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OSCE > Resp Exam > Flashcards

Resp Exam Flashcards

1
Q

Peripheral cyanosis

A

Hypoxaemia (O2 says <85%)

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2
Q

Clubbing

A 
Lung cancer 
Pulmonary fibrosis
Bronchiectasis
Cystic fibrosis
Tuberculosis
Abscess
Empyema
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3
Q

Tar staining on fingers

A

Smoking

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4
Q

Temperature

A

Cold- poor peripheral perfusion

Warm with dilated veins- CO2 retention

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5
Q

Flapping tremor (asterisks)

A

Ask patient to hold hands in front of them extended at the wrist for 30s
CO2 retention

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6
Q

Fine tremor

A

Overuse of beta agonists (salbutamol)

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7
Q

Tachycardia ‘bounding’ pulse

A

CO2 retention

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8
Q

Pulses paradoxus

A

Pulse wave volume decreases significantly during inspiration

Severe acute asthma/COPD (also cardiac tamponade)

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9
Q

Mucosal pallor of conjunctivae

A

Anaemia

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10
Q

Jaundice of sclera

A

Anaemia

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11
Q

Horner’s syndrome

A

Ptosis
Miosis and enophthalmos
Caused by compression of the sympathetic chain in chest cavity (Pancoast tumour, sarcoidosis, fibrosis)

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12
Q

Red sclera

A

Anterior uveitis (TB, sarcoidosis)

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13
Q

Central cyanosis

A

Hypoxaemia

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14
Q

Oral candidiasis

A

Inhaled steroid use or immunosuppressants

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15
Q

JVP

A

Increased in pulmonary hypertension (e.g. COPD, interstitial lung disease)

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16
Q

Tracheal deviation- away

A

Pneumothorax

Large pleural effusions

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17
Q

Tracheal deviation- towards

A

Lung collapse

Pneumonectomy

18
Q

Scars in chest

A

Chest drain in MAL

Thoracotomies

19
Q

Chest wall deformities

A

Scoliosis
Kyphosis
Barrel chest (hyperinflation; COPD)
Pectus carinatum/excavatum

20
Q

Resp effort and breathing pattern

A

Prolonged expiration phase- asthma/COPD exacerbations

21
Q

Asymmetry of chest movement

A

Pneumonectomy or thoracoplasty

22
Q

Symmetrical decreased chest expansion

A

Pulmonary fibrosis

23
Q

Asymmetrical decreased chest expansion

A

Pneumothorax
Pneumonia
Pleural effusion

24
Q

Normal percussion sound

A

Resonant

25
Q

percussion dullness

A

Over areas of increased density

Consolidation, collapse, pulmonary oedema, abscess

26
Q

Stony dullness on percussion

A

Pleural effusion

27
Q

Hyper-resonance on percussion

A

Areas of decreased density

Pneumothorax, emphysema bullae, COPD

28
Q

Bronchial breathing

A 
Caused by increased density of matter in peripheral lung allowing sound from the larynx to the stethoscope unchanged, hollow/blowing quality
Consolidation
Lung abscess at chest wall
Dense fibrosis
Squashed lung above pleural effusion
29
Q

Reduce volume breath sounds- Locally

A 
Effusion
Tumour
Pneumothorax
Pneumonia
Lung collapse
30
Q

Reduce breath sounds volume globally

A

COPD

Asthma

31
Q

Polymorphic wheeze on expiration

A

Asthma

COPD

32
Q

Monomorphic wheeze on expiration

A

Foreign body

Carcinoma

33
Q

Stridor

A

High pitched extra-thoracic breath sounds

Upper airway obstruction

34
Q

Crackles

A

Crepitations, rales

On inspiration

35
Q

Coarse crackles

A

Early inspiration
Fluid
Infection

36
Q

Fine crackles

A

Later in inspiration
Fluid
Fibrosis

37
Q

Rub

A

At height of inspiration- inflamed pleural surfaces rubbing against one another

38
Q

Hyper-resonance on vocal resonance

A

Consolidation

Collapse

39
Q

Decreased resonance on vocal resonance

A

Fluid

Air (plural effusion, pneumothorax)

40
Q

Legs

A

Sacral oedema
Pedal oedema
DVT
Erythema nodosum e.g. sarcoidosis

41
Q

Extra tests

A 
Obs
Cardio exam
Peak flow
Sputum MC+S
ABG
CXR

OSCE (15 decks)

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