Respiratory 1 Flashcards
5 Functions of the respiratory system
- Gas exchange
- Regulation of blood pH
- Voice production
- Olfaction
- Protection of respiratory surfaces
A chronic cough is a symptoms which should initiate seeking medical attention. After how many weeks is a cough chronic? Sub-acute?
Acute <3wks
Sub-acute 3-8wks
Chronic >8wks
3 MC causes of an acute cough
Viral/Bacterial URTI
Pneumonia
Pulmonary Emboli/Edema
A chronic cough in a smoker is most likely caused by what condition? What are 4 other causes in non-smokers?
Chronic bronchitis Post-nasal drip GERD Asthma ACE Inhibitors
What are the 3 key organ systems which can contribute to dyspnea?
Cardiovascular (heart)
Respiratory
Neuromuscular
DDX acute dyspnea
Asthma
Pulmonary infarction
Pulmonary Edema/Emboli
Pneumothorax
DDX Chronic dyspnea
CHF
CHronic Bronchitis
COPD
Hemoptysis is expectoration of blood that originates below the ____________
Larynx
What is the medical term for chest pain aggravated by respiratory motion?
Pleuritic pain
DDX chest pain (5)
Chronic bronchitis Bronchogenic CA LV failure/Mitral stenosis Pulmonary emboli Pneumonia
In which population is allergic rhinitis a main cause of chronic airway diseases?
Children 6-14yo
rare in <6yo, LC in adults
MC cause of cough in adults 40+
COPD
What condition is the most likely cause for each of the following percussive sounds of the lung:
- Flat (like thigh)
- Dull
- Resonant
- Hyperressonant
- Tympanic (like puffed out cheek)
- Pleural effusion
- Lobar pneumonia
- Normal lung, or could be bronchitis
- Emphysema, pneumothorax
- Pneumothorax
Normal lung sounds over the periphery can be described as ___________________ and there (is/is not) a pause between inspiration and expiration.
Normal lung sounds superior to the sternal notch can be described as ___________________ and there (is/is not) a pause between inspiration and expiration.
Vesicular (gentle rustling quality in inspiration that fades during expiration); is not
Bronchial (louder, higher pitch, louder on expiration); is
Bronchial sounds in the peripheral fields of the lung suggests which 3 possible conditions?
Consolidation:
- Pneumonia
- Atelectasis
- Fluid infiltration
True or false: a wheeze can usually be heard on both expiration and inspiration while crackles are usually on heard on inspiration
True
What is ronchi?
coarse rattling lung sounds caused by sputum in bronchi
What is rales/crackles? What is the ddx?
Discontinuous, brief crackle sounds due to:
a) airways that open/deform quickly (i.e. lung fibrosis)
b) movement of bubbles in aiway fluid (i.e. pulmonary edema, chronic bronchitis)
Fine crackles indicate a (dry/wet) cause of lung sounds while coarse crackle indicate a (dry/wet) cause.
Dry/wet
What are 3 causes of decreased transmitted voice sounds?
Asthma
Emphysema
Pleural effusion
COPD is the ___ leading cause of death worldwide
3rd
Why is the incidence of COPD increasing in women?
Many women started smoking in the 60s
Which 2 markers of lung function, measured by spirometry, are BOTH reduced in COPD?
FEV1
FEV1/FVC
What is the diagnostic criteria for chronic bronchitis
Daily productive cough for 3months or more in at least 2 consecutive years
Which spirometry value is decreased in chronic bronchitis?
FEV1 (25-75% reduction)
Because air can’t get out due to inflammation of bronchial tree
What is a “Blue Bloater”?
COPD patient with primarily chronic bronchitis (pursed-lip breathing, barrel chest, cyanosis, accessory respiratory muscle use)
What are 2 key markers of disease severity in COPD which should be asked about in the history?
- Breathlessness when wheezing present
2. Wheezing/whistling without a cold
What is the MC primary complaint of someone presenting with COPD?
Chronic productive cough (usually not dyspnea)
Will also have fatigue, frequent infections
What is a “pink puffer”?
Emphysema Dominant COPD
- Pink in color
- Air trapping
- Barrel chest
- Emaciated appearance
