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Respiratory > Clinical signs in respiratory > Flashcards

Clinical signs in respiratory Flashcards

1
Q

What are the causes of finger clubbing?

A
  • Bronchial carcinoma
  • Fibrosing alveolitis
  • Lung suppuration (e.g. (bronchiectasis, lung abscess, empyema)
  • Cyanotic congenital heart disease
  • Infective endocarditis
  • Malabsorption states
  • Congenital, idiopathic
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2
Q

What are the symptoms of Horner’s syndrome?

A

Small pupil
Ptosis (dropping of upper eyelid)
Enophthalmos
Unilateral loss of sweating

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3
Q

What is uveitis and it what is it a sign of?

A

Inflammation of the uvea (pigmented layer of the eye)

Sign of TB and sarcoidosis

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4
Q

What are dilated retinal veins a sign of?

A

Chronically raised pCO2

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5
Q

Name the lymph nodes around the neck

A 
– supra-clavicular
– cervical chain
– sub-mental, submandibular
– parotid
– post-auricular, pre-auricular 
– occipital
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6
Q

What are the symptoms of cor pulmonale?

A
  • Cyanosis
  • Raised JVP (jugular venous pressure)
  • Pitting oedema
  • Parasternal heave
  • Loud P2
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7
Q

What are the 4 stages in chest examinations?

A

Inspect
Palpate
Percuss
Auscultate

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8
Q

What do you look for on inspection?

A

Chest wall deformities
Operation scars
Expansion
Abnormal respiratory movement

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9
Q

Give 4 examples of chest wall deformities

A 
– Kyphoscoliosis
– Pectus excavatum
– Hyperinflation
(emphysema)
– Thoracoplasty
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10
Q

What do you feel for on palpation

A

Trachea deviation
Crepitation (crackling sensation)
Chest expansion

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11
Q

What are the three different sounds to listen for during percussion and what does each demonstrate?

A
  1. hyper-resonance - emphysema, pnuemothorax
  2. Impaired resonance - consolidation, pleural thickening, raised hemi-diaphragm
  3. Stony dull percussion - pleural effusion
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12
Q

What side of the stethoscope do you use for high-pitched sounds?

A

The diaphragm of the stethoscope (bell for low-pitched sounds)

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13
Q

What 3 categories of sounds do you listen for on auscultation?

A
  1. Breath sounds
  2. Added sounds
  3. Voice sounds
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14
Q

List 5 added sounds that may be heard on auscultation

A 
Wheeze
Squeaks
Crackle 
Pleural rub
Pleural click
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15
Q

If the PEFR is decreased does it indicate an obstructive or a restrictive condition?

A

Obstructive

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16
Q

What would the FEV1/FVC ratio be in a patient with a restrictive condition?

A

> 75%

17
Q

What would be the FEV1 response to a B2-agonist in an asthma and a COPD patient?

A

> 15% asthma

<15% COPD

18
Q

What affect would a restrictive condition have on a patients FVC?

A

Decreased FVC

19
Q

What is the normal vause for FEV1/FVC ratio?

A

Approx. 80%

20
Q

What is diffusing capacity?

A

It is a measurement of how well oxygen and carbon dioxide are diffused between the lungs and the blood

21
Q

What is exhaled breath nitric oxide used for?

A

It is a non-invasive marker of eosinophilic airway inflammation in asthma

22
Q

What are the actions of a spacer device?

A

Avoid coordination problems with pMDI
Reduces oropharyngeal and laryngeal side effects
Reduces systemic absorption from swallowed fraction
Acts as a holding chamber
Reduces the particle size and velocity
Improves lung deposition

23
Q

Name the oral steroid is given for acute exacerbations

A

Prednisolone

low therapeutic ratio

24
Q

Name the inhaled steriod used in maintenance therapy

A

Beclomethasone

25
Q

Name a leukotriene antagonist used only in asthma

A

Montelukast

oral route, OD, high therapeutic ratio

26
Q

Name an anti-IgE monoclonal antibody drug given to patients with severe persistent allergic asthma despite maximum therpay (step 5)

A

Omalizumab (Xolair)

injected

27
Q

Name a short acting muscarinic antagonist

A

Ipratripium

inhaled, od, high therapeutuc ratio

28
Q

Name a long acting muscarinic antagonist

A

Tiotropium

inhaled, od, high therapeutic ratio

29
Q

Name a methylxanthine drug given for maintenance therapy

A

Theophylline

oral

30
Q

Name a methylxanthine given for acute attacks

A

Aminophylline

IV

31
Q

Name a PDE4 inhibitor used in COPD

A

Roflumilast

oral, od

Respiratory (12 decks)

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