RESP EXAMINATION

Question 1

What pathologies is a productive cough associated with?

Answer 1

Pneumonia
Bronchiectasis
COPD
CF

Question 2

What pathologies is a dry cough associated with?

Answer 2

Asthma

Interstitial lung disease

Question 3

What is a Wheeze often associated with?

Answer 3

Asthma
COPD
Bronchiectasis

Question 4

What is an example of an acute and chronic cause of stridor?

Answer 4

Acute: Foreign body inhalation
Chronic: subglottic stenosis

Question 5

Why do we observe the colour of the hands in Resp Examination?

Answer 5

Cyanosis of the hands may suggest underlying hypoxaemia

Question 6

Why do we look for tar staining in the hands for a Resp Examination?

Answer 6

Caused by smoking

Which is a signficiant risk factor for respiratory disease (e.g. COPD, lung cancer)

Question 7

Why do we look for skin changes in the hands for a Resp Examination?

Answer 7

Bruising and thinning of the skin can be associated with long-term steroid use

Question 8

Why do we look for joint swelling or deformity for a Resp Examination?

Answer 8

May be associated with rheumatoid arthritis which has several extra-articular manifestations that affect the resp system (e.g. pleural effusions/pulmonary fibrosis)

Question 9

What respiratory conditions is finger clubbing associated with?

Answer 9

Lung cancer
Interstitial lung disease
Cystic fibrosis
Bronchiectasis

Question 10

What is a fine tremor normally associated with?

Answer 10

Typically associated with beta-2-agonist use (e.g. salbutamol)

Question 11

What is the most likely respiratory cause of Asterixis?

Answer 11

CO2 retention in conditions that result in type 2 respiratory failure (e.g. COPD)

Question 12

What are some of the other causes of asterixis?

Answer 12

Uraemia

Hepatic encephalopathy

Question 13

What are the two main pulse abnormalities for a Resp Examination?

Answer 13

Bounding Pulse

Pulsus Paradoxus

Question 14

What is a bounding pulse associated with?

Answer 14

Underlying CO2 retention (e.g. type 2 respiratory failure)

Question 15

What is Pulsus Paradoxus?

Answer 15

Pulse wave volume decreases signficantly during the inspiratory phase

Question 16

What is Pulsus Paradoxus a sign of?

Answer 16

A late sign of:
Cardiac tamponade
Severe acute asthma
Severe Exacerbations of COPD

Question 17

What is a respiratory rate of fewer than 12 breaths per minute referred to as?

Answer 17

Bradypnoea (e.g. opiate overdose)

Question 18

What is a respiratory rate of more than 20 breaths per minute referred to as?

Answer 18

Tachypnoea (e.g. acute asthma)

Question 19

What are the respiratory causes of a raised JVP?

Answer 19

Pulmonary hypertension: causes right-sided heart failure, often occuring due to COPD or interstitial lung disease

Question 20

What is a Plethroic Complexion?

Answer 20

A congested red-faced appearance associated with polycythaemia (e.g COPD) and CO2 retention (e.g. type 2 resp failure)

Question 21

What is Conjuntive pallor suggestive of?

Answer 21

Underlying anaemia

Question 22

What is Oral Candidiasis associated with?

Answer 22

Steroid inhaler use due to local immunosuppression

Question 23

What is Asymmetry of the chest associated with?

Answer 23

Pneumonectomy (e.g. lung cancer)

Thoracoplasty (e.g. TB)

Question 24

What is Hyperexpansion of the chest associated with?

Answer 24

Chronic lung diseases such as asthma and COPD

Question 25

What are the causes of tracheal deviation?

Answer 25

The trachea deviates away from tension pneumothorax and large pleural effusions The trachea deviates towards lobar collapse and pneumonectomy

Question 26

What are the causes of abnormal cricosternal distance?

Answer 26

A distance of fewer than 3 fingers suggests underlying lung hyperinflation (e.g. asthma, COPD)

Question 27

What are the respiratory causes of a displaced apex beat?

Answer 27

Right ventricular hypertrophy (e.g. pulmonary hypertension, COPD, interstitial lung disease) Large pleural effusion Tension pneumothorax

Question 28

What are the respiratory causes of symmetrical reduced chest expansion?

Answer 28

Pulmonary fibrosis reduces lung elasticity restricting overall chest expansion

Question 29

What are the respiratory causes of Asymmetrical reduced chest expansion?

Answer 29

Pneumothorax Pneumonia Pleural effusion All cause ipsilateral chest expansion

Question 30

What does a dull percussion note suggest?

Answer 30

Increased tissue density | E.g. cardiac dullness, consolidation, tumour, lobar collapse

Question 31

What does a stony dullness suggest?

Answer 31

Caused by an underlying plerual effusion

Question 32

What is Hyper-resonance?

Answer 32

The opposite of dullness Suggestive of decreased tissue density E.g. pneumothorax

Question 33

What are the two different types of Abnormal tactile vocal fremitus?

Answer 33

Increased vibration over an area suggests increased tissue density (e.g. consolidation, tumour, lobar collapse) Decreased vibration over an area suggest the presence of fluid or air outside of the lung (e.g. pleural effusion, pneumothorax)

Question 34

What are Bronchial breath sounds?

Answer 34

Harsh-sounding Insipration and expiration are equal and there is a pause between Associated with consolidation

Question 35

What do quiet breath sounds suggest?

Answer 35

Reduced air entry into that region of the lung | E.g. pleural effusion, pneumothorax

Question 36

What are coarse crackles?

Answer 36

Discontinous, brief, popping lung sounds typically associated with pneumonia, bronchiectasis and pulmonary oedema

Question 37

What are Fine end-Inspiratory crackles?

Answer 37

Similar to the noise when separating velcro | Associated with pulmonary fibrosis

Question 38

What are the two types of abnormal vocal resonance?

Answer 38

Increased volume over an area suggests increased tissue density (e.g. consolidation, tumour, lobar collapse) Decreased volume over an area suggests the presence of fluid or air outside of the lung (e.g. pleural effusion, pneumothorax)

Question 39

What are the respiratory causes of lymphadenopathy?

Answer 39

Lung cancer with metastases TB Sarcoidosis

Question 40

What can erythema nodosum be associated with?

Answer 40

Sarcoidosis