Respiratory Flashcards
Hyperexpanded chest
COPD Chronic asthma
Postural flapping tremor
Acute CO2 retention
Stony dull percussion
Pleural effusion
Fine crepitations
Pulmonary oedema Pulmonary fibrosis
Pleuritic chest pain
Pulmonary embolism, pneumonia, pneumothorax
Stridor
Upper airway obstruction, e.g. foreign body, croup
Causes of clubbing
Bronchial Carcinoma Bronchiectasis Lung Abscess Empyema Cystic Fibrosis Cryptogenic fibrosing alveolitis mesothelioma TB NOT ASTHMA OR COPD
Kerley B lines Bat-wing shadowing
Heart failure
Tram-line shadowing
bronchiectasis
Miliary shadowing
miliary TB
Wedge-shaped infarct
Pulmonary embolus
Ground-glass appearance
fibrosis
honeycomb appearance
late fibrosis
Pleural mass with lobulated margin
mesothelioma
Early-onset emphysema plus liver disease Fever, cough, shortness of breath hours after exposure to antigen (usually farmer after hay exposure)
1-Antitrypsin deficiency Extrinsic allergic alveolitis
Asymptomatic with bilateral hilar lymphadenopathy (BHL)/progressive shortness of breath/dry cough Non-pulmonary manifestations, e.g. erythema nodosum ↑ serum ACE (angiotensin-converting enzyme) or hypercalcaemia may be mentioned
Sarcoidosis
History of recurrent chest infections, failure to thrive May mention steatorrhoea (pancreatic insufficiency) Positive sweat test (sodium, chloride 60 mmol/l)
Cystic fibrosis
Progressive dyspnoea and cyanosis Gross clubbing, fine end-inspiratory crackles Chest radiograph: ground-glass → honeycomb lung
Fibrosing alveolitis
Non-specific, e.g. fever, nightsweats, anorexia, haemoptysis Ziehl–Neelsen staining shows acid-fast bacilli (AFBs)
TB
Swinging fever, copious foul-smelling sputum Usually patient has persistent, worsening pneumonia
Lung abscess
Positive cold agglutinins
Mycoplasma infection
Occupation involving water systems
Legionella infection
Cavitating lung(s)
Staphylococcal/klebsiella infection
Contact with birds
Chlamydia psittaci infection
