Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM2 > Exam 6 > Flashcards

Exam 6 Flashcards

1
Q

What are the aspects of the lung exam?

A
  1. Percussion
  2. Vibration transmission (auscultation, whispered pectoriloquy), fremitus
  3. Extra sounds (wheezing, crackles, rhonci, stridor)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two steps of auscultation?

A
  1. Breath sound intensity (normal, increase, decrease)

2. Extra sounds (crackles, wheezing, stridor, rhonci)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are classic radiographic findings of acute lobar pneumonia?

A
  1. Consolidation
  2. Air bronchograms
  3. Silhouette sign (don’t see left heart border because alveoli and heart are both fluid filled)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is seen on histology in acute lobar pneumonia?

A

Consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What sound would you hear in acute lobar pneumonia and why?

A

Increased bronchial breath sounds

Alveoli are full of puss, there is less muffling, breath sounds are louder than typically heard over the chest wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Breath sounds originate in the ___ where turbulence induces vibrations.

A

Large airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are bronchial breath sounds?

A

Normal sounds heard over the tracheobronchial tree; louder, harsher, higher pitch, short silence between inspiration and expiration, expiration lasts longer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are vesicular breath sounds?

A

Normal sounds heard over the lung tissue; soft and low pitched, heard through inspiration, continue without pause through expiration, fade away 1/3 of the way through expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What other sounds might be heard in acute lobar pneumonia?

A

Crackles, egophany

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the general examination of the patient with lobar pneumonia.

A

Acutely ill, toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the resonance to percussion of the patient with lobar pneumonia?

A

+/- dullness over consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the breath sounds in the patient with lobar pneumonia.

A

Bronchial breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the adventitious sounds in the patient with lobar pneumonia.

A

Crackles, pleural rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the classic CXR for COPD.

A
  1. Hyperinflation
  2. Flat diaphragm
  3. Increased retrosternal airspace
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the classic PFT findings for COPD.

A
  1. Obstruction with minimal BDR
  2. Hyperinflation/gas trapping
  3. Low DLCO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What physical exam finding is most likely in the patient with COPD?

A

Prolonged expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the general examination of the patient with COPD.

A

Tachypneic, +/- hypoxemia, +/- exercise desaturation, pink puffer or blue bloater, NO clubbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe the resonance to percussion in the patient with COPD.

A

Hyperresonant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the breath sounds in the patient with COPD.

A

Decreased to absent/prolonged expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the adventitious sounds in the patient with COPD.

A

Wheezing, rhonci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the classic CXR findings in a patient with ILD?

A
  1. Small volume

2. Reticulonodular opacities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the general examination of the patient with ILD.

A

Use of accessory muscles of respiration, cyanosis, +/- clubbing, +/- hypoxemia, +/- exercise desaturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the resonance to percussion in the patient with ILD.

A

+/- decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the breath sounds in the patient with ILD.

A

Harsh, coarse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Describe the adventitious sounds in the patient with ILD.

A

Crackles (dry, cellophane, velcro)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Describe the general examination of the patient with PT.

A

Asymptomatic to dyspneic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe the resonance to percussion in the patient with PT.

A

Hyperresonant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Describe the breath sounds in the patient with PT.

A

Absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe the adventitious sounds in the patient with PT.

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is seen on CXR in PT?

A

Lack of lung markings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is seen on CXR in pleural effusion?

A
  1. Blutning of the angle
  2. Meniscus sign
  3. White out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe the general examination of the patient with pleural effusion.

A

Asymptomatic to dyspneic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Describe the resonance to percussion in the patient with pleural effusion.

A

Dull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describe the breath sounds in the patient with pleural effusion.

A

Absent or decreased

35
Q

Describe the adventitious sounds in the patient with pleural effusion.

A

Egophony

36
Q

Describe the general examination of the patient with asthma.

A

Dyspneic

37
Q

Describe the resonance to percussion in the patient with asthma.

A

Normal to hyperresonant

38
Q

Describe the breath sounds in the patient with asthma.

A

Prolonged expiration

39
Q

Describe the adventitious sounds in the patient with pleural asthma.

A

Wheezing

40
Q

What is the classic cause of wheezing?

A

Bronchospasm (asthma/COPD)

41
Q

Which lung diseases tend to have crackles?

A

ILD, pulmonary edema, also lobar pneumonia

42
Q

Which lung diseases tend to have egophony?

A

Lobar pneumonia

Pleural effusion

43
Q

Which lung diseases are hyperresonant to percussion?

A

Pneumothorax

COPD and asthma can be

44
Q

Which lung diseases are dull to percusion?

A

Lobar pneumonia, atelectasis, pleural effusion

45
Q

Which lung diseases tend to have decreased breath sounds and fremitus/pectoriloquy?

A

PT, atelectasis, pleural effusions

46
Q

What are causes of late inspiratory crackles?

A

ILD, early heart failure

47
Q

What are causes of early inspiratory crackles?

A

Chronic bronchitis, asthma

48
Q

What are causes of midinspiratory and expiratory crackles?

A

Bronchiectasis (not specific)

49
Q

What are causes of wheezes?

A

Asthma, chronic bronchitis, COPD, heart failure

50
Q

What is stridor?

A

A wheeze that is entirely/predominantly inspiratory

51
Q

What does stridor indicate?

A

Partial obstruction of larynx or trachea

52
Q

When will the trachea be shifted toward the involved side of a problem?

A

Maybe in atelectasis

53
Q

When will the trachea be shift opposite the involved side of a problem?

A

Pleural effusion, PT

54
Q

How do you differentiate normal bronchial and vesicular breath sounds?

A

Bronchial: hollow, clear in both phases
Vesicular: inspiration and early expiration only

55
Q

Key features of crackles (rales)

A

Sound like crackles

56
Q

Key features of rhonic

A

Sounds like snoring

57
Q

Key features of wheezing

A

Sounds like a dog whining/sighing

58
Q

Key features of stridor

A

Sounds whimpering, high pitched

59
Q

Key features of pleural rub

A

Sounds like rubbing, sitting on a leather car seat

60
Q

Key features of abnormal bronchial breathing

A

Both phases of respiratory cycle, sounds slower/more strained

61
Q

What are the parts of the eFAST exam?

A
  1. RUQ (Morison’s pouch)
  2. LUQ (splenorenal recess)
  3. Sub-xiphoid cardiac window
  4. Suprapubic window
  5. Thorax (R&L)
62
Q

What is the most sensitive view in eFAST?

A

RUQ

63
Q

What is seen in the sub-xihpoid cardiac window?

A

Liver at the top
4 chambers of the heart
Pericardium (can be fluid filled)

64
Q

What is seen in the RUQ view?

A 
Lung (L)
Liver (upper middle)
Diaphragm (bottom)
Right kidney (R)
Morison's pouch - between liver and kidney
65
Q

What is seen in the LUQ view?

A 
Lung (bottom left)
Diaphragm (bottom)
Spleen (upper left)
Left kidney (R)
Splenorenal recess (between spleen and kidney)
66
Q

What is seen in the suprapubic window?

A

Bladder/uterus (female)

Bladder/prostate (male)

67
Q

What is the potential space in females in the suprapubic window?

A

Pouch of douglas (posterior to uterus)

68
Q

What is the potential space in males in the suprapubic window?

A

Retrovesicular pouch (between bladder and rectum)

69
Q

What is seen in a normal thorax view?

A

Pleural line between 2 ribs with ants marching/shimmering appearance

70
Q

What is a negative eFAST in M mode?

A

Sea-shore line (difference between pleura and lung)

71
Q

What is a positive eFAST in the thorax?

A

Absence of lung slide (no ants marching) and barcode sign

72
Q

What bloodborne pathogens do we worry about in the hospital?

A

HIV, HepB, HepC

73
Q

Which factors increase risk after HIV exposure?

A
  1. More blood (visible contamination, direct into vein/artery, deep injury)
  2. Hollow bore needle
  3. Viral load of patient
74
Q

What are standard precautions for routine patient care?

A

Wear gloves to touch blood, body fluids except sweat, non-intact skin, mucus membranes

Wash hands before and after

75
Q

When should eye protection or a face shield be worn?

A

OR, ED, suctioning, etc.

76
Q

When do we use soap and water rather than alcohol gel?

A

C. diff.

77
Q

What is worn in airborne precautions?

A

Hand hygiene, N-95

78
Q

What is worn in contact precautions?

A

Hand hygiene, gloves, gown

79
Q

What is worn in droplet precautions?

A

Hand hygiene, mask, gloves, gown

80
Q

When the problem is coagulation factors, where is bleeding seen?

A

Joints

81
Q

When the problem is platelets, where is bleeding seen?

A

Mucosal tissue

82
Q

Spleen palpable to umbilicus is suggestive of ___ pathology.

A

Hematologic

83
Q

What are the nodes in the axilla/arm?

A

ALPCA:

Anterior pectoral
Lateral
Posterior
Central
Apical

Also epitrochlear

PCM2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions