Resp

Question 1

Resp clubbing causes

Answer 1

CF
Bronchiectasis
Mesothelioma
Bronchogenic Ca
Interstitial lung disease
TB
Empyema

Question 2

What is resp distress? causes?

Answer 2

usage of accessory muscles to breathe

causes: COPD

Question 3

Peripheral cyanosis causes

Answer 3

PVD
Raynauds phen
CCF
central cyanosis

Question 4

1st web space wasting?

Answer 4

Pancoast tumor

Question 5

Flapping tremor causes?

Answer 5

Hypercapnia

Question 6

Why assess JVP?

Answer 6

increased in RHF, PE, SVC obstruction

Question 7

How to assess tracheal tug?

Answer 7

fingers on trachea, ask pt to breathe in, tug on inspiration

Question 8

causes of hyper-resonant percussion?

Answer 8

COPD, pneumothorax

Question 9

Causes of sacral/peripheral edema?

Answer 9

RHF

Question 10

How to assess SVC obstruction?

Answer 10

Pemberton’s sign

Question 11

Indications for lobectomy/pneumonectomy?

Answer 11

bronchogenic ca (25%)
bronchiectasis
trauma
TB

Question 12

Hyperinflation signs?

Answer 12

decreased cricosternal distance ± tracheal tug
increased AP diameter
Hoover's sign
Non-palpable apex beat
Hyper-resonant percussion note

Question 13

why is there Mediastinal shift to the right?

Answer 13

shift direction:
towards lesion - collapse, pneumonectomy
away from lesion - pneumothorax, effusion if big

consolidation doesnt have mediastinal shift

Question 14

Interstitial lung disease (plm fibrosis), desc what you know

Answer 14

1) idiopathic - cryptogenic fibrosing alveolitis
2) inhaled antigen (extrinsic allergic alveolitis) - bird fanciers; farmers lung
3) irritants - asbestosis; silicosis; coal workers pneumoconiosis
4) assoc w/ systemic disease - SLE; RA: Sarcoid: systemic sclerosis
5) iatrogenic - MTX; amiodarone; radiotherapy

Question 15

Bibasal creps (fine and coarse) causes?

Answer 15

Fine
- plm edema
- interstitial lung disease
Coarse
- bronchiectasis
- CF
- bibasal pneumonia

Question 16

Causes for Pleural effusion if fluid is transudate?

Answer 16

Transudate (protein < 30g/l)

• volume overload
• LVF
• hypoalbuminemia
• Meig’s syndrome (fibroma of the ovarian tumor leading to pleural effusion and ascites)

Question 17

Causes for Pleural effusion if fluid is exudate?

iiim

Answer 17

Exudate (protein > 30 g/l)

• infection: pneumonia; TB
• infarction: PE
• inflammation: RA; SLE
• malignancy: bronchogenic ca; mesothelioma

Question 18

DDx for Horner’s syndrome?

If it wasnt Horners syndrome, what else could it be?

Answer 18

1) Central lesion
- storke/tumor/MS
- syringobulbia
2) T1 root lesion
- spondylosis
- neurofibroma
3) Brachial plexus lesion
- pancoast tumor
- cervical rib
- trauma/birth injury (Klumpke’s)
4) Neck lesion
- tumor
- carotid artery aneurysm
- sympathectomy
5) W/ cluster headaches