Pedia 3B - Applied Pulmonary Flashcards

1
Q

Cough - Dry

A

Pleurisy

Hacking - LTB

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2
Q

Cough - Productive (2)

A

Pneumonia

TB

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3
Q

Sputum - Purulent (2)

A
Lung abscess (also very bad smell; copious)
Cystic Fibrosis
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4
Q

Sputum - Frothy

A

Heart Disease

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5
Q

Sputum - Copious

A

Lung Abscess (also very bad smell)

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6
Q

Sputum - Blood tinged

A

Mitral stenosis

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7
Q

Sputum - Greenish

A

Cystic Fibrosis

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8
Q

Sputum - Frank blood

A

Hemoptysis

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9
Q

Sputum - Very bad smell

A

Lung abscess (purulent; copious)

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10
Q

Cough - Worse on lying down

A

Postnasal drip (also when sleeping/awakening)

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11
Q

Cough - w/pain on chest

A

Pleurisy

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12
Q

Cough - hoarse

A

laryngotracheobronchitis

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13
Q

Cough - Whoop

A

Pertussis

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14
Q

Cough - Aphonic

A

Vocal cord paralysis

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15
Q

Cough - All day but only while awake

A

Habit

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16
Q

Cough - Worse when asleep/awakening

A

Postnasal drip (also on lying down)

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17
Q

Stridor (6)

A
Harsh
High Pitch
During or end of INspiration 
Narrowing of upper air passages  
LTB, Foreign bodies, Epiglottitis, Diphtheria, Vocal cord paralysis
Snoring
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18
Q

Snoring

A

stridor while asleep

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19
Q

Noise at start of expiration

A

Grunt

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20
Q

Rapid succession of short, sharp sounds
Usu. moribund/dying
D/t air going in/out thru pooled saliva

A

Rattle

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21
Q
Harsh
High Pitch
During or end of INspiration 
Narrowing of upper air passages  
LTB, Foreign bodies, Epiglottitis, Diphtheria, Vocal cord paralysis
Snoring
A

Stridor (6)

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22
Q

Musical sound
Asthma
Heard w/o stethoscope

A

Wheeze

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23
Q

Cyanosis - Definition

A

Bluish discoloration of skin & mucus membranes

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24
Q

Rattle

A

Rapid succession of short, sharp sounds
Usu. moribund/dying
D/t air going in/out thru pooled saliva

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25
Q

Cough - Definition

A

Paroxysmal expiratory movements

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26
Q

Central Cyanosis - Definition

A

Generalized (inc. tongue)

Ward extremities

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27
Q

Wheeze

A

Musical sound
Asthma
Heard w/o stethoscope

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28
Q

Absence of Clavicle

A

Cleido-cranial dysostosis

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29
Q

Pre-sternal edema

A

Mumps

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30
Q

Unilaterally prominent anterior chest

A

Cardiac Problems
Rib Abnormalities
Scoliosis

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31
Q

Hypo-plastic nipples

A

Down’s

Turner’s

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32
Q

Super-numerary nipples

A

Renal abnormality

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33
Q

Shield chest

A

Turner’s

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34
Q

Pectus excavatum

A

Congenital anomaly,
Chronic nasal obstruction
- adenoidal hypertrophy

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35
Q

Pigeon Breast

A

Normal
Pectus carinatum
Rickets
Osteomalacia

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36
Q

Costo-condral swelling

A

Rickets

Rachitic

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37
Q

Deep groove along lower ribs

A

Normal (esp in premature)

Harrison’s Sulcus (if late)

  • Rickets
  • COPD
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38
Q

(-) Pectoralis major

- Unilateral Flattened Chest

A

(-) Nipple
(-) Breast
Pleural herniation

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39
Q

Sprengel’s Deformity

A

HIGH Scapula

Lower angle to the spine

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40
Q

Paroxysmal

  • Dx Test
  • Abd on INSP
  • Abd on EXP
  • Dse
A
  • Requires fluoroscopy
  • Abd flattens on INSP
  • Abd bulges on EXP
  • Diaphragmatic Paralysis (Congen, Poliomyelitis)
  • Pneumothorax
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41
Q

Non-Paroxysmal

  • Dx Test
  • Abd on INSP
  • Abd on EXP
  • Dse
A

Chest and Abd move
Abd more visible
- Abd bulges on INSP
= Thorax moves up and out (chest exp)

  • Abd Flattens on EXP
    = Thorax resting

Dse: Normal

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42
Q

DEC Fremitus

A

FACE P

  • FBO (Bronchus)
  • Atelectasis
  • Collapsed lung
  • Effusion
  • Pneumothorax
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43
Q

INC Fremitus

A

CPC

  • Consolidation
  • Pneumonia
  • Cavity (large)
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44
Q

Breaths/Minute (Tachycardia)

A
0-2m   30-50 (60)
2-12m 20-30 (50)
1-5y     20-30 (40) 
6-12y   15-20 (30) 
12-18y 12-16 (24)
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45
Q

INSP

Upper Obstruction

A

Croup

Diptheria

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46
Q

EXP

Airway Obstruction

A

Bronchial Asthma

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47
Q

Tracheal Deviation
Right -
Ipsilateral -
Contralateral -

A
Tracheal Deviation 
EXCLUDE SCOLIOSIS FIRST 
R -   Normal 
Ipsi- Fibrosis & Collapse 
Contra - Pneumothorax & Effusion
48
Q

Tracheal Notch

  • Shallow, Supra-sternal -
  • Deep, supra-sternal -
A

Tracheal Notch

  • Shallow, Supra-sternal - Ant displacement, Mediastinitis
  • Deep, supra-sternal - MASS
49
Q

Tracheal Movement

- Pendular

A

Tracheal Movement
- Pendular
= Obstruction of large bronchus
= Large pneumothorax

50
Q

Tracheal Movement

- Rhonchus/Thud

A

Tracheal or Laryngeal Obstruction

51
Q

Asymmetry of chest excursion

A

Effusion
Collapse
Consolidation

52
Q

Normal Chest Circumference

A

Birth 33 +/-3
1 year 48 +/-3
3 Years 52 (50-56)

53
Q

Head>Chest:

Chest<Head:

A

Head>Chest: first 9-12 months (or 6 months, depending on chapter)

Chest<Head: After 1 year

54
Q

Persistent infantile head:chest proportion

A

Hydrocephalus

55
Q

Small thoracic Cage

A

Ellis Van Crivald

56
Q

Oval Chest seen after _____ year

A

After 2 years

57
Q

Breathing Movement

- After 4-5 years

A

Intercostal

58
Q

Breathing - Splinting

A

INC ICP
Pleural irritation
CNS irritation

59
Q

Breathing - Short Grunt on EXP

A

Painful condition

60
Q

Breath Sounds - INCREASED

A

Broncho-pneumonia
Collapse of lung
FBO
(Anything that DEC air entry)

61
Q

Breath Sounds - DECREASED

A

Fibrosis
Thickened Pleura
Pleural Effusion
Pneumothorax

62
Q

Crunching sound over chest, near pericardium

A

Pneumothorax

63
Q

INSP Wheeze

A

Croup

64
Q

EXP Wheeze

A

Asthma

65
Q

End INSP crackles

A

Profuse
Best heard when sitting
Restrictive lung disease

66
Q

EARLY INSP Crackles

A

Lower chest
Any position
Airway Obstruction

67
Q

Wheeze - HIGH pitch

Whistling

A

Asthma (also expiratory)

68
Q

Wheeze - LOW pitch

Snoring

A

Emphysema

69
Q

Discontinuous, interrupted

A

Rales
Crepitations
Crackles

70
Q

Adventitious

  • Continuous
  • UN-interrupted
A

Wheeze

Rhonchus

71
Q

Vocal Resonance - INC

A
PCPC
Consolidation 
Lobar Pneumonia 
Cavity (Large, TB)
Pleural effusion
72
Q

Vocal Resonance - DECREASED

A
FBO 
Emphysema 
Pleural Effusion 
Pleural Thickening 
Pneumothorax
73
Q

Tugging Sound in Trachea

A

FB

74
Q

Percussion - DULL

A

Heart
Lung

Effusion 
Consolidation 
Fibrosis 
Collapse 
Pleural Thickening
75
Q

Percussion - Resonant

A

Lungs

76
Q

Percussion - HYPER-resonant

A

Lung of infants
Thin chest wall

Emphysema (asthmatic)
Pneumothorax

77
Q

Percussion - Tympanic

A

Stomach

78
Q

Resonance - INC

A

Whispered Pectorilloquy

Bronchophony

79
Q

Sternal Tenderness -

A

Leukemia?

80
Q

Cold - Clear

A

Viral
Allergy
LATE bacterial

81
Q

Cold - Green (hilog)

A

Bacterial

LATE Viral

82
Q

Cold - Unilateral, foul, persistent

A

FB

Polyp

83
Q

Cold - Blood tinged

A

Nose picking
Allergic rhinitis w epistaxis
Pliable Kesselbach’s

84
Q

Upon waking =

A

Allergic usually

85
Q

Cold - Immunizations to ask

A
HiB 
Flu
Pneumococcal 
BCG
DPT 
Influenza
86
Q

Cough - Dry

A

Pleursy

Dry Hacking - LTB

87
Q

Cough - Paroxysmal

Pertussoid

A
Cough Cough Cough Whoop 
High Pitch 
Loud Insp 
Pale 
Cyanosis 
NO Inhalation between
88
Q
Cough - (Pertussoid or Staccato) 
Cough Cough Cough Whoop 
High Pitch 
Loud Insp 
Pale 
Cyanosis 
NO Inhalation between
A

Pertussoid

89
Q

Cough - Staccato

A

inspiration in between cough
–> cough-inspiration-cough-inspiration •

Heard in atypical pneumonia (Chlamydia, Mycoplasma, Adenovirus

90
Q

Cough
Inspiration in between cough
–> cough-inspiration-cough-inspiration •

Heard in atypical pneumonia (Chlamydia, Mycoplasma, Adenovirus

A

Paroxysmal Staccato

91
Q

Rickets
Scurvy

  • Costochondral swelling
  • Scorbutic: sharp angle
  • Rickets: obtuse angle
A

Rosary Beads

92
Q

Rosary Beads description

A

Rickets
Scurvy

  • Costochondral swelling
  • Scorbutic: sharp angle
  • Rickets: obtuse angle
93
Q

Crackles - Late INSP

A

ILD

Pneumonia

94
Q

Crackles - Early INSP

A

Asthma

Bronchitis

95
Q

Crackles - Mid-INSP

A

Bronchiectasis

96
Q

Crackles - Implications (4)

A

Inflammation
Edema
Infection
CHF

97
Q

Wheeze - HIGH Pitch

A

Asthma (also expiratory)

98
Q

Wheeze - Low Pitch

A

Emphysema

99
Q

Wheeze - Expiratory

A

Asthma (also HIGH pitch)

Most wheezes are expiratory

100
Q

Wheeze - Late INSP

A

Croup

101
Q

Wheeze - Implications (5)

A
  • Obstructive airway disease
  • Occlusion of bronchus
  • CHF

Diff by tapping/physiotherapy

  • if clears wheeze – likely infectious
  • If localized – Mass
102
Q
  • Vary a lot, difficult to identify
  • Coarser, lower pitch, snoring or moaning quality, continuous, usu superimposed on a vesicular breath sound
  • Also d/t narrowing
  • Bronchial secretions in the large airways
  • Occult neoplasm (esp localized)
  • Clear when you cough/tap
A

Rhonchi

103
Q

Rhonchi

A
• Vary a lot, difficult to identify 
• Coarser, 
- Lower pitch, 
- Snoring or moaning quality, 
- Continuous, 
- Usu superimposed on a vesicular breath sound 
• Also d/t narrowing
  • Bronchial secretions in the large airways
  • Occult neoplasm (esp localized)
  • Clear when you cough/tap
104
Q

• Rubbery, grating sound produced by friction of pleural surface • Palpable, bilateral, do not clear w/cough
- INSP and EXP
-

A

Pleural Rub

105
Q

Physiologic PEEP,
Raises functional residual capacity by closing glottis at the end of expiration
- Pulm Pathology
- Mod-Severe Resp. distress (Very ominous)

A

Grunt

106
Q

Mono: Usually I

  • INSP - Usu obstruction above glottis
  • EXP - usu obstruction intrathoracic
  • Bi: - obstruction in area btwn glottis and subglottis
A

Stridor

107
Q

Vomit after coughing

A

Post-tussive

108
Q

Vomit after eating

A

Non-respiratory

109
Q

Cough - Barking

A

Croup

Epiglottitis

110
Q

Laryngomalacia is physiologic up to

A

18 months

111
Q

MC sign of DOB

A

Tachypnea

112
Q

Alar flaring is (early/late?) sign of Resp. distress

A

LATE

113
Q

Cessation of normal breathing > 10 sec
w/o cyanosis and
w/o any sign and symptoms

A

Periodic breathing

114
Q

Head _______ is synchronous with respiration

Head _______ is synchronous with cardiac rate

A

Bobbing

Nodding

115
Q

Intercostal retractions best seen in the _______ portion

A

Posterior

116
Q

Rosary + Obtuse angle

A

Rickets

117
Q

Rosary + Sharp angle

A

Scorbutic