Diagnosis of Respiratory diseases

Question 1

Major categories of respiratory system diseases

Answer 1

1. Obstructive
2. Restrictive
3. Abnormalities of vasculature

Question 2

Obstructive lung diseases

Answer 2

1. Asthma
2. COPD
3. Bronchiectasis
4. Bronchiolitis

Question 3

Cardinal symptoms of respiratory disease

Answer 3

dyspnea and cough

Question 4

Chronic cough

Answer 4

> 8 weeks

Question 5

nonrespiratory causes of cough

Answer 5

1. Gerd

2. Postnasal dri

Question 6

kind of cough of Diffuse parenchymal lung disease

Answer 6

persistent and non productive

Question 7

Wheezing

Answer 7

asthma

Question 8

T or F, Lung parenchyma is innervated with pain fibers?

Answer 8

False

Question 9

Diseases associated with smoking

Answer 9

COPD, bronchogenic lung cancer, diffuse parenchymal lung diseases

Question 10

kyphoscoliosis

Answer 10

restrictive

Question 11

How to establish diagphragm excursion and lung size

Answer 11

percussion

Question 12

Role of palpation

Answer 12

subcutaneous air -> barotrauma

Question 13

Tactile frenitus finding for consolidation

Answer 13

INCREASED

Question 14

Tactile frenitus finding for pleural effusion

Answer 14

DECREASED

Question 15

Rhonchi

Answer 15

Obstruction of medium sized air ways, most often with secretions

viral or bacterial bronchitis

Question 16

Chronic rhonchi

Answer 16

suggests bronchiectasis or COPD

Question 17

high pitched, focal inspiratory wheeze, usually head over the neck

Answer 17

Stridor , manifestation of upper airway obstruction

Question 18

Crackles or rales

Answer 18

commonly sign of alveolar disease

Question 19

Kind of crackles for pneumonia

Answer 19

Focal

Question 20

pulmonary edema is prominent where?

Answer 20

bases

Question 21

Kind of crackles for IF

Answer 21

Like velcro being ripped apart

Question 22

How to Differentiate crackles of IF and alveolar diseases

Answer 22

Egophony - ausculation of “AH” instead of “EEE” when the pt phonates EEE

• pneumonia

Question 23

Quiet chest with diffusely decreased breath sounds

Answer 23

emphysema

Question 24

Area of absent breath sound

Answer 24

pneumothorax

Question 25

Kind of edema that suggests cor pulmonale

Answer 25

symmetric pedal edema

Question 26

Characteristic of pulse in patients with obstructive lung disease

Answer 26

Pulsus paradoxus

Question 27

Cyanosis is seen at what level of deoxygenated hemoglobin?

Answer 27

>5g/dL

Question 28

Initial pulmonary functional test

Answer 28

SPIROMETRY

Question 29

FEV1/FVC ratio of obstructive

Answer 29

<70% of expected

Question 30

What does plateau of inspiratory and expiratory curves suggests?

Answer 30

Large airway obstruction in extrathoracic and intrathoracic locations

Question 31

Total lung capacity for patients with restrictive lung disease

Answer 31

<80% of the predicted value for a patient's age, race, sex, and height

Question 32

Causes of restrictive lung disease

Answer 32

parenchymal, neuromuscular weakness, or chest wall or pleural disease

Question 33

Normal spirometry, normal lung volumes, and low DLCO

Answer 33

evaluate for pulmonary vascular disease

Question 34

Increased (A-a) DO2 at rest

Answer 34

V/Q mismatch or shunt physiology

Question 35

Function of Respiratory system

Answer 35

1. oxygenate blood | 2. eliminate carbon dioxide

Question 36

Blood flow through the lung

Answer 36

Unidirectional via continuous vascular path

Question 37

Alveolar surface area

Answer 37

70 sq.m

Question 38

Average volume of thoracic cavity

Answer 38

7L

Question 39

X ray position to detect free flowing fluid

Answer 39

lateral decubitus

Question 40

X ray position to visualize apices

Answer 40

apical lordotic view

Question 41

Limitations of poratable x ray

Answer 41

1. single AP view 2. Variability in over and underexposed film 3. shorter focal spot-film distance - lack of edge sharpness and loss of detail 4. magnification of cardiac silhouette

Question 42

Produces images using echoes or reflection of US beam from interfaces between tissues with differing acoustic properties

Answer 42

Ultrasound

Question 43

Modality used to identify sepatations within loculated collections and can facilitate placement of needle for sampling

Answer 43

Ultrasound

Question 44

US probe is passed through a broncoscope

Answer 44

Endobronchial US

Question 45

Modality that is valuable in assessing hilar and mediastinal disease and in identifying and characterizing disease adjacent to the chest wall or spine.

Answer 45

CT scan

Question 46

Distinguish vascular from non vascular structure (modality)

Answer 46

CT scan

Question 47

Thickness of cross sectional images in high resolution CT scan

Answer 47

1-2 mm

Question 48

Thickness of cross sectional images in conventional CT scan

Answer 48

7-10 mm

Question 49

Standard method for thoracic CT

Answer 49

Helical scanning

Question 50

Can obtain multiple slices in single rotaion that are thinner and can be acquired in a shorter period of time

Answer 50

multidetector CT scan

Question 51

commonly used to identify malignant lesions in the lung based on their increased uptake and metabolism of glucose

Answer 51

PET scanning

Question 52

Radiolabel in PET scan

Answer 52

FDG

Question 53

Modality useful in demonstrating pulmonary emboli, aortic lesions, or other vascular abnormalities

Answer 53

MRI

Question 54

sampling of pleural liquid

Answer 54

thoracentesis

Question 55

direct visualization of the tracheobronchial tree

Answer 55

Bronchoscopy

Question 56

Specimen of choice for recovery of pneumocystis jiroveci

Answer 56

bronchoalveolar lavage