RESPIRATORY

Question 1

Pneumonia

Answer 1

rhonchi, crackles, egophony, dullness on percussion, increased fremitus, wet cough STREP PNEUMONIAE most common cause

Gold Standard: CXR, sometimes CT

Question 2

Asthma

Answer 2

recurrent SOB, chest tightness, wheezing cough

Diagnostics:
< 80% FEV1 **
peak expiratory flow rates **

CXR: normal or hyperinflated
CBC: elevated esonophils

Question 3

pulmonary embolism

Answer 3

PLEURITIC CHEST PAIN

Question 4

croup

Answer 4

hoarse/seal bark/cough/fever

Question 5

anaphylaxis

Answer 5

a

Question 6

pneumothorax

Answer 6

unilateral chest pain, absent breath sounds, tracheal deviation, coke history, tall and thin

Question 7

COPD

Answer 7

Barrel chest, clubbing

polysomnography

COPD- OBSTRUCTIVE disease, over-inflated lungs, barrel-shaped chest
Includes emphysema, chronic bronchitis, bronchiectasis

Question 8

Epiglottitis

Answer 8

Caused by H. influenza B or Beta hemolytic strep

Muffled voice, drooling, high fever very ill-appearing very dangerous for airway obstruction
difficulty swallowing, beefy red epiglottis

Question 9

RSV

Answer 9

a

Question 10

viral URI

Answer 10

a

Question 11

Laryngeal obstruction would elicit what sounds

Answer 11

stridor

Question 12

Grating sound in left lower lobe

Answer 12

Rubs/grating sound-pleural or pericardial effusion-have them hold their breath!
Pleuritic chest pain

Question 13

Both pleural effusion and lobar pneumonia are characterized by ____ percussion

Answer 13

DULLNESS on percussion could be indicative of pneumonia or effusion

Question 14

acute vs chronic cough causes

Answer 14

Acute cough: viral RTI, bacterial infection (acute bronchitis), inhaled foreign body, inhalation of irritant,
Abnormal CXR: pneumonia, pneumonitis
< 3 weeks

Chronic cough: GERD, asthma, smoking, drugs (ACE)
Abnormal CXR: lung tumor, TB, bronchiectasis, interstitial lung disease
> 8 weeks

Question 15

Emergent Urgent Referrals

Answer 15

Emergent: PE (wells score - more than 4), foreign body aspiration, anaphylaxis, croup, status asthmaticus

Urgent: CHF, CAD/MI/ACS, Brady/Heart Block, PE, Pneumothorax, anaphylaxis, pericardial tamponade, aortic dissection?

Question 16

Cough Diagnostic Testing

Answer 16

CBC
CXR
Nasal Swab/Flu Swab
Sputum Culture

Question 17

Dyspnea

Answer 17

3 Causes:

• Abnormal breathing patterns
• Abnormal workload (restriction)
• Abnormal ventilation

Diagnostics: 
Pulse Ox 
CXR 
EKG 
D DIMER if history or suspect