxygen so the vessels dilate to try increased blood flow and increase oxygen delivery to tissues

Question 6

What is cyanosis?

Answer 6

A bluish discoloration of the skin due to poor circulation or inadequate oxygenation of the blood

Question 7

What may be found secondary to cyanosis?

Answer 7

Polycythermia

Question 8

What is polycythermia?

Answer 8

An abnormal increase in haemoglobin because of either increased RBC or decreased plasma volume

Question 9

Where is peripheral cyanosis seen?

Answer 9

Hands
Feet
Nose

Question 10

What occurs due to hypercapnia encephalopathy?

Answer 10

CO2 flap

Question 11

What is CO2 flap?

Answer 11

Irregular flapping of hand when wrist is hyperextended

Question 12

You get peripheral vasodilation with hypercapnia?

Answer 12

TRUE

Question 13

Why might fingernails be yellow?

Answer 13

Nicotine
Tar
Fungus

Question 14

Erythema nodosum….?

Answer 14

TB

Sarcoidosis

Question 15

Describe finger clubbing.

Answer 15

Increased curvature

Loss of nail bed

Question 16

List causes of clubbing.

Answer 16

Fibrosing alveolitis
Carcinoma
Abscess
Empyema
Bronchiectasis

Question 17

List the 4 main features of Horner’s.

Answer 17

Small pupil
Ptosis (drooping of upper lid)
Unilateral loss of sweating on face
Enophthalmos (eye goes posterior)

Question 18

What causes Horner’s?

Answer 18

Disruption of cervical chain

Question 19

What lung problems can disrupt the cervical chain?

Answer 19

Pancoast tumour

Cervical lymphadenopathy

Question 20

What does chronically raised CO2 do to the eyes?

Answer 20

Dilated retinal veins/ papilloedema

Question 21

Uveitis

Answer 21

TB

Sarcoidosis

Question 22

What is Cor Pulmonale?

Answer 22

Abnormally enlarged right side of the heart (right heart failure) due to respiratory disease or disease of pulmonary blood vessels

Question 23

Name 3 features of cor pulmonale?

Answer 23

Cyanosis
Raised JVP
Loud P2

Question 24

What kind of heave do you get with cor pulmonate?

Answer 24

Parasternal heave

Question 25

What condition causes hyperinflation of the chest?

Answer 25

Emphysema

Question 26

Trachea deviation AWAY?

Answer 26

Effusion

Question 27

Trachea deviation TOWARDS?

Answer 27

Consolidation

Question 28

Pneumothorax, effusion, blocked central bronchus and diaphragm palsy all cause?

Answer 28

Unilateral reduced chest expansion

Question 29

Restrictive lung disease and hyperinflation (emphysema) cause?

Answer 29

Bilateral reduced chest expansion

Question 30

Stony dull to percussion

Answer 30

Pleural effusion

Question 31

Hyper-resonant percussion

Answer 31

Emphysema

Pneumothorax

Question 32

Low pitched

Answer 32

Bell

Question 33

High pitched

Answer 33

Diaphragm

Question 34

Vesicular?

Answer 34

Normal breath sounds

Question 35

Wheeze

Answer 35

Air passing through narrow airway

Question 36

Localised wheeze?

Answer 36

Large airway tumour

Question 37

Generalised wheeze?

Answer 37

Small airway obstruction
Asthma
Bronchitis

Question 38

Squeaks

Answer 38

Bronchiolitis

Question 39

Crackled/crepitations

Answer 39

Explosive re-opening of small airways blocked by exudate, inflammation or fibrosis
On inspiration

Question 40

Fine (late) crackles

Answer 40

Pulmonary fibrosis

Question 41

Pleural click

Answer 41

Pneumothorax

Question 42

Pleural rub

Answer 42

Leathery, creaking sound made by inflamed pleural surfaces rubbing together

Question 43

Pneumonia, PE, viral/auto-immune pleurisy?

Answer 43

Pleural rub