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Differential Diagnosis > Pulmonary Diseases > Flashcards

Pulmonary Diseases Flashcards

1
Q

A persistent, dry cough could indicate what pathologies?

A

tumor, congestion, hypersensitive airways

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2
Q

A productive cough with purulent sputum (yellow or green) could indicate what pathology?

A

infection

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3
Q

A productive cough with non purulent sputum (clear or white) could indicate what pathology?

A

non-specific airway irritation

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4
Q

A cough with rust-colored sputum could indicate?

A

pneumonia

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5
Q

Hemoptysis could be a sign of:

A
  • Infection
  • Inflammation
  • Abscess
  • Tumor
  • Infarction
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6
Q

Tracheobronchial pain often occurs due to inflammatory lesions, irritating foreign material +/- tumors. Where dues it typically refer?

A

Neck and anterolateral chest at same levels as the points of irritation in the air passages.

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7
Q

How does phrenic nerve damage affect the diaphragm?

A

Ipsilateral diaphragm paresis

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8
Q

Diaphragmatic pleural pain referrs where?

A

Peripherally to the costal margins, centrally to the shoulder and upper trap

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9
Q

I present with

  • Decreased ventilation
  • Confusion
  • Sleepiness and unconsciousness
  • Diaphoresis
  • Shallow, rapid breathing (blow off CO2)
  • Restlessness
  • Cyanosis

who am I?

A

Respiratory Acidosis

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10
Q

I present with

  • Hyperventilation
  • Lightheadedness
  • Dizziness
  • Numbness + tingling of the face, fingers and toes
  • Syncope
  • Severe: muscular tetany + convulsions

Who am I?

A

Respiratory alkalosis

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11
Q

What is COPD?

A

Several airway disorders that have abnormal airway structures (narrowing) resulting in obstruction of air exiting and entering the lungs.

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12
Q

What are the predisposing factors for COPD?

A
  • Smoking
  • Air pollution
  • Occupational exposure
  • Genetics
  • Infections
  • Allergies
  • Aging
  • Potentially harmful drugs/chemicals
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13
Q

I present with

  • Mild fever (1-3 days)
  • Malaise
  • Back and muscle pain
  • Sore throat –> laryngitis
  • Productive cough f/b wheezing

Who am I?

A

Acute Bronchitis

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14
Q

I present with

  • Persistent, productive cough (**worse in am/pm)
  • Reduced chest expansion**
  • Wheezing
  • Periodic fever
  • Dyspnea
  • Cyanosis
  • **Decreased exercise tolerance **

who am I?

A

Chronic Bronchitis

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15
Q

Chronic bronchitis is defined by

A

a cough for at least 3 months/year for 2 consecutive years

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16
Q

What is bronchiectasis?

A

Permanent dilation of bronchi and destruction of bronchi walls

Often results after infections

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17
Q

I present with…

  • Chronic “wet” cough with abundant foul-smelling secretions
  • Hemoptysis
  • Occasional wheezing
  • Dyspnea
  • Sinusitis
  • Weight Loss
  • Anemia
  • Malaise
  • Recurrent fever/chills
  • Fatigue

Who am I?

A

Bronchiectasis

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18
Q

What is emphysema?

A

permanent overdistension and loss of normal elastic tension in lung tissue.

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19
Q

I present with

  • SOB/dyspnea on exertion/orthopnea/use of accessory muscles
  • Chronic cough
  • Barrel chest (increased A/P diameter)
  • Weight loss
  • Malaise
  • Prolonged expiratory periods (w/grunting)
  • Wheezing
  • Pursed-lip breathing
  • Increased RR
  • Peripheral cyanosis
A

Emphysema

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20
Q

Triggers for Asthma include

A
  • Respiratory infections, colds
  • Cigarette smoke
  • Allergic reactions to pollen mold, animal dander, feather, dust, food, insect
  • Indoor/outdoor pollutants
  • Physcial exertion or vigorous exercise
  • Exposure to cold air or sudden temperature changes
  • Excitement, strong emotion, psychological or emotional stress
21
Q

When assessing for asthma you will listen for:

A
  • Wheezing (however light)
  • Irregular breathing with prolonged expiration
  • Noisy, difficult breathing
  • Episodes of dyspnea
  • Clearing the throat (tickle at the back of the throat or neck)
  • Cough with or without sputum production, especially in the absence of a cold +/- occurring 5-10 minutes after exercise.
22
Q

When assessing a patient with asthma - you should look for:

A
  • Skin retraction (clavicles, ribs, sternum)
  • Hunched over body posture; inability to stand, sit straight or relax
  • Pursed-lip breathing
  • Nostrils flaring
  • Unusual pallor or unexplained sweating
23
Q

When assessing a patient with asthma - you should make sure you ask about…

A
  • Restlessness during sleep
  • Vomiting
  • Fatigue unrelated to working or playing
24
Q

What are some causes of pneumonia?

A
  • Aspiration of food, fluids, vomit
  • Inhalation of toxic/caustic chemicals, smoke, dust, gasses
  • A bacterial, viral or mycoplasma infection
25
Q

Some risk factors for pneumonia include:

A
  • Age (very young or old)
  • Absence of pneumococcal vaccine
  • Smoking
  • URI
  • Altered consciousness
  • Endotracheal intubation/NG tube
  • Recent chest surgery
  • Prolonged immunity
  • Immunosuppressive therapy
  • Nonfunctional immune system
  • Severe periodontal disease
  • Prolonged exposure to virulent organisms
  • Malnutrition, dehydration
  • Chronic diseases
  • Prolonged debilitating disease
  • Inhalation of noxious substances
  • Aspiration w/poor immune system
  • Chronically ill w/older adults
26
Q

I present with

  • Sudden/sharp pleuritic chest pain aggravated by chest movement.
  • Shoulder pain
  • Hacking, productive cough (rust colored or green, purulent sputum)
  • Dyspnea
  • Tachypnea w/decreased chest excursion (affected sided)
  • Cyanosis
  • Headache
  • Fever + chills
  • Generalized aches and myalgia
  • Painful + swollen knees possibly
  • Fatigue
  • Confusion in older adult

Who am I?

A

Pneumonia

27
Q

Who is at an increased risk of developing Tuberculosis, a bacterial infection?

A
  • Healthcare workers
  • Older adults/Infants/children <5
  • Overcroweded housing/homelss
  • Incarceration
  • US born non-Hispanic African Americans
  • Immigrants from Southeast, Central Asia, Ethiopia, Latin America, Eastern Europe
    -Reduced immunity or malnutrition + HIV positive lung cancer or head/neck cancer
    RA
    DM +/- end-stage renal disease
    Hx of GI disease
28
Q

I present with

  • Fatigue
  • Malaise
  • Anorexia
  • Weight-loss
  • Low-grade fever
  • Night sweats
  • Frequent productive cough
  • Dull chest pain, tightness, or discomfort
  • Dyspnea

Who am I?

A

Tuberculosis

29
Q

What is scleroderma?

A

Restrictive lung disease of unknown etiologic origin, leads to inflammation and fibrosis of many organs.

30
Q

What are the s&s associated with scleroderma?

A
  • Dyspnea on exertion
  • Nonproductive cough
  • Peripheral edema
  • Orthopnea
  • Paroxysmal nocturnal dyspnea
  • Hemoptysis
31
Q

Where does lung cancer commonly metastasize?

A
  • Brain
  • Long bones
  • Vertebrae (esp thoracic)
  • Liver
  • Adrenal Glands
32
Q

Where is the LOCAL metatasis of lung cancer?

A
  • Pleura
  • Pulmonary parenchyma or bronchi
33
Q

Lung Cancer Risk Factors Include

A
  • Age >50Y
  • Smoking or other tobacco use
  • Previous tobacco-related cancer
  • Passive (environmental) smoke
  • Low consumption of fruits and veggies
  • Genetic predisposition
  • Exposure to air pollution, toxic chemicals, fumes, or radon gas
  • Previous lung diseases
34
Q

I present with..

  • Any change in respiratory patterns
  • Recurrent pneumonia or bronchitis
  • Hemoptysis
  • Persistent cough
  • Change in cough or development of hemoptysis (for a chronic smoker)
  • Hoarseness or dysphagia
  • Dyspnea
  • Wheezing
  • Sharp chest, upper back, shoulder, scapular, rib or arm pain aggravated by inspiration or accompanies by respiratory S&S
  • Sudden, unexplained weight loss; anorexia; fatigue
  • Chest, shoulder or arm pain; bone aching, joint pain
  • Atrophy and weakness of the arm and hand muscles
  • Fecal breath odor

Who am I?

A

Lung Cancer

35
Q

In the early and undiagnosed stages of cystic fibrosis, what signs and symptoms are present?

A
  • Persistent coughing and wheezing
  • Recurrent pneumonia
  • Excessive appetite, poor weight gain
  • Salty skin/sweat
  • Bulky, foul-smelling stools
36
Q

Older children/young adults with cystic fibrosis can present with:

A
  • Infertility
  • Nasal polyps
  • Periostitis (periosteum inflammation)
  • Glucose intolerance
37
Q

Pulmonary involvement of what disease includes:

  • Tachypnea
  • Sustained chronic cough with mucus production + vomiting (due to coughing)
  • Accessory muscle use
  • Cyanosis and digital clubbing
  • Exertional dyspnea with decreased exercise tolerance
A

Cystic Fibrosis

38
Q

Further complications of cystic fibrosis include

A
  • Pneumothorax
  • Hemoptysis
  • Right-sided heart failure secondary to pulmonary hypertension
39
Q

The PE Rule-Out Criteria (PERC) includes:

A
  • Age <50Y
  • Heart rate <100bpm
  • Oxygen sat >/=95%
  • NO hemptysis
  • NO estrogen use
  • NO prior DVT/PE
  • NO unilateral leg swelling
  • NO surgery or trauma req. hospitalization within the past 4 weeks
40
Q

Well’s Criteria for PE

A
  • Clinical symptoms of DVT
  • Other Dx less likley than PE
  • Heart rate >100
  • Immobilization 3+ days or more or surgery in the past 4 weeks.
  • Previous history of DVT/PE
  • Hemoptysis
  • Malignancy

Score 2+ = PE likely; Score 0 or 1 = PE unlikely

41
Q

I present with…

  • Dyspnea
  • Pleuritic (sharp, localized) chest pain
  • Diffuse chest discomfort
  • Persistent cough
  • Hemoptysis
  • Apprehension, anxeity, restlessness
  • Tachypnea
  • Tachycardia
  • Fever

who am I?

A

Pulmonary Embolism

42
Q

I present with…

  • Peripheral edema (BLEs)
  • Chronic cough
  • Central chest pain
  • Exertional dyspnea or dyspnea at rest
  • Distention of neck veins
  • Fatigue
  • Wheezing
  • Weakness

who am I?

A

Cor pulmonale

43
Q

Pulmonary arterial hypertension can occur secondary to…

A
  • PE
  • Chronic lung disease
  • Sickle-cell disease
  • Grave’s disease
  • Polycythemia
  • Collagen vascular hypertension
  • Portal hypertension
  • Heart abnormalities
  • Sleep apnea
44
Q

Dry Pleurisy

A

no change in the fluid between pleural layers

45
Q

Wet pleurisy

A

abnormal increase of fluid between pleural layers

46
Q

Risk Factors for Pleurisy

A
  • Pneumonia
  • TB
  • Lung Abscess
  • Influenza
  • Systemic lupus erythematosus
  • RA
  • Pulmonary infarction
47
Q

I present with…

  • Pain (ipsilateral shoulder, upper trap, neck, lower chest wall, and abdomen)
  • Cough
  • Dyspnea
  • Fever, chills
  • Tachypnea

Who am I?

A

Pleurisy

48
Q
A

Differential Diagnosis (8 decks)

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