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Part 2/3 boards > General Diagnosis 3 > Flashcards

General Diagnosis 3 Flashcards

1
Q

deformities of thorax

A 
barrel chest- COPD, cystic fibrosis
pectus excavatum (funnel chest)
pectus carinatum (pigeon chest)
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2
Q

tachypnea

A

rapid, shallow breathing

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3
Q

bradypnea

A

slow breathing

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4
Q

biot’s breathing

A

characterized by groups of quick, shallow inspriations followed by irregular periods of apnea

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5
Q

cheyne stokes respiration

A

breathing pattern characterized by alternating periods of apnea and hyperpnea
respiratory acidosis

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6
Q

kussmauls’s

A

breathing is first rapid and shallow but as metabolic acidosis worsens
breathing gradually becomes deep, slow, labored and gasping

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7
Q

pitted nails

A

unguinal indentations (psoriasis)

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8
Q

spinter hemorrhage

A

subacute bacterial endocarditis

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9
Q

beau’s lines

A

transverse ridging associated with acute severe disease

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10
Q

paronychia

A

inflammation of mail fold near cuticle

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11
Q

clubbing

A

nail base has an angle >180

hypoxia(early), COPD (late)

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12
Q

koionychia

A

spoon nail

iron deficiency anemia

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13
Q

respiratory exursion

A

place hands over posteiror ribs and ahve patient stake keep greaths

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14
Q

tactile fremitus

A

palpable vibration, say 99
increase with fluid (pneumonia)
decreased with air ( emphysema, penumothorax)
decreased with atelectasis and pleuisy because sound barrier is created

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15
Q

resonant

A

normal over lungs

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16
Q

hyperresonant

A

increased air in chest (emphysema, pneumothorax)

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17
Q

dull

A

increased density (pneumonia, atelectasis)

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18
Q

diaphragmatic excursion

A

go from resonant to dull
have patient breathe in and hold
measure distance between bottom lung fields

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19
Q

breath sounds

A

tracheal- inspiration=expiration, over trachea
bronchial- expiration longer than inspiration, over manubrium
bronchovesicular- inspiration =expiration, between 1st and 2nd ribs anteriorly, between scapulae posteriorly
vesicular- inspiration longer than expiration, remaining lung field

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20
Q

rales

A

small clicking, bubbling, or rattling sounds in lung

moist, dry, fine, coarse (bronchitis)

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21
Q

rhonchi

A

resembles snoring

when air is blocked or becomes rough through large ariways (bronchiectasis)

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22
Q

wheezes

A

high pitched sounds
asthma in young people
emphysema in old people

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23
Q

stridor

A

wheeze like sound heard upon inspiration
usually blockage of airflow
croup

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24
Q

bronchophony

A

if clear, distinct sounds are heard as the patietns says 99, consolidation is present

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25
Q

egophony

A

if you hear aaa as patient says eee, consolidation is present

26
Q

whispered pectoriloquy

A

if words 1,2,3 are heard clearly and distinctly, consolidation is present

27
Q

conditions that have resonant sounds

A

asthma
bronchiectasis
bronchitis

28
Q

conditions that have dull sounds

A

atelectasis
pleurisy
pneumonia

29
Q

conditions that have hyperresonant sounds

A

emphysema

pneumothorax

30
Q

fremitus decreased in what conditions?

A 
asthma
atelectasis
emphysema
pleurisy
pneumothorax
31
Q

fremitus normal in what conditions?

A

bronchiectasis

bronchitis

32
Q

fremitus increase in what condition?

A

pneumonia

33
Q

breath sound is wheezing in what conditions

A

asthma

emphysema

34
Q

breath sound is absent/decreased in what conditions?

A

atelectasis

decrased

35
Q

lobar pneumonia

A

consolidation of lung
rusty brown sputum for around 10 days and a fever
percussion is dull, rales, increased tactile fremitius
silhouette sign, air bronchogram

36
Q

friedlander’s pneumonia

A

currant red jeely sputum and caused by klebsiella pneumonia

seen with old age of immune compromised hosts, alcoholics

37
Q

pneumocystic carinii

A

caused by yeast/fungus

MC seen in AIDS, pregnancy

38
Q

cytomegalovirus

A

caused by CMV, MC AIDS

39
Q

tuberculossi

A

mycobacterium tuberculosis
presents with low-grade fever, night sweats, productive cough (yellow/green sputum)
small white lesions (ghon lesions)
positive tine test/mantoux test, purified protein derivative
most definitive test for diagnosis is a sputum culture

40
Q

pleurisy

A 
inflammation of pleura, producing exudative pleural effusion
stabbing chest pain worse with breathing
dry, non productive cough
decreased respiratory excursion
decreased tactile fremitus
dull percussion
friction rub is present
positive shepelmann's test
41
Q

pneumothorax

A

ruptured lung cauing air to become trapped in a pleural space
decreased chest expansion
decreased tactile fremitus
hyperresonant on percussion
decreased breath sounds
tracheal deviation away from bad lung
can occur in young, preiously healthy individuals

42
Q

atelectasis

A 
collapse of lung that is usually result of bronchial bostruction due to a mucous plug
presents ith decreased tactile fremitus
dull on percussion
decreased chest expansion
decreased/absent breath sounds
43
Q

bronchiectasis

A

irreversible focal bronchial dilation that presents with a chronic, productive cough

44
Q

COPD

A

long term cough with mucus
SOB, wheezing
cigarrette smoking main cause

45
Q

asthma

A

bronchospasm
Type I hypersensitivity reaction triggered by airborned allergens
tachycardia, tachypnea, decreased tactile fremitus, wheezing
eosinophils and IgE rise
labs: curshmann’s spirals, charcot laden cyrstals (in sputum

46
Q

emphysema

A 
destruction of elastic pulmonary CT results in permanent dilation of alveoli air sacs
deficiency of alpha I antitrypsin
decreased tactile fremitus
hyperresonant on percussion
decreased breath sounds
wheezing
47
Q

bronchogenic carcinoma

A

primary malignant lung tumor that starts in area of bronchus
long term history of smoking
patient presents with non productive cough, more than 30 days, afebrile, dyspnea, weight loss

48
Q

costochondritis

A

inflammation of cartilage connection between ribs and sternum
physical activity causes it, worse with eercise
pain increased wile taking deep breath
palpable tenderness at 3rd, 4th, 5th costosternal articulation
can be chronic

49
Q

herpes zoster

A

shingles
painful rash along a dermatome
involves DRG, can involved CN (V MC)

50
Q

sarcoidosis

A

disease inwhich abnormal collections fo inflamatory cells (granulomas) form as nodules
most often appear in the lungs or lymph nodes
MC seen in african descent in US

51
Q

hodgkin’s

A

pain after alcohol
cancer of lymphatic system, can spread to spleen
caucasian males
fever, night sweats, weight loss, intense puritis, enlarged spleen
biopsy

52
Q

cystic fibrosis

A 
COPD
chronic, progressive, frequently fatal genetic disease of body's mucus glands
produce/secrete sweat, mucus
lots of salt in sweat
pancreatic insufficiency
meconium ileus
53
Q

jugular venous pulsations

A

measures pressure of right side of heart

can be made more proncounced when CHF is present by applying pressure to liver (hepatojugular reflex

54
Q

pulsus magnus

A

bounding
increased CO
exercise, anxiety, fever, hyperthyroidism

55
Q

pulsus parvus

A

weak/thready, decreased stroke volume, hypovolemia, aortic stenosis CHF

56
Q

pulsus alternans

A

alternates in amplitude, left ventricular filure

57
Q

pulsus bisferiens

A

2 strong systolic peaks separated by mid systolic dip (best felt at carotid artery)
aortic regurgitation, aortic stenosis

58
Q

pulsus paradoxus

A 
decreased amplitude on inspiration, increased with expiration
COPD
bronchial asthma
emphysema
pericardial effusion
59
Q

water hammer pulse

A

jerky pulse that is rrapidly increasing and then collapsing because of aortic insufficiency

60
Q

thrills

A

vibration produced by turbulent blood flow within the heart (murmurs)

Part 2/3 boards (16 decks)

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