Hands

Question 1

what to inspect in the hands

Answer 1

tar staining, clubbing, peripheral cyanosis, rheumatological disease features, skin changes

Question 2

what lung pathology does clubbing indicate

Answer 2

lung cancer, interstitial lung disease and bronchiecstasis

Question 3

what does peripheral cyanosis indicate

Answer 3

O2 saturation is <85%

Question 4

why are rheumatological disease features relevant to resp exam

Answer 4

rheumatological diseases (rheumatoid arthritis) can be associated w pleural effusions and pulmonary fibrosis

Question 5

what skin changes are relecant to resp exam

Answer 5

bruising and thinning of skin are associated w long term steroid use (ILD/asthma/COPD)

Question 6

what else do you assess in the hands/wrist

Answer 6

temperature, palpate pulse, resp rate, pulsus paradoxus, fine tremor and flapping tremor

Question 7

what is pulsus paradoxus

Answer 7

pulse wave volume decreases with inspiration - asthma/copd

Question 8

fine tremor

Answer 8

side effect of beta 2 agonist use - salbutamol

Question 9

flapping tremor

Answer 9

co2 retention - type 2 resp failure (COPD)