Resp, GI + Cardio Examinations Flashcards by Olivia Chrisp

What do you look for in General inspection in resp exam?

Around bed: inhalers, oxygen mask, sputum pot
Patient: cyanosis, sob, cough, wheeze, stridor

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What would bruising or thinned skin in hands suggest?

Long term steroid use

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What does fine tremor in resp exam suggest

B2 agonist use - salbutamol

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What does asterisks in Resp exam suggest

CO2 retention

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What is normal resp rate?

12-20 breaths per minute

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Resp exam: when would JVP be raised?

Cor pulmonale

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Resp exam: what facial central cyanosis indicate?

Hypoxia

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What does conjunctival pallor indicate

Anaemia

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Resp exam: scar in central chest. What is it likely to be?

Sternotomy, thoracotomy

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Resp exam: scar in clavicular region. What is it likely to be?

Pacemaker

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Resp exam: scar in mid-axillary line. What is is likely to be?

Chest drain

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Anatomically describe where to find apex beat

5th intercostal space, MCL

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What (2 things) does reduced chest expansion indicate?

Lung collapse
Pneumonia

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Percuss lung fields: what does resonant percussion suggest

Normal!

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Percuss lung fields: what does dull percussion note suggest? (4 things)

Consolidation
Collapse
Effusion (stony dullness)
Cardiac dullness

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Lung auscultation: what does inspiratory stridor suggest?

Upper airway obstruction

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Lung auscultation: what does wheeze suggest? (2 things)

Asthma
COPD

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Difference between wheeze and stridor?

Stridor is usually just on inspiration and wheeze is both inspiration and expiration

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Lung auscultation: what do coarse crackles suggest? (2)

Pneumonia
Pulmonary oedema

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Lung auscultation: what to fine crackles suggest? (1)

Pulmonary fibrosis

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Lungs: What does increased vocal resonance suggest? (3) + Explain

Increased vibration suggests greater density
- Consolidation
- Lobar collapse
- Tumor

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Lungs: what does decreased vocal resonance suggest?

Decreased vibration suggests lesser density
- Pleural effusion
- Pneumothorax

Causes of Lymphadenopathy

Infection
Malignancy
Sarcoidosis

What does unilaterally reduced chest expansion suggest? (2)

Pneumonia
Lung collapse

Chest wall percussion: what does hyper-resonant percussion note indicate?

Pneumothorax

Resp exam: what does pedal oedema indicate?

- RV failure

Resp exam: what does pain in calf indicate?

- DVT

What do you do to complete resp exam?

- Sputum sample - Oxygen sats - Peak flow

What do you look for in abdo inspection?

- Body habits - Jaudice - Scars - Abdo distention - Masses - Unwell - Consciousness

What does asterixis indicate in abdo exam?

- Hepatic encephalopathy - Uraemia

What does Xanthelasma suggest?

Hyperlipidamia

What does yellowing of eyes suggest?

- Jaundice: raised bilirubin

Where is virchows lymph node

Left supraclavicular fossa

What is virchows lymph node associated with?

Gastric malignancy

What angle should the bed be when palpating abdo?

0! lie them down flat

What do you feel for in soft palpation of abdo?

- Tenderness - Guarding (voluntary/involuntary) - Masses

What do you feel on deep palpation of abdo?

Try to visualise the organs

Palpate aorta: what does expansion pulsating mass suggest?

- Abdominal aortic aneurysm

What do you do to complete abdo exam?

ISHRUG - Check for inguinal lymph nodes - Stool sample - Check hernial orifices - Digital rectal exam - Urine sample - Examination of external genitalia

Abdo exam: what does lower limb pitting oedema suggest?

Hypoalbuminaemia (potentially due to liver cirrhosis)

What could cause a collapsing pulse?

- Normal physiological states: fever, pregnancy - Cardiac lesions: aortic regurgitation

What is slow-raising pulse associated with

Aortic stenosis

What is bounding pulse associated with? (2)

- Aortic regurgitation - CO2 retention

What is thready pulse associated with?

- Hypovolaemia (like sepsis) Makes sense: thready is small

What heart murmur is associated with malaria flush?

Mitral stenosis

What murmur could be heard at apex point with patient rolled (45) to their left

Mitral stenosis

what murmur: 4th/5th intercostal space to the left of the sternum on held expiration, diaphragm

Aortic regurgitation

What signs found in hands to indicate infective endocarditis? what do they look like

- Splinter haemorrhages (nails) - Janeway lesions (non-tender, haemorrhagic lesions on thenar + hypothenar) - Oslers nodes (red/purple, slightly raised, tender lumps) - Clubbing

What could finger clubbing suggest in cardiac exam?

- IE - Congenital heart disease

What is normal capillary refill time (s) ?

Less than 2 seconds

What does radio-radial delay suggest?

Aortic coarctation

When should check for carotid bruits during exam?

Before checking carotid pulse

What does corneal arcus suggest?

Hyperlipidaemia

What do you do to complete a cardiac exam?

- Complete peripheral vascular exam - 12 lead ECG - Measure BP