lungs Flashcards
1
Q
- 3 D’s: dysphagia, drooling, distress
- Odynophagia, inspiratory stridor
- Tripoding
- Muffled “hot potato” voice
- Thumbprint sign on cervical x-rays
A
Epiglottitis
2
Q
Blunting of costophrenic angles on CXR
A
Pleural effusion
3
Q
- Chronic cough with sputum production
- Productive cough x 3 months/year for 2 consecutive years
- Dyspnea
- History of smoking (common)
- PFT: decreased FEV1, decreased FEV1/FVC < 70%
- Increased hemoglobin and hematocrit (erythrocytosis)
- Respiratory acidosis
A
Chronic bronchitis
4
Q
- Difficulty in ventilating patient
- Hyperresonance to chest percussion over affected side
- Decreased breath sounds on affected side
- Tracheal shift to contralateral side (very late, premortem)
- Jugular venous distention (late sign)
A
Tension pneumothorax
5
Q
- Dyspnea
- History of smoking (common)
- Decreased breath sounds
- Barrel chest
- Pursed lip breathing
- PFT: decreased FEV1, decreased FEV1/FVC < 70%
- CXR: flattening of diaphragm, increased AP diameter, decreased vascular markings
A
Emphysema
6
Q
- Dyspnea
- Wheezing
- Cough (nocturnal)
- Decreased FEV1
A
Asthma
7
Q
- Exploring caves/exposure to bird or bat guano
- Mississippi and Ohio River Valleys
- Atypical pneumonia features (like walking pneumonia) or flu symptoms
A
Histoplasmosis
8
Q
- Flu-like symptoms
- Exposure to birds
A
Psittacosis
9
Q
- History of work in shipyards, construction, insulation
- Pleural plaques on CXR
- “Shaggy heart” on CXR
- Restrictive pattern on PFT: normal or increased FEV1/FVC, normal or decreased FEV1, decreased lung volumes
A
Asbestosis (bronchogenic carcinoma or mesothelioma)
10
Q
- HIV positive
- Dyspnea on exertion
- Fever
- Nonproductive cough
- Oxygen desaturation with ambulation
- Diffuse bilateral interstitial infiltrates
- Increased lactate dehydrogenase (LDH)
A
Pneumocystis jiroveci pneumonia
11
Q
- Honeycombing (reticular opacities on CXR)
- Ground glass opacification on CT scan
- Restrictive pattern on PFT: normal or increased FEV1/FVC, normal or decreased FEV1, decreased lung volumes
A
Pulmonary fibrosis
12
Q
- Pleuritic chest pain
- Increased with movement and deep breathing
- Reproducible point tenderness
- Absence of palpable edema
A
Costochondritis
(AKA: Tiezte syndrome if there is palpable edema)
13
Q
- Pneumonia
- Alcoholism
- Purple-colored (currant jelly) sputum
- Cavitary lesions on CXR
A
Klebsiella pneumoniae pneumonia
14
Q
- Pneumonia
- Fever
- Chills and rigors
- Blood-tinged “rusty” phlegm
A
Streptococcus pneumoniae pneumonia
15
Q
- Pneumonia
- Immunocompromised and age extremes
A
Haemophilus influenzae pneumonia
16
Q
- Pneumonia
- Contaminated water source (AC unit, cooling units and towers, Jacuzzi, pools)
- GI symptoms (diarrhea)
- Hyponatremia
- Increased liver transaminases
- Neurologic symptoms: headaches, confusion, altered mental status
A
Legionella pneumophila pneumonia
17
Q
- Pneumonia symptoms with URI and pharyngitis prodrome
- Previously young and healthy
- No chills or rigors
- Dry nonproductive cough
A
Mycoplasma pneumoniae pneumonia
(AKA: “walking pneumonia”)
18
Q
- Refractory hypoxemia with no hypercarbia
- Bilateral diffuse pulmonary infiltrates (may spare costophrenic angles)
A
Acute respiratory distress syndrome
19
Q
- “Seal-like barking” cough
- Inspiratory stridor
- Hoarseness
- Symptoms worse at night
- “Steeple” Sign on cervical x-rays
A
Croup
(AKA: laryngotracheitis)
20
Q
- Sudden onset of dyspnea, pleuritic chest pain, and possible hemoptysis
- Look for history of prolonged immobilization/venous stasis, intimal endothelial damage, and hypercoagulability (Virchow’s triad)
- Tachypnea
- Tachycardia
- S1Q3T3 on ECG
A
Pulmonary embolism
21
Q
- Sweat chloride test elevated
- Meconium ileus (pathognomonic)
A
Cystic fibrosis
22
Q
- Tram-track appearance on CT scan (thickened bronchial walls with airway dilation and lack of airway tapering)
- Signet ring sign (increased airway diameter > adjacent vessel diameter)
- Most commonly noted in cystic fibrosis or recurrent lung infections
A
Bronchiectasis
23
Q
A
