General Flashcards
A tension pneumothorax results in which sign on a CXR?
Tracheal deviation away from affected side
What are the causes of pleural effusion?
Heart failure,
infection, malignancy, PE
What are signs can be seen on CXR indicative of COPD?
hyperinflation, flat hemi-diaphragms, decreased lung markings, bulla- more gas, prominent hila
Which seminal sign is seen in consolidation on CXR?
air bronchogram
A patient requires a chest drain. Name two indications for this?
Pleural effusion and pneumothorax
A chest drain has failed to resolved accumulation of fluid in response to pleural effusion. Which other procedure could be conducted to address this issue?
pleurodesis- chemical is inserted in pleural space to adhere lung tissue to chest wall, thus forming a seal that will prevent fluid accumulation. Talc powder is commonly used.
Name three causes of pulmonary hypertension?
- Pulmonary fibrosis
- Connective tissue disorder e.g. lupus
- Left heart failure
- Pulmonary artery obstruction e.g thromboembolic
What would be indicative of unilateral basal crackles versus bilateral basal crackles?
Unilateral- pneumonia, bilateral- pulmonary oedema or bronchitis
What are the causes of a compromised airway?
- secretions/blood vomit
- Swelling- anaphylaxis
- Mass- tumour
- Foreign object
What are the three pressures referred to in resp physiology?
intrapulmonary pressure, intrapleural pressure, atmospheric pressure
Is the intrapleural pressure negative or positive? How does intrapulmonary pressure compare to atmospheric pressure?
Intrapleural pressure is negative relative to atmospheric pressure (-4 mmHg). Atmospheric and intrapulmonary is equal= 0 mmHG
How does an increase in pressure of gas affect the volume?
decrease in volume (according to boyle’s law)
What is the intrapleural pressure?
756 mmHg
Which autoimmune disease is associated with pleural effusions?
rheumatoid arthritis
When are coarse crackles heard? Where are they heard best?
chronic bronchitis, bronchiectasis, pneumonia, pulmonary oedema. Anywhere in the lung fields
When are fine crackles heard? where are they heard best?
chronic bronchitis, pneumonia, congestive heart failure, atelectasis.
lung bases
What is atelectasis?
=collapsed lung
What causes the pleural rub sounds?
movement of inflamed pleural surfaces against one another, creaking/harsh grating sound
What causes pleural rub?
TB and pneumonia
List two parameters that predict lung function in a normal, non-smoking patient?
height and age
What are the features of an obstructive pattern on spirometry?
FEV1< 80% predicted + FEV1:FVC ratio <0.7
Aside from FEV1 and FVC, what other info can be derived from spirometry?
reversibility testing -/+
DLCO- if decreased then alveolar surface area has been reduced e.g. emphysema
TLC- if increased then lung hyperinflation
Why might patient with obstructive pattern on spirometry have raised Hb?
secondary polycythaemia
patient is hypoxic- juxtaglomerular apparatus senses hypoxia, increased EPO production which leads to incr RCC production
List three methods for smoking cessation
- Community smoking cessation group
- Nicotine replacement therapy (patches, gum)
- Champix
- Pyscho-social- counselling, monetary benefits
Two features of finger clubbing?
- Soft tissue of distal phalynx expansion
- Softening of nail bed- floating appearance
- Schamroth window is lost
- Curvature- upside down spoon= concave appearance rather than convex
Three conditions that cause finger clubbing?
Respiratory:
- Carcinoma
- CF
- Bronchiectasis
- Empyema, abscess
- TB
- Idiopathic pulmonary fibrosis
Cardiac
- Infective endocarditis
- Congenital cyanotic heart disease
GIT (4 C’s)
- Cirrhosis
- Crohn’s, uC
- Coeliac
- Cancer
Three causes of cyanosis?
Respiratory
Hypoventilation: COPD, MSK
↓ diffusion: pulm oedema, fibrosing alveolitis
V/Q mismatch: PE, AVM (e.g. HHT)
Cardiac:
Congenital: Fallot’s, TGA
↓ CO: MS, systolic LVF
Vascular: Raynaud’s, DVT
RBCs
Low affinity Hb, may be hereditary or acquired
Most common lung cancer in people who have never smoked?
adenocarcinoma
