OSCE

Question 1

Whats the normal values of Hb in women and men?

Answer 1

W: 120-150 g/L
M: 135-175 g/L

Question 2

Where is cyanosis more prominent?

Answer 2

Cyanosis is best appreciated in areas where the overlying epidermis is thin and subepidermal vessels are abundant, such as the lips, nose, cheeks, ears, hands, feet, and mucous membranes of the oral cavity.

Question 3

T or F: Peripheral cyanosis causes blue hands and feet, although the mucous membranes
of the mouth are pink

Answer 3

T

Question 4

What is hypoxia?

Answer 4

Older <90% or PaO2<60mmHG
Lung Disease <88%
Young healthy <97%

Question 5

What are causes of peripheral cyanosis?

Answer 5

common causes of peripheral cyanosis are low cardiac output, arterial disease or obstruction (e.g., Raynaud disease), and venous disease.

Question 6

What is barrel chest deformity?

Answer 6

Barrel chest deformity refers to a chest with a transverse section that is more round than oval.

Question 7

What disease is associated with barrel chest deformity?

Answer 7

chronic obstructive lung disease (i.e., chronic bronchitis or emphysema)

Question 8

What signs are associated with barrel chest deformity?

Answer 8

Most patients also have dorsal kyphosis, a prominent sternum, widened intercostal spaces, elevated clavicles, and a shortened neck.

Question 9

What is the thoracic ratio?

Answer 9

The ratio of the anteroposterior diameter to the lateral diameter

Question 10

What is the thoracic ratio for barrel chest deformity?

Answer 10

The thoracic ratio of these patients exceeds 0.9

Question 11

Why is the thoracic ratio elevated in BCD?

Answer 11

overactivity of the scalene and sternocleidomastoid muscles lifts the upper ribs and sternum

Question 12

What is pursed-lip breathing?

Answer 12

Many patients with chronic obstructive lung disease instinctively learn that pursing the lips during expiration reduces dyspnea.

Question 13

What is the effect of pursed-lip breathing?

Answer 13

Pursed-lips breathing significantly reduces
the respiratory rate (from about 20 breaths/min to 12 to 15 breaths/min), increases tidal volume (by about 250 to 800 mL), decreases the PaCO2 (by 5%), and increases oxygen saturation (by 3%).

Question 14

T or F: Accessory muscle use is a common finding in patients with chronic obstructive lung disease or respiratory muscle fatigue

Answer 14

T

Question 15

What are accessory muscles for breathing

Answer 15

inspiratory contraction of the sternocleidomastoid

and scalene muscles