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Differential Dx > Lung Screening > Flashcards

Lung Screening Flashcards

1
Q

Persistent dry cough might be indicative of ____

A

Tumor, congestion, or hypersensitive
airways

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2
Q

Productive cough with purulent
sputum (yellow or green) may indicate____

A

infection

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3
Q

a productive cough with non-
purulent sputum (thus it is clear or white) is best described as __

A

Nonspecific, indicates airway irritation

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4
Q

Rust-colored sputum is characteristic of

A

pneumonia

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5
Q

A pathologic condition—infection,
inflammation, abscess, tumor, or infarction might all present as this red flag (hint: IMMEDIATE REFERRAL)

A

Hemoptysis

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6
Q

___ is a specific type of dyspnea that occurs when a pt is lying down

A

orthopnea

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7
Q

cyanosis is a sign that indicates a problem with ____ can be observed in the skin, nails, and tongue.

A

Oxygen saturation and circulating Hgb

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8
Q

the thickening and widening of the terminal phalanges, also known as clubbing, is commonly caused by ____

A

Hypoxia

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9
Q

T/F: Referral pain is often unchanged with with respiratory movement

A

False. it increases

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10
Q

where does pulmonary pathology often refer?

A

neck and upper traps
chest, shoulder and medial arm
thoracic spine and ribs

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11
Q

T/F: While generally tracheobronchial pain is usually local, when observing finer bronchi and lung parenchyma, there is no pain innervation at all.

A

true

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12
Q

tracheobronchial pain is generally caused by ___

A

inflammation, foreign materials and tumors.

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13
Q

pleural pain is best described as

A

sharp and localized

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14
Q

diaphragmatic pain occurs with phrenic nerve damage and presents with _____ paresis. (contralateral or ipsilateral? )

A

ipsalateral

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15
Q

when considering diaphragmatic pleural pain , peripheral irritation refers to ___ while central irritation refers to ____

A

peripheral: costal margins
central : shoulder and upper trap

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16
Q

Any condition that decreases
pulmonary ventilation
increases retention and
concentration of CO2,
hydrogen, & carbonic acid will put the body in a state of ___

A

respiratory acidosis

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17
Q

respiratory acidosis is often linked with s/s such as

A

diaphoresis, shallow and rapid breath, cyanosis, restlessness and decreased consciousness/alertness

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18
Q

A condition of increased respiratory rate &
depth that decreases the amount of
available CO2 and hydrogen is best described as

A

respiratory alkalosis

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19
Q

T/F : Usually caused by hyperventilation, respiratory acidosis can result in tetany and convulsions if severe enough.

A

False. It’s respiratory alkalosis

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20
Q

respiratory alkalosis is often linked with s/s such as

A

hyperventilation, lightheadedness, and numbness/tingling of face and digits

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21
Q

T/F: Chronic Obstructive Pulmonary Disease, an umbrella term describing abnormal airway structures blocking airflow, is a leading cause of morbidity and mortality for young children.

A

False-it’s the leading cause for smokers.

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22
Q

Predisposing factors of COPD are

A

smoking, environmental pollution (occupational or air), allergies, infection, aging, potentially harmful drugs and chemicals, genetics

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23
Q

Though both chronic and acute bronchitis are characterized by productive coughs f/b wheezing, for chronic bronchitis the episodes are worse ____ (time of day)

A

in the morning AND evening.

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24
Q

Acute bronchitis s/s:

A

a few days of cold s/s (fever ,sore throat ,malaise) + muscle/back pain, potential laryngitis

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25
Q

what visual s/s might we observe in a patient with chronic bronchitis?

A

CYANOSIS, reduced chest wall expansion , SOB and decreased exercise tolerance, fever

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26
Q

what s/s might indicate that chonic bronchitis has evolved into bronchiectasis?

A

“foul smelling” secretions and hemoptysis, sinusitis, weight loss and anemia, fatigue

27
Q

why are patients with bonchiectasis predisposed to frequent respiratory infections?

A

permanent bronchi dilation and wall destruction via inflammation

28
Q

____is described as a type of COPD characterized by supersized alveoli lacking normal elastic tension

A

emphysema

29
Q

describe the breathing patterns characteristic of a patient with emphysema

A

SOB/dyspnea at rest and w/ exertion, pursed lip breathing, prolonged expiration (+ grunts) , use of accessory muscles, wheezing and increased RR, supine orthopnea

30
Q

What physical attributes might you expect of a pt with emphysema

A

barrel chest, weight loss, peripheral cyanosis

31
Q

What are the 4 common COPD conditions?

A

acute and chronic bronchitis, emphysema, bronchiectasis

32
Q

The general triggers for asthma attacks include allergies, physical exertion, temp, excitement/stress and ___ (2)

A

resp infections/colds and environmental pollutants

32
Q

What are the 5 inflammatory/infectious diseases we’ve discussed?

A

asthma, pneumonia, tuberculosis (TB) , scleroderma, and lung cancer

32
Q

T/F: Asthma is an irreversible obstructive lung disease caused by inflammatory response of the airways to various stimuli

A

false. it is reversible

33
Q

What do we typically want to look for in asthma pts? (hint: PUSH’N P)

A

pushing pumps lol
-pursed lip breathing
-unusual pallor or sweat
-skin retraction (chest region)
-hunched posture
-nostrils flaring

34
Q

What do we typically want to ask our asthma pts?

A

sleep restlessness, vomiting, abnormal fatigue

35
Q

what are we supposed to listen for in asthma pts?

A

wheezing, noisy and irregular breathing w/ prolonged expiration, unproductive cough or throat clearing (esp w/o a cold or post-exercise)

36
Q

what are the 3 causes of pneumonia?

A

aspiration, inhalation of toxins or irritants, infection

37
Q

In addition to general signs of infection (fever, fatigue malaise,etc) , patients with pneumonia may present with dyspnea, tachypnea, hakcing cough and ___ (think MSK pain)

A

sudden/sharp chest pain, shoulder pain, general myalgia and potentially swollen knees

38
Q

this infectious disease is transmitted by gram-positive acid fast bacillus and spread by repeated close contact.

A

tuberculosis (TB)

39
Q

T/F: TB treatment should only take place until symptoms resolve.

A

false. pts should comply with full course (6-9 months) to avoid passing drug resistant strains.

40
Q

extrapulmonary TB can occur in the kidneys, growth plates, meninges, and ___

A

spine (Pott’s), lymph nodes, and hips

41
Q

In addition to typical s/s of infection, TB pts might experience

A

DULL chest pain or discomfort, anorexia/weight loss, and frequent productive cough

42
Q

____is a restrictive lung disease with unknown etiology that features inflammation and fibrosis of the skin and viscera

A

scleroderma

43
Q

these 6 symptoms are characteristic for someone with scleroderma: exertional dyspnea, paroxysmal nocturnal dyspnea, orthopnea, ___

A

peripheral edema, nonproductive cough, ad hemoptysis

44
Q

what are the 2 major divisions of lung cancer?

A

small cell lung cancer
non-small cell lung cancer

45
Q

what are the 3 subtypes on non-small cell lung cancer?

A

squamous cell carcinoma
adenocarcinoma
large cell carcinoma

46
Q

Along with breathing changes and sharp inspiratory pain in the UE/trunk, what other s/s are specifically related to lung cancer—as opposed to other cancers (5)

A

recurrent pneumonia or bronchitis, hemoptysis, UE atrophy/weakness, fecal breath odor, hoarseness/dysphagia

47
Q

___ is a genetic disease of the exocrine glands that mainly impacts the GI and respiratory systems

A

cystic fibrosis

48
Q

T/F: Cystic fibrosis is a recessive trait that typically manifests in early childhood

A

true

49
Q

In cystic fibrosis, ____ accumulates in tissue lining and creates viscous mucous and duct obstructions.

A

salt

50
Q

pneumothorax, hemoptysis, and _____ are severe complications of cystic fibrosis.

A

RHF secondary to pulmonary HTN

51
Q

How might we distinguish early or undiagnosed CF from asthma?

A

excessive appetite w/ no gains, bulky and foul stools, salty skin/sweat, frequent pneumonia

52
Q

how might CF present in young adults?

A

nasal polyops, glucose intolerance, periostitis, infertility

53
Q

Along with the “5 No’s”, what are the PE rule out criteria?

A

Age <50 y/o, HR<100, O2 sat>/=95%

54
Q

What are the “5 No’s” of PE rule out criteria

A

no hemoptysis, estrogen use, prior DVT/PE, unilateral leg swelling, trauma or hospitalization in the past 4 weeks.

55
Q

what qualifies as pulmonary arterial HTN?

A

mean PA pressure >/= 25 mmHg and capillary wedge pressure </=15 mmHg

56
Q

what is the difference between types of pleurisy?

A

dry or wet based on presence of abnormal increase of fluid between pleural layers. When infected, it’s considered purulent

57
Q

what are the typical pain distributions for pleurisy?

A

ipsilateral shoulder, upper trap, neck, lower chest wall and abs

(» basically . ipsi shoulder + trunk)

58
Q

Pneumothorax can be secondary to _____(3)

A

puncture, spontaneous or idiopathic spontaneous

59
Q

what is a common sign of spontaneous pneumothorax?

A

abrupt dyspnea in healthy person

common in 20s-40s

60
Q

tight skin around the eyes, lips and joints is characteristic of this inflammatory pleural condition

A

scleroderma

61
Q

according to the PERC tool for PE, what is the cutoff score that indicates a need for referral?

A

> /= 2

Differential Dx (6 decks)

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