PE Exam 2

Question 1

Kussamaul Breathing

Answer 1

Deep, labored sighing respiration

A compensatory response to Metabolic Acidosis

Question 2

Periodic (Cheyenne-Strokes) breathing

Respiration are interrupted by _______

Answer 2

Cyclic HYPERventilation followed by Compensatory Apnea

Periods of Apnea

Question 3

Obstructive Breathing

Answer 3

Expiration is prolonged because of narrowed airways

Question 4

Restrictive Breathing

Answer 4

Reduced lung capacity

Question 5

Painful respiration

Answer 5

Otherwise normal respiration interrupted by the pain of thoracic movement

Question 6

Abnormal rate

Reduce CO2 in the blood due to INC rate and depth of respiration

Answer 6

HYPERpnea, HYPERventilation

Question 7

Dyspnea while laying flat

Answer 7

Orthopnea

Question 8

Paroxysmal Noctural Dyspnea (PND)

Answer 8

SUDDEN ONSET of Dyspnea while sleeping

Question 9

Platypnea

Dyspnea worse w/ _______________

Answer 9

Upright posture (Pericarditis)

Question 10

Signs of Respiratory Compromise

Answer 10

Retractions of the interspaces and
Use of accessory muscles during inspiration

Pursing or Cyanosis of the LIPs

Nasal Flaring

Question 11

Depression in lower sternum; Compresses the heart and great vessels and may cause murmurs (Pushing away heart, lung, Major vasculature s)

Answer 11

Pectus Excavatum

Question 12

Pectus Carinatum

Answer 12

Sternum displaced anteriorly

Question 13

Flail Chest

Answer 13

Multiple rib fractures —> paradoxical movements of the thorax

Question 14

Fremitus (Increased/louder)

Answer 14

Pneumonia

Question 15

Fremitus

Decreased or absent

Answer 15

PE, Pneumothorax, COPD, Asthma

Question 16

Soft and low-pitched sounds heard through inspiration

Answer 16

Vesicular

Question 17

Louder and high in pitch w/ a short silence between inspiration and expiration

Answer 17

Bronchial

Question 18

Very loud and high in pitch

Answer 18

Tracheal

Question 19

Adventitious sounds

Discontinuousm intermittent, nonmusical, brief

Answer 19

Crackles

Pneumonia, Fibrosis, Early CHF, Bronchitis

Question 20

Continuous, Musical, and Prolonged

Answer 20

Wheezes and Rhonchi (Obstruction)

Question 21

Relative high-pitched w/ shrill quality

Answer 21

Narrowed airways from Asthma, COPD

Question 22

Lower-pitched w/ a snoring quality

Answer 22

Rhonchi — Secretions in the larger airways

Question 23

Marfan;s

Answer 23

Aortic Regurgitation/Dissection

Question 24

Down’s

Answer 24

ASD/VSD

Question 25

Turner

Answer 25

Coarctation of aorta

Question 26

Spondyloarthritides (Ankylosing Spondylitis)

Answer 26

Aortic Regurgitation

Question 27

Redness on cheeks

Answer 27

Malar Flush Mitral Stenosis

Question 28

Yellow lipids around eyes/palm

Answer 28

Xanthomata HYPERlipidemia

Question 29

Ring around cornea

Answer 29

Corneal Arcus Age, HYPERlipidemia

Question 30

Sings of Infective Endocarditis

Answer 30

Clubbing — Splinter Hemorrhages — Streak hemorrhages in nailbed Janeway Lesions — Non-tender macules on hand/fingers Osler’s Nodes - Tender nodules in fingers

Question 31

Structure Needle Tension Pneumothorax — Chest tube — Most prominent spinous process — Inferior tip of scapula —

Answer 31

2 ICS (MCL) 4 ICS (MAL) C7 7th rib

Question 32

Lungs (A) Apex — _____ above clavicle Lower border (2) (P) Lower border — Oblique fissures —

Answer 32

2cm above clavicle 6th rib (MCL) & 8th rib (MAL) (P) T10 (Lower border) T3 (Oblique fissures)

Question 33

Midsystolic, Click, Radiates to Carotid (Carotid Bruits), 2RICS

Answer 33

Aortic Stenosis

Question 34

Diastolic, 2RICS, Blowing, Carotid pulse (Waterhammer)

Answer 34

Aortic Regurgiation

Question 35

Midsystolic, 2LICS, Click, Radiate to L Shoulder/Neck

Answer 35

Pulmonic Stenosis

Question 36

Diastolic, 2LICS, Blowing, Rare

Answer 36

Pulmonic Regurgitation

Question 37

Diastolic, Erb’s, Blowing, Pulse in neck (Waterhammer)

Answer 37

Aortic Regurgitation

Question 38

Diastolic, Erb’s, Blowing, Rare

Answer 38

Pulmonic Regurgiation

Question 39

Midsystolic, Erbs, Cres-Decres w/ Thrill, INC Valsalva/Stand (—Preload)

Answer 39

HCM

Question 40

Holosystolic, LLSB, Blowing, INC Inspiration

Answer 40

Tricuspid Regurgiation

Question 41

Mid-diastolic, LLSB, Opening snap

Answer 41

Tricuspid Stenosis

Question 42

Holosystolic, LLSB, Thrill

Answer 42

VSD

Question 43

Diastolic (Mid/Late), Apex, Opening Sanp, Decres, Rumbling, Low-pitched

Answer 43

Mitral Stenosis (Bell — Low rumble)

Question 44

Holosystolic, Apex, Harsh, Radiation to axilla

Answer 44

Mitral Regurgiation

Question 45

Resonant, Vesicular, Normal Fremitus, Crackles(Late inspiration) wheezes maybe

Answer 45

L HF

Question 46

Dull to percussion, Bronchial Sounds, Crackles (Late Inspiration), Fremitus (INC)

Answer 46

Lobar Pneumonia

Question 47

Dull to percussion, Shift toward (Trachea), Absent (Breath sounds), Absent (Fremitus) RU = increases day

Answer 47

Atelectasis partial Lobar Obstruction

Question 48

Hyperresonant, Decrease/absent (breath sounds), Decreased/absent Fremitus

Answer 48

COPD

Question 49

Hyperresonant, Decrease/absent (breath sounds), Decreased/absent Fremitus. Tension (Away from Trachea)

Answer 49

Pneumothorax

Question 50

Resonant (Maybe Hyper) Wheezing breath sounds Wheezes (maybe crackles) — Adventitious sounds Dec/absent (Fremitus)

Answer 50

Asthma

Question 51

Paradoxical Split (S2) Syncope + 75 yo

Answer 51

Aortic Stenosis

Question 52

Paradoxical Split (S2) Delay on L -> R squeezed so Pulm closes first (not normal) so will the tricuspid

Answer 52

LBBB (MC reason)

Question 53

NO murmur, Fixed/Wide S2

Answer 53

ASD