Lower Respiratory CIS

Question 1

What can cause cyanosis?

Answer 1

chronic hypoxia

Question 2

Pectus carinatum

Answer 2

pigeon chest

comes out

Question 3

Barrel chest

Answer 3

increase in AP diameter

common w/ COPD

Question 4

Pectus excavatum

Answer 4

funnel chest

Question 5

Hemoptysis

Answer 5

coughing up blood

Question 6

What is important about chief complaint?

Answer 6

should be in pt’s words

Question 7

conversational dyspnea

Answer 7

how many words can get in for each breath

Question 8

Epistaxis

Answer 8

bloody nose

Question 9

Otalgia

Answer 9

ear pain

Question 10

What is considered a palpation technique when examining a respiratory pt?

Answer 10

thoracic expansion

put hands on thoracic spine around ribs & feel for expansion/contraction w/ breaths

Question 11

Order of respiratory exam

Answer 11

Inspection
Palpation
Percussion
Auscultation

Question 12

Egophony

Answer 12

auscultation technique

as listen w/ stethoscope, ask them to say “E” and sounds more like an “A”

transmit of sound is being altered

Question 13

Diaphragmatic excursion

Answer 13

percussion technique

how far diaphragm has moved during inspiration & expiration

Question 14

Whispered pectoriloquy

Answer 14

auscultation technique

whisper & you are able to hear it really well is not normal (consolidation that is transmitting the sound better)

Question 15

A 75 yr old male presents w/ shortness of breath & cough, what should be first obtained @ beginning of encounter?

Answer 15

pulse oximetry

measure oxygenation & pulse rate (esp for respiratory concern)

Question 16

Arterial blood gas

Answer 16

invasive procedure done in radial artery

looks @ pH, oxygenation, CO2 of blood

Question 17

PFT (pulmonary function test)

Answer 17

sitting in chamber & getting all information about lung function

can diagnose obstructive v restrictive lung disorders

Question 18

A 32 yr old female admitted & has decreased breath sounds over lower lobes. Chest X ray shows atelectasis. What is best treatment for diagnosis?

Answer 18

Atelectasis leads to shallow breaths & may cause pneumonia (can occur post-surgery)

spirometry (so inhale & exhale fully)

Question 19

What does atelectasis mean?

Answer 19

collapse of alveolar lung tissue affecting O2 absorption

Question 20

What is absence of breathing?

Answer 20

apnea

Question 21

If experiencing shortness of breath & decreased breath sounds in RLL. What PE finding would most likely be found with underlying diagnosis?

Answer 21

most likely underlying diagnosis will be atelectasis

diaphragmatic excursion is elevated on R (uneven diaphragm)

Question 22

An 18yo presents w/ shortness of breath & pleuritic chest pain (inflammation of pleura). What would be found on exam?

Answer 22

chest pain should be worse w/ inhalation & exhalation

tension pneumothorax causing mediastinal shift to the R

hyper-resonance on percussion on L

Question 23

Vesicular breath sounds

Answer 23

normal breath sounds of most of lung (auscultation technique)