H&P

Question 1

difficult labored uncomfortable breathing; unpleasant not painful

Answer 1

dyspnea

Question 2

dyspnea can be caused by ________dissociation of respiratory muscles

Answer 2

length-tension

Question 3

what is one of the most important questions to ask about dyspnea?

Answer 3

rapid vs gradual onset

Question 4

what is the most useful clinical indicator for dyspnea?

Answer 4

level of activity

Question 5

dyspnea over 1-2 hrs, often with wheeze

Answer 5

1. asthma

2. LV failure

Question 6

dyspnea over hours/days with fever + sputum

Answer 6

1. pneumonia

2. acute bronchitis

Question 7

dyspnea with hyperventilation

Answer 7

1. acidosis
2. poisoning
3. hyperventilation syndrome

Question 8

immediate dyspnea +/- pain

Answer 8

1. pulmonary embolism

2. foreign body aspiration

Question 9

high pitched continous sounds, inspiratory or expiratory

Answer 9

wheezing

Question 10

wheezing can be caused by airway obstruction due to _______ or _______

Answer 10

airway narrowing or secretions

Question 11

acute onset wheezing can be due to _______in addition to asthma

Answer 11

foreign body aspiration

Question 12

does severity of wheezing correlate with severity of airflow obstruction?

Answer 12

no

Question 13

pulmonry chest pain is due to inflammation of which pleura?

Answer 13

parietal

Question 14

how do we classify cough?

Answer 14

based on duration

Question 15

cough less than 3 weeks duration

Answer 15

acute

Question 16

cough 3-8 weeks duration

Answer 16

subacute

Question 17

cough >8 weeks duration

Answer 17

chronic

Question 18

what is the most common etiology for acute cough?

Answer 18

viral and bacterial infxns

Question 19

non productive chronic cough most likely due to (3)?

Answer 19

1. upper airway cough syndrome
2. asthma
3. GERD

Question 20

what position is used to stabilize should girdle to help accesory muscles?

Answer 20

tripod position

Question 21

obesity can be assc’d wtih?

Answer 21

obstructive sleep apnea or obesity hypoventilation syndrome

Question 22

barrel chest can be assc’d with?

Answer 22

COPD

Question 23

normal percussion is?

Answer 23

resonant

Question 24

hyper-resonance with percussion suggests?

Answer 24

incr air in thorax (ie from air trapping or pneumothorax)

Question 25

dullness with percussion indicates?

Answer 25

incr density with effusion, mass, consolidation

Question 26

lower pitched continuous sounds

Answer 26

rhonchi

Question 27

what are rhonchi due to?

Answer 27

thick secretions narrowing the airway lumen

Question 28

discontinuous sounds

Answer 28

crackles or rales

Question 29

what are crackles due to?

Answer 29

explosive opening of small airways as surface tension is overcome

Question 30

Inspiratory wheezing most likely due to?

Answer 30

upper airway obstrcution

Question 31

Expiratory wheezing most likely due to?

Answer 31

intrathoracic airway obstruction (decr airway lumen)