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NBCE Part 4 > Path and Physical Exam > Flashcards

Path and Physical Exam Flashcards

1
Q

Malar Rash

A

SLE

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2
Q

Heliotrope Rash

A

Dermatomyositis; Rash around eyes

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3
Q

Rashes over dorsal joints of hand, upper back, around eyes

A

Dermatomyositis

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4
Q

Rashes with Progressive muscle weakness

A

Dermatomyositis

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5
Q

Rash on left elbow and forearm with weakness of that arm that is getting worse

A

Dermatomyositis

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6
Q

Rash on extensors

A

Psoriasis

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7
Q

Silver Scale Rash

A

Psoriasis

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8
Q

Rash on Flexors

A

Eczema

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9
Q

Eczema

A

Severe Itching. SO Itchy that Pts will scratch till it bleeds; In areas of folded skin;

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10
Q

Psoriasis

A

Well-defined lesions; thick, silver scale; Feels less itchy (Mild) but more like a burn

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11
Q

Contact dermatitis can cause

A

Eczema

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12
Q

Skin Conditions to avoid Sun exposure

A

SLE; Dermatomyositis

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13
Q

Skin lesion with ulceration and crusting; signs of bleeding; Border irregular

A

Squamous Cell Carcinoma

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14
Q

Shiny Pearly Skin lesion with raised borders and flat center

A

Basal Cell

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15
Q

Basal Cell Slow or Fast growing

A

SLow

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16
Q

Hyperpigmented skin lesion that has been changing quickly

A

Melanoma

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17
Q

Icterus (AKA)

A

Jaundice

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18
Q

Enopthalmos

A

Sunken eye

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19
Q

Unilateral Miosis

A

Horner’s; B/L = Drugs

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20
Q

Dry Eyes could indicate

A

Sjorgrens

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21
Q

Vertical Nystagmus

A

Brain Stem or MS; Vertical Nystagmus is not good. Horizontal can be normal or is much more likely to be benign

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22
Q

If asked to perform CN 2 and 3 perform which tests?

A

Direct; Indirect; Accommodation and convergence (Look for pupil constriction)

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23
Q

Mydriasis is?

A

Fully Dilated pupil

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24
Q

Anisocoria is?

A

Irregular pupil size compared B/L; Can be normal; affects 20% of the population??

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25
Q

Pupil that accommodates but does not react to light

A

Argyll-Robinson Pupil

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26
Q

Nerve responsible for “Opening of eyelid”

A

CN3

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27
Q

Nerve responsible for “Closing of eyelid”

A

CN7

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28
Q

Dilation of Pupil (Sympath or parasympathetic Nerve?)

A

Sympath

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29
Q

Why do chiros eval the eyes?

A

For early signs of getting MS, MG, DM

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30
Q

Silver Wire/Copper Wire Appearance; AV Nicking (sign of?)

A

Atherosclerosis

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31
Q

Absent Red light reflex (Sign of?)

A

Cataracts

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32
Q

DM signs in the EYE?

A

Hard Waxy Exudates, Microaneurysms

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33
Q

Disc:Cup ratio > 2:1 (Sign of?)

A

Glucoma or Increased intra-ocular pressure; Volcano disc appearence

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34
Q

Flame Hemorrhages (Sign of?)

A

HTN

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35
Q

Cotton Wool appearance (Sign of?)

A

HTN

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36
Q

Coryza (Def?)

A

Inflammation of Mucus membrane of nose

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37
Q

Red Mucus membrane of nose (Types of conditions?)

A

Acute Infection

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38
Q

Pale, Grey-Blue Membrane of nose (Types of conditions?)

A

Chronic Infection or allergies

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39
Q

Clear and Thin Nasal Drainage Indicates

A

Coryza/allergies

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40
Q

Clear and thin and sweet Nasal Drainage (Indicates?)

A

Possible Basal Skull Fracture; Ask about trauma. If Trauma ER visit.

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41
Q

Clear and thick Nasal Drainage (Viscous) (Indicates?)

A

Viral Infection

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42
Q

What should you ask the PT if they have nasal drainage?

A

Any memory loss, confusion, or recent Trauma? Any recent colds, fevers, headaches, or infections?

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43
Q

Pain with Palpation the Auricle or Tragus could indicate?

A

Otitis Externa

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44
Q

Pain with palpation of Mastoid Process Could indicate?

A

Otitis Media

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45
Q

To instrument (Look inside) the Ear pull the ear which direction for Adult and then for child?

A 
Adult = Up and Back
Child = DOWN and back
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46
Q

Ear: AC>BC (Normal or abnormal?)

A

Normal

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47
Q

Perform Rinnes test in which ear after Weber’s Test?

A

The ear the sound lateralizes to (Do it in the ear that hears the best); Weber’s Lateralizes to the potential conductive deficit side

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48
Q

Examples of Conductive deficit in an Ear

A

Ear Infection, Wax, or Foreign object

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49
Q

Examples of Sensorineural deficit in an Ear

A

Presbycusis (Ear hair cell damage); Neuroma, Meniere’s (MC on boards)(AKA CN8 damage).

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50
Q

What to Ask a Patient if Weber’s lateralizes

A

Do you have any hearing loss?

Do you have Tinnitus or ringing in your ears?

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51
Q

Webers Lateralizes to which ear?

A

The ear that they hear better

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52
Q

Describe the 3 possibilities of Rinnes test.

A

Sensorineural = AC>BC (In lateralized ear)

Conductive Hearing loss = AC=/

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53
Q

Signs of Acute Otitis EXTERNA

A

Canal: Swollen Canal, Moist, Pale red

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54
Q

Signs of Perforated Ear

A

Black and Chronic Infections

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55
Q

Signs of Chronic Otitis EXTERNA

A

Canal: Thick, Red, itchy

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56
Q

Serous Otitis Media

A

A CHRONIC condition; Tympanic Membrane: Bubbles, yellow, retraction

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57
Q

Serous Otitis Media

A

A CHRONIC condition; Tympanic Membrane: BUBBLES, yellow, retraction

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58
Q

Describe Serous Fluid

A

Resemble serum; Pale yellow/Transparent; Benign; Fluid found between membranes and provides lubrication to joints or to the lungs between visceral and parietal plura

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59
Q

Describe Herpes Lesion

A

Vesicles near mouth

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60
Q

Myxedema (What is it?)

A

Severe Hypothyroidism; Can result in Coma

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61
Q

Hashimotos, Hypothyroidism, and Myxedema (Difference?)

A

Hashimotos and Myxedema are AI conditions; Hypothyroidism is not AI and could be the result of pituitary abnormality or a thyroid tumor.

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62
Q

Hashimotos, Hypothyroidism, and Myxedema (Difference?)

A

Hashimotos and Myxedema are AI conditions; Hypothyroidism is not AI and could be the result of pituitary abnormality or a thyroid tumor.

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63
Q

DIabetics Vs Myxedema Vs Cushings

A

All: Mostly Female and Fat and aging;
DM = Polys (Polyneuropathy, polydipsea, Polyphasia, Polyurea)
Myxedema = Everything in body is slowing down bec it controls BMR (Basal metabolic rate); Constipation, fatigue, cat naps, PERIORBITAL swelling (Anopthalmosis)
Cushings = Moon Face (puffy face), Buffalo hump; takes on male features (Hirutism: Face hair and chest hair, male aggression, short temper)

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64
Q

Anopthalmosis (What is it?)

A

Periorbital swelling

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65
Q

XRay in Hashimotos?, Graves?, Myxedema?, Cushings?, Addisons?

A

Addisons and Cushings BECAUSE Tx is Steroids -> Osteoporosis. !!XRAY before CMT!!

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66
Q

Chiro Tx for Addisons and Cushings?

A

Immune Boosters

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67
Q

Chiro Tx (Vit) for Peripheral Neuropathies?

A

B6

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68
Q

If you are considering diagnosing a PT with endocrine disease perform lateral skull XRay. (Why?)

A

Rule out Pituitary Tumor.

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69
Q

If you are considering diagnosing a PT with endocrine disease perform lateral skull XRay. (Why?)

A

Rule out Pituitary Tumor.

Not always done because a Pit tumor would also cause BiTemporal Hemianopia (Loss of lateral field of vision)

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70
Q

Bitemporal Hemianopia indicates?
Unilateral VIsion loss indicates?
Homonymous hemianopia indicates?

A

Pituitary Tumor
Optic Nerve Compression
Contralateral cerebrovascular event

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71
Q

There are 4 conditions to consider during male exam (Name them)

A

Acute Prostatitis; Chronic Prostatitis; Benign Hypertrophy; Cancer

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72
Q

Male Exam: PT has: Warm and tender prostate w/ Fever, Normal PSA (Diagnose)

A

Acute Prostatitis

Tender Prostate only in Acute Prostatitis

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73
Q

Male Exam: Normal Prostate Exam (DRE = Digital Rectal Exam) except prostate has general enlargement, PSA > 4

A

Chronic Prostatitis

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74
Q

Male Exam: DRE reveals Enlarged LATERAL lobe of prostate with LOSS of median sulcus, Boggy feel, Nocturia, PSA > 4

A

Benign Hypertrophy of prostate
PSA will be increased
Nocturia not seen in other prostate issues

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75
Q

Male Exam: Hard Walnut Nodule of Posterior Lobe, non-tender=, PSA > 4

A

Cancer of Prostate

Cancer of Prostate is Blastic; Most Cancers are lytic. Therefore Alk Phos test is useful.

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76
Q

Alk Phos Measures?

A

Bone growth and Blastic growths; Blastic Mets (Most Cancers are lytic)

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77
Q

PET is used to evalute?

A

All ST Cancers

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78
Q

Signs of Breast Cancer

A

Niiple retraction, Dimpling

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79
Q

MC location of Breast Cancer

A

Tail of Spence (Near Axilla) via lymphatic drainage channels

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80
Q

What is Mastitis?

A

Inflammed Breasts; Tender, enlarged, red streaks;

ER referal

81
Q

Age and description of lesion in Fibroadenoma

A

<30yo; Benign Nodule(s) of Breast

82
Q

What is Pagets disease of the breast?

A

Breast Cancer; Not Bone cancer also called Pagets

83
Q

Where is the Adnexal region?

A

Ovaries, uterine ligaments, fallopian tubes, uterus.

84
Q

HCG increased indicates?

A

Tumors

85
Q

Back pain and Chiro (Tx?)

A

Adjust, Nutrition

86
Q

HCG decreased during pregnancy indicates?

A

Ectopic

87
Q

Endometriosis (What is it?)

A

Ectopic endometrium

88
Q

Endometriosis (SS?)

A

Irregular period and trouble getting pregnant (IE Dysmenorrhea and infertility)

89
Q

Cause OF PID

A

STD

Such as: Gonorrhea and Chlamydia

90
Q

Virchow node (What is it?)

A

Mets; Located in supraclavicular lymph chain

91
Q

Sentinal Node (What is it?)

A

Mets; Located in Axilla

92
Q

Right Vs Left Supraclavicular Lymph node (What is)

A

Right: Drains Breast, Inside Chest, and Arm
Left: Perform ROS; Rare; Could be from anywhere

93
Q

Inguinal lymph nodes drain?

Indicate?

A

Legs and genitals

Possible STD

94
Q

What is observed with: Lymphangitis, Lymphadenopathy, Lymphoma

A

Lymphangitis: Red Streak – ER referral
Lymphadenopathy: Swelling – Monitor
Lymphoma: Tumor – Biopsy

95
Q

3 Conditions that produce Lymphadenopathy: Mono, Hodgkins, AIDs
Describe Chest XRay findings of Hodgkins?

A

Mono: Neg
Hodgkins: Mediastinal widening due to lymphadenopathy
AIDS: Variable

96
Q

3 Conditions that produce Lymphadenopathy: Mono, Hodgkins, AIDs
Describe Chest XRay findings of Hodgkins?

A

Mono: Neg
Hodgkins: Mediastinal widening due to lymphadenopathy (Box Car look, Potato nodules)
AIDS: Variable

97
Q

Lymphadenopathy with Weight loss, relapsing fever suggests?

A

Hodgkins

98
Q

What do these have in common:

TB, Thrush, Herpes, Candida, Toxoplasmosis, Kaposi Sarcoma, Pneumocystic carinii

A

Opportunistic Infections
Note: Kaposi Sarcoma is caused by the Kaposi Sarcoma virus. Not everyone with the virus develops the ST masses.
Note: These infections occur in late stages of AIDs.

99
Q

PVE (Stands for?)

A

Peripheral Vascular Exam

100
Q

PVE Tx? (General)

A

Walking

101
Q

PVE: Arterial Vs Venous disease. Name 3 differences?

A

A: Skin cool pale cyanotic, Vessel color is red and tortuous, Pulse weak, Raynauds MBS, Vit C def, Skin thinning.
No swelling.
V: Skin warm normal to red color, Pulse normal, Swelling MBS, Stasis dermatitis with Age.
No Vit C def as cause/excarbent, no Raynauds.

102
Q

Where is the Brachial Artery Palpated?

A

Medial aspect of arm and press up under biceps

103
Q

Where is the Subclavian Artery Palpated?

A

Medial Aspect of Supraclavicular Fossa just deep to Clavicle

104
Q

Describe Artery Palpation Steps

A
  1. Ask PT to remove any clothing that could interfere with Exam
  2. Palpate Pulse
  3. Look off into Space as if counting (For test) and count quietly to 5
  4. Perform B/L
  5. Always tell PT to relax after each full Exam question (For Test)
105
Q

Describe the Capillary Refill Test

A
  1. Raise Limb above heart level (If possible).
  2. Pinch each Finger/Toes until blanched/White (Occurs quickly. SO just pinch and let go for test)
  3. Observe for blood to return to Fingers/Toes
    Pos when Remains Blanched >2sec.
    Pos indicates dehydration, Shock, PVD, Hypothermia
106
Q

Describe Allens Test for Arterial Refill

A
  1. Pt seated resting hands palm up on legs.
  2. Have PT make a tight fist.
  3. Dr Occludes Radial and Ulnar Arteries
  4. Have PT open hand. (Hand should be blanched/White).
  5. Observe Hand while letting go of Ulnar A.
  6. Repeat for Radial A.
  7. Compare to opposite open hand.
  8. Perform B/L
  9. Ask Pt to relax.
107
Q

Describe Buerger’s Test

A
  1. PT supine
  2. Raise PTs legs to ~45deg
  3. Pump PTs ankles for 5secs (Dorsiflex/Plantarflex)
  4. Sit PT up and observe refill (5 Sec)
  5. Ask PT to relax
108
Q

Describe Homan’s Test

A

*Do not perform in my clinic
EX: PT has pain in R calf
1. Raise PTs L leg ~45deg
2. Dorsiflex ankle. Ask if there is pain
3. Squeeze calf w/ Ankle dorsiflex. Ask if there is pain.
4. W PTs legs on table Dorsiflex R Leg. Ask PT if this reproduces pain.
IF there is pain ASK:
Have you recent been immobilized or have been seated for a long period of time? Are you on Blood thinners, birth control, or steroids?

109
Q

Where is Carotid A. Auscultated?

A

At Bifurcation of Carotid (C4)

110
Q

Describe Hepatojugular Reflux test and what is it for

A
  1. PT supine. Observe Jugular Vein in Neck. (Should be seen)
  2. Raise PT to 45 deg inclination. (Jugular V should Disappear)
  3. Compress Abdomen over Inf. Vena Cava and continue to observe Jugular Vein
  4. If Jugular V re-appears and stays visible then pos.
    Pos indicates CHF.
    Because Pressing on a major vein will increase Venous return to the heart and the heart has to work harder to pump this blood out. As the heart works harder the jugular vein will swell until the heart is able to compensate for the increased blood in the veins. If the JUgular vein does not disappear then this means that the heart is not able to pump this extra blood.
111
Q

CHF

A

Coronary Heart Failure

112
Q

Describe the Claudication Test?

What is positive for Vascular Claudication?

A
  1. PT Stands and marches in place for 5sec
  2. Ask if pain
  3. IF PAIN PT repeats w forward hip flexion
    Pain w Flex = Vascular Claudication
    Pain reduced w flex = Neurogenic Claudication (Because flexion reduces Canal Stenosis)
113
Q

Tx or refer? Neurogenic Claudication

A

Treat

114
Q

Tx or refer? Vascular Claudication

A

Co-Manage

115
Q

Buerger’s disease AKA?

What is Buerger’s Dx?

A

Thromboangiitis Obliterans

Caludication in LE (Artery of Vein) in younf male smokee

116
Q

Thrombosis Vs Thrombophlebitis

A

Thrombosis is superficial. Deep Vein Thrombophlebitis

117
Q

Describe Raynauds

A

Triphasic color changel Female; UE; No ice

118
Q

Perform Serum Chemistry for PAD

A

Peripheral Arterial disease

119
Q

What spinal level does the Carotid bifurcate?

A

C4

120
Q

Describe the Pattern/TIming for Neurgogenic Claudication?

A

Unpredictable

121
Q

Describe Episodes of relief with Vasc and neurogenic claudication

A 
Vasc = No relief
Neuro = With rest (Only)
122
Q

Describe the treatment for vasc and neurogenic claudication

A

WALK
Vasc = mid-late stage REFER, Early = Walk
Neuro = CMT and have PT walk

123
Q

Describe the Pattern/TIming for Vasc Claudication?

A

Predictable with amount of acitivity

124
Q

Causes of vasc and neurogenic claudication

A 
Neuro = Central Stenosis, DJD, Facet, Disc.
Vasc = Arteriosclerosis, DM, PVD, Beurger's
125
Q

Testing for vasc and neurogenic claudication?

A 
Neuro= Claudication Test, bicycle test, stoop test.
Vasc = Claudication test, Serum Chemistry, BP.
126
Q

Describe Capillary Refill test

A

Pinch each finger while limb is above heart and watch for refill. (Perform quickly for boards)

127
Q

Describe Allen’s Test

A

PT makes a fist and dr compresses Radial and ulnar arteries in hand. PT relaxes hand and dr release an artery

128
Q

Describe Buerger’s Test

A

PT Supine. Dr raises (Both) legs of PT to ~45. Dr/PT pumps ankles (Dorsi/Plantar flexion) several times (5sec) pt SITS UP and dr observes blood return to feet (5Sec).
Pos = Blood does not return in 2 min.

129
Q

Describe Homans Test

A

PT has calf pain. PT supine. Dr raises unaffected limb to 45 and then dorsiflexes ankle. Then Squeezes the calf. Ask PT if this changes the pain. Perform on opposite limb but start small. Do not raise the limb right away. First try dorsiflex to see if pain increases. If no pain then raise the affected limb and dorsiflex.

130
Q

Where do you palpate the heart?

A

AT the 4 listening points (A,P,T,M)

131
Q

What and where are the 4 listening points for the heart?

A

A = 2nd R intercoastal (Para-sternal)
P = 2nd L intercoastal (Para-sternal)
T = 4th L intercoastal (Para-sternal)
M = 5th L intercoastal space (Mid-clavicular)
*When palpating press w/3 palpating fingers for 5sec at each location.
Point of maximum impulse?

132
Q

How to percuss the heart

A

Percuss from mid-axillary line on left to left boarder of heart. Repeat 3 times starting at R4 then R5 then R6.

133
Q

How to Auscultate the heart

A

A PeT Monkey; 5 Sec each pnt; Bell for low sounds = Bruit (Stenosis).
Diaphragm for higher sounds = (Regurgitation)
State: I am listening for murmurs of splitting and evaluating the rate, rythym, and syncopation (Disturbance of rythym).

134
Q

How to Ausc and Palpate the Abdominal Aorta

A

Palpate lateral to medial for both sides (Dont press on the ab. Aorta. It can rupture if enlarged.)
Ausc with Bell.

135
Q

Disease when R side heart fails

A

Cor Pulmonale (Rare)

136
Q

Cause of Cor Pulmonale?

A

Pulmonary HTN -> R side heart failure

137
Q

SS of Cor Pulmonale

A

Jugular distention; Portal HTN (Liver dx)

138
Q

Tests/Monitor for Cor Pulmonale

A

Spirometry, Pulse Ox.

139
Q

Tests/Monitor for CHF

A

BP; Labs; Stress test; Xray Cardiomegaly; Echo

140
Q

Cause of CHF

A

Left sides heart failure

141
Q

SS of CHF

A

Nocturnal Dyspnea, Pul edema (Fluid in lungs), Pul Effusion (Pink and frothy sputum)(Fluid around lungs)

142
Q

Thirsty all the time = dx?

A

Diabetes insipidous

143
Q

Pitting edema = dx?

A

CHF

144
Q

Pitting edema how to perform

A

Depress tissue and count for recovery time

145
Q

MI SS

A

Pain > 10m after rest

146
Q

MI labs (Cardiac enzymes) explain

A

Troponin > CPK > SGOT (AST) > LDH
Troponin shows up first
Next is CPK

147
Q

Angina Vs MI

A

Anginia = pain with activity and stops w rest

148
Q

Aortic Aneurysm Vs Heart

A

Heart = pain everywhere in chest (“Its the big one”)

Aortic Aneurysm = Localized pain (Knife like)(Straight through chest)

149
Q

Pneumonia Vs Pleurisy

A 
Pneumonia = Pain w fever, no position of relief.
Pleurisy = Positional Relief (Pt holds side of chest and leans towards that side)
150
Q

How to Ausc the lungs?

Where is the R middle lobe?

A

*Be able to tell them which lobes you are ausc.
Right middle lobe is directly across from heart. Note that the R inferior lobe is more lateral and slightly inferior to middle lobe.

151
Q

Flat Sound with Percussion indicates?

A

Tumor or Atelectasis (Collapse)

152
Q

Dull Sound with Percussion indicates?

A

Fluid; Pneumonia

153
Q

Resonant Sound with Percussion indicates?

A

Normal; But can occur with Bronchitis/laryngitis

154
Q

Hyper-resonant Sound with Percussion indicates?

A

Air trapping; COPD

155
Q

Respiratory Excursion performed where/how?

A

At T10 with both hands

156
Q

Decreased B/L Respiratory excursion could indicate?

A

Emphysema, AS

157
Q

Decreased U/L Respiratory excursion could indicate?

A

Pneumothorax

158
Q

Rhonchi vs Rales/wheezing/Crackling

A 
Rhonchi = Fluid in larger airways
Rales/wheezing/Crackling = Fluid in SMALLER airways
159
Q

Whispered pecteriloquay looks for?

A

Fluid

160
Q

What is Stridor and what is Tx?

A

Tx = ER
High pitched whistling sound (Crowing), often heard wo stethescope.
Indicates: Upper airway obstruction.

161
Q

What does Rhonchi sound like?

A

Low pitched rattle that resembles snoring

162
Q

What does Rales sound like?

A

Low pitched velcro sound; Crackly; Crackles and Rales are the same thing (Sort of). Rales are crackles occuring LATE in the inspiration cycle.

163
Q

Prolonged inspiration indicates?

A

CHF

164
Q

Prolonged expiration indicates?

A

COPD

165
Q

Bacterial Vs Viral: Chills indicate?

A

Virus; Fever goes up and down often.

166
Q

Bacterial Vs Viral: Night Sweats indicate?

A

Bacterial

167
Q

Bacterial Vs Viral: What would auscultation reveal for each?

A 
Viral = Clear/Normal
Bacterial = Rales, Wheezing, Voice changes
168
Q

Bacterial Vs Viral: Neutrophils and lymphocytes. Which are elevated and which are decreased for each condition?

A 
Viral = DEC Neutrophils; INC Lymphocytes; WBC 5000 - 10000.
Bacterial = INC Neutrophils; WBC 10k+, (Schilling shift)
169
Q

Opportunistic infections causes:
Pneumocystic Carnii =caused by what AI dx?
Klebsella pneumonia =caused by what AI dx?

A

Pneumocystic Carnii = AIDs

Klebsella pneumonia = Alcohol

170
Q

TB describe Xray finding progression

A

Ghon lesions develop from healing lymph tissue.

171
Q

What is a Ranke Complex

A

From healing Primary TB.

Ghon lesion and Fingernail calcifications

172
Q

Milliary TB. Primary or secondary TB?

A

Secondary

173
Q

What diagnostic test is used to determine primary or secondary TB?

A

XRay

174
Q

Name 2 Screening tests for TB and describe them?

A

Mantoux = More commonly used
Tine
Both Use Tuberculin injection; Size of resulting lesion measured

175
Q

XRay: Widening of the Mediastinum indicates?

A

Hodgkin’s Lymphoma

176
Q

What is Cachexia?

A

Weakening and Wastin of the body due to illness; Occurs with Cancer and eating disorders.

177
Q

Chronic un-productive cough could indicate?

A

Lung Cancer

178
Q

Causes of Stridor?

A

Pertusses, Croup, Epiglotitis, Aspiration of an object.

Upper airway obstruction

179
Q

Crackling heard in late inspiration indicates?

A

Rales

180
Q

Crackling heard in late inspiration indicates?

A

Rales; Occurs in Bronchiectasis, Pul. Edema, Asthma, Bronchitis

181
Q

Rales are best heard at what part of the lung

A

Base

182
Q

Rales are sounds that cant be cleared by coughing

A

But posture and deep breaths may clear it

183
Q

Name of normal breath sounds heard over small airways?

A

Vesicular

184
Q

Crackles heard at start of inspiration is characteristic of what dx?

A

COPD or emphysema = air trapping. Air can get in (a bit) but cant get out easily.

185
Q

Bronchiectasis: Chronic bronchiole thickening and fibrosis from chronic inflamm and infections
SS of Bronchiectasis?

A

Abnormal breath sounds, Chronic bad breath, Recurrent respiratory infections with green/yellow sputum, chronic coughing, SOB

186
Q

What is Bronchiectasis?

A

Thickening of the bronchioles

187
Q

Pleurisy/Pluritis of lung. Causes (Plural)?

A

Flu or pneumonia OR Pul. Embolism

Cause: Inflamm of the lung tissue.

188
Q

Symptoms of Pleurisy?

A

Sudden onset. PT leans towards side of lesion to decrease pain. PT may hold their side. Fever MBS if cause is infection.

189
Q

XRay findings of Pleurisy?

A

NONE

190
Q

XRAY findings of COPD/Emphysema?

A

Barrel chest: Horizontal ribs w/ INC space BTW ribs.
Narrow mediastinum
Flattening of B/L diaphrams because increasing lung sizes.

191
Q

Widdening of mediastinum indicates

A

Hodgkins

192
Q

XRAY findings of Lobar pneumonia?

A

Silhouette sign

193
Q

Describe Silhouette sign?

A

Blurring of the borders of the heart due to fluid buildup in bronchioles

194
Q

Cause of Silhouette sign?

A

Pneumonia (Lobar)

195
Q

Describe Meniscus sign? Indicates?

A

Occurs in late Plural effusion. Significant sign. Indicates plural effusion; Fluid accumulation (Outside the lungs)!!

196
Q

Describe XRAY findings in both Plural effusion and Pul. edema?

A

Early findings appear the same: Fluid covering costophrenic angles.
Late Plural effusion = occurs w meniscus sign; fluid outside the lungs
Pul. Edema = occurs w/ CHF; Kerley B Lines

197
Q

Characteristic XRAY finding of late Plural effusion?

A

Meniscus sign

198
Q

Pul edema occurs in CHF. Is the fluid inside or outside the lungs? Name another characterisitc XRAY finding?

A

Inside the lungs; Kerely B lines

199
Q

XRAY finding of Kerely B lines occur in what Dx?

A

CHF; Pul edema

NBCE Part 4 (5 decks)

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