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3- Respiratory Medicine > Examination > Flashcards

Examination Flashcards

1
Q

General examination at foot of bed

A

Gait
Physique
Acute illness ? Chronic illness ?
Nutritional status ? Cachexia ?
Fever ? Sweating ? Chills ?
Breathless ?
Audible wheeze ? Stridor ?
Hoarse voice ?
Cyanosis ?
Pallor ?
Intercostal recession
Visible pulses ?
Bedside table (inhalers , peak flow meter, tissues, sputum pot , oxygen mask )

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2
Q

Signs of breathlessness on patients

A

Use of accessory muscles (sternocleidomastoid )

Pursed lips

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3
Q

Angle of bed in respiratory exam

A

45 degrees

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4
Q

Hand examination in respiratory exam

A

Clubbing
Pallor
Cyanosis
Flapping of the hands
Fine tremor
Respiratory rate

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5
Q

Respiratory causes of clubbing

A

Carcinoma of bronchus
Pulmonary fibrosis
Bronchiectasis
Lung abscess
Pleural empyema

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6
Q

When do you see fine tremor in respiratory disease

A

Inhaled beta agonists (salbutamol)

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7
Q

Normal respiratory rate

A

14-16 breaths / min

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8
Q

Tachypnoea DEFINTION

A

Increased RR

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9
Q

Dyspnoea

A

Symptom of breathlessness experienced by patient

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10
Q

Apnoea

A

Cessation of respiration

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11
Q

Cheyenne stokes breathing

A

Cyclical deepening and quickening of respiration followed by diminished respiratory rate and effort which can be associated with short apnea period
Cycle then repeats

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12
Q

When do you see Cheyne stoke breathing

A

Severely ill patients
Severe cardiac failure
Narcotic drug poisoning
Neurological disorders
Elderly sleeping with no signs of dx

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13
Q

Obstructive sleep apnea
What is it and when do you see it

A

Apnea despite continuation of respiratory efforts

Seen in obese patients dye to obstruction of upper airways by soft tissues

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14
Q

Face exam

A

Eyes for anemia
Eyes for Horner’s syndrome (miosis, ptôsis, anhidrosis )
Lips and tongue for central cyanosis
Oral candida

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15
Q

Dx of the lungs with horners syndrome possible

A

Pancoast tumor of the lung apex invading cervical sympathetic chain

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16
Q

What can cause oral candida

A

Inhaled steroids
Debilitation
Underlying immune suppression of patient

17
Q

Chest inspection

A

Rate of respiration
Rythm of respiration

Chest expansion

Symmetry (bilaterally symmetrical and elliptical in cross section, kyphosis, scoliosis )

Barrel shaped

Obvious scars (thoracotomy running from below scapula posteriorly to anterior chest wall , intercostal draining with small scars in axilla or posteriorly)

Lumps

Symmetrical movement

Intercostal recession on inspiration

Paradoxical Inwards movement of lower ribs in inspiration in COPD

18
Q

Anatomical landmark bifurcation of trachea

A

Sternal angle

19
Q

Disease with barrel shaped chest due to lungs overinflation

A

Long term COPD

20
Q

Causes of severe intercostal recession on inspiration

A

Severe upper airways obstruction in laryngeal dx, tumors of trachea

21
Q

Palpation of chest

A

Lymph nodes in neck
Swellings
Trachea position
Cardiac apex
Chest expansion
Tactile vocal fremitus

22
Q

Sounds possibly heard on Percussion of the chest

A

Resonance
Dullness
Hyper-resonance

23
Q

Most and least resonant part of the lungs

A

Most resonsnat below clavicles and scapula posterior
Least resonant over scapulae

24
Q

When do you have dull percussion of the chest

A

Fluid like in Pleural effusion
Consolidation or collapse

25
Q

type of dullness in pleural effusion

A

Stony dullness

26
Q

Causes of hyper resonance

A

Pneumothorax

27
Q

Side of stethoscope used in chest auscultation

A

Diaphragm

28
Q

Normal breath sound quality

A

Vesicular

29
Q

When do you hear bronchial breathing

A

Consolidation

30
Q

Added breath sounds

A

Wheezes
Crackles
Pleural rub

31
Q

When do you hear wheezes

A

Asthma
COPD

32
Q

Crackles

A

Short explosive sounds ,bubbling or clicking

33
Q

Crackles at beginning of inspiration heard in

A

COPD

34
Q

Localized pound and coarse crackles heard in

A

Bronchiectasis

35
Q

Fine character crackles in late inspiration heard in

A

Diffuse interstitial fibrosis

36
Q

Pleural rub associated with what dx

A

Pleural inflammation

3- Respiratory Medicine (12 decks)

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