Resp Flashcards
Indications for lobectomy
Congenital ling malformations
CPAM
Bronchopulmonary sequestration (abnormal mass of non-functioning lung tissue)
Bronchigenic cyst
Congenital lobar emphysema
Trachea is displacement - which way for what!
Displaced in directions of less pressure
Toward: Pneumonectomy
UL fibrosis or collapse
Away: tension pneumo, massive effusion
Name chains
Blue - post and pre auricular
Pink - posterior cervical
Purple - submental and submandibular
Light green - tonsillar and supraclav
Dark green - anterior cervical
Non-CF bronchiectasis differentials
Infection: persistent bacterial bronchitis, bronch obliterans, TB, mycoplasma
Congenital anatomical defects:
Bronchomalacia, bronchogenic cyst, CPAM
Abnormal secretion clearance: PCD, neuromuscular disorder
Immunodeficiency: 22q11 (thymic hypoplasia), complement deficiency, selective IgA deficiency
Other: Sarcoidosis
Invx resp exam
Sputum cultures
CXR PFTs
VBG (resp support*), FBC, CRP, septic screen (resp distress)
Serology - mycoplasma, TB, atypical mycobacteria
CF - r/v NBST, sweat chloride test, genetic testing
PCD - nasal or bronchial biliary biopsy with motility studies
CT chest +/- angiogram (vascular rings and slings)
CF complications: OGTT, nutritional bloods, stool (fecal elastase)
Inspiratory stridor DDx
Non-fixed obstruction. Laryngeal or supralaryngeal
Laryngomalacia + tracheomalacia
Subglottic Haemangioma
Subglottic stenosis
RLN palsy
Arnold Chiari (UMN)
Expiratory stridor
Non-fixed obstruction
Trachea
FB
Tracheal stenosis
Vascular ring or sling
Trachea bronchial tree malformations
Biphasic stridor
Fixed obstruction
Severe laryngomalacia or tracheomalacia
Subglottic haemangioma
Vocal cord paresis
Vascular ring
Stridor invx
AP + lateral XRs (airway)
Barium swallow
Definitive- direct observation by laryngoscopy
Resp exam: general inspection
Well/ unwell
Colour
Iatrogenic - monitoring devices, airway support
Expose!
WOB, resp noises
Scars
Chest wall deformity
Dysmorphisms
- PRS: micrognathia, macroglossia
- cleft lip sequence
Growth
Ask to cough
Resp exam: upper limb
Nails: clubbing - suppurative lung disease, pulm fibrosis, cyanotic heart disease
Fingertips: prick marks BGL
Palms: crease pallor (anaemia)
Dorsum of hand: scars/ IVC
Joint swelling: hypertrophic pulmonary osteoarthopathy
Pulse
ASTERIXIS: CO2 retention
AXILLARY NODES
Exam face
Dysmorphisms, Cushingoid
Nasal polyps
Mouth: cyanosis (tongue to roof), dentition, tonsils
Ears: OM
Cervical LNs
Tonsil grades
