READ ME / 1: Clinical signs Flashcards
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The vast majority of information leading to diagnosis will come from a patient’s ___.
history
When examining a patient from the end of the bed, what are you looking for?
Respiratory distress
Stridor (high pitched wheezing heard on inspiration)
Cyanosis
State of nutrition
What do you look at in a peripheral examination of a patient’s respiratory system?
Mouth
Hands
Skin perfusion
CO2 flap
Lymph nodes
JVP
What is the difference between a symptom and a sign?
Symptom - what the patient feels / tells you; found by taking history
Sign - physical variations from the norm; what you find on examination
What is cachexia?
Wasting caused by chronic disease
What is obesity?
Accumulation of body fat to the degree that it has negative effects on health
What is anaemia?
Decrease in the number of red blood cells
What is hypercapnia?
Abnormally elevated levels of CO2 in the blood
What is encephalopathy?
Any disease which affects the brain
What causes a CO2 flap?
i.e CO2 retention
Hypercapnic encephalopathy
What does a CO2 flap look like?
Flapping of hand when wrist is hyperextended
What causes yellowing of fingernails?
Nicotine
Tar
Fungus
What kind of disease is eczema?
Atopic disease
atopy - diseases where there is a heightened immune response to ordinary allergens
What is erythema nodosum?
Red bumps found on the shins
What diseases are associated with erythema nodosum?
Sarcoidosis
TB
What is lupus pernio?
Hard purple patches on the face - particularly the cheeks, nose
What disease is lupus pernio associated with?
Sarcoidosis
What is finger clubbing?
Increased curvature of nails
and
loss of nail bed angle
What are some respiratory causes of finger clubbing?
Bronchial carinoma
Fibrosing alveolitis
Lung suppuration (common in bronchiectasis, lung abscesses, empyema)
What are some cardiovascular causes of finger clubbing?
Infective endocarditis
Congenital heart disease
If you examined someone’s eyes and found a small pupil unilaterally, what syndrome would you suspect?
If you later found a tumour on a CXR, what tumour would it be and where exactly is it found?
Horner’s Syndrome
Pancoast’s Tumour, found at lung apex
If a patient had uveitis (inflammation of the middle layer of eye), what respiratory diseases may they have?
Sarcoidosis
TB
Why may a patient have dilated retinal veins in their eyes?
CO2 retention
What signs may you see in a patient who has cor pulmonale?
Cyanosis
Raised JVP
Pitting oedema (sacrum / ankles)
Parasternal heaves
Loud 2nd heart sound
What are the four steps of chest examination?
Inspection
Palpation
Percussion
Auscultation
What is kyphoscoliosis?
Abnormal curvature of the spine
What is pectus excavatum?
Abnormal deformity of the anterior thoracic wall - caved-in chest
What is a hyperinflated chest an indicator of?
Emphysema
What are you looking for on inspection of a patient’s chest?
Operation scars
Expansion
Respiratory abdominal movement
On palpation, what do you feel in the suprasternal notch for?
Tracheal deviation
The trachea moves:
towards / away - collapse
towards / away - consolidation
towards / away - effusion
What are some causes of reduced chest expansion?
Unilateral pneumothorax
Pleural effusion
Bilaterally - restrictive lung disease, hyperinflation from emphysema
On percussion, why may a chest sound hyper-resonant?
Emphysema
Pneumothorax
Why may a chest sound stony dull on percussion?
Pleural effusion
What name is given to normal breath sounds?
Vesicular
Why may breath sounds be reduced?
Effusion, collapse, obstruction, emphysema
What are transmited breath sounds also known as?
Bronchial breath sounds
Why may breath sounds be described as bronchial?77
Consolidation –> pneumonia, pulmonary fibrosis
What name is given to a musical sound which is made as air passes through narrowed airways?
Wheeze (rhonchi)
What are fine crepitations a sign of?
Pulmonary fibrosis
What are moderate/coarse crackles?
Pulmonary oedema, consolidation, bronchiectasis
What is a pleural rub?
Leathery, creaking sound made by inflamed pleural surfaces rubbing together
What are some causes of pleural rub?
Pneumonia, pulmonary embolus, pleurisy
In which disease would you hear a pleural click?
Pneumothorax
