Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

awesomesauce fracp > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Clubbing: causes

A

RESP: lung carcinoma (usually not NSLC), chronic pulmonary suppuration (e.g. bronchiectasis, lung abscess, empyema), idiopathic pulmonary fibrosis, asbestosis, cystic fibrosis, pleural fibroma or mesothelioma, mediastinal disease (e.g. thymoma, lymphoma, carcinoma).
CVS: IE, cyanotic congenital heart disease
OTHER: IBD, cirrhosis, coeliac disease, thyrotoxicosis, brachial AV aneurysm or arterial graft sepsis (unilateral), neurogenic diaphragmatic tumours, familial or idiopathic, hemiplegic stroke (unilateral).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pleural effusion: transudate vs exudate

A

Transudate =
Pleural:serum protein <0.5
Pleural LDH <2/3 upper limit of normal
Pleural:serum LDH <0.6

Exudate=
Pleural:serum protein >0.5
Pleural LDH >2/3 upper limit of normal
Pleural:serum LDH >0.6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pleural effusion: causes of transudate

A 
Cardiac failure
Nephrotic syndrome
Liver failure
Meigs' syndrome (ovarian fibroma and pleural effusion)
Hypothyroidism (classically exudate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pleural effusion: causes of exudate

A 
Pneumonia
Neoplasm- lung Ca, metastatic carcinoma, mesothelioma
Tuberculosis, sarcoidosis
Pulmonary infarction
Subphrenic abscess
Pancreatitis (raised amylase)
CTD- RA, SLE (decreased complement)
Drugs- nitrofurantoin (acute), methysergide (chronic), drugs causing lupus, chemotherapeutic agents, bromocriptine
Radiation

If pH <7.2 = empyema, TB, neoplasm, RA, oesophageal rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Breath sounds: vesicular

A

normal, rustling leaves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Breath sounds: bronchial

A

Expiratory phase prolonged and has blowing quality

Causes: lobar pneumonia, localised fibrosis or collapse, above a pleural effusion, large lung cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Breath sounds: reduced

A

Causes: emphysema, large lung mass, collapse / fibrosis / pneumonia, effusion, pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Added sounds: wheeze (rhonchi)

A

Inspiratory wheeze = asthma or upper airway extrathoracic obstruction
Expiratory wheeze = asthma and COPD
Fixed inspiratory wheeze = monophonic and does not change with respiration; usually fixed bronchial obstruction (e.g. carcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Added sounds: crackles (crepitations)

A 
Late or pan inspiration:
- Fine = fibrosis
- Medium = LVF
- Coarse = bronchiectasis or retained secretions
Early inspiratory:
- Coarse = COPD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of haemoptysis

A

RESP: bronchitis, bronchial carcinoma, bronchiectasis, penumonia, pulmonary infarction, cystic fibrosis, lung abscess, TB, foreign body, goodpasture’s syndrome, rupture of a mucosal blood vessel after vigorous coughing.
CVS: MS (severe), acute LV failure
Bleeding diatheses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tracheal displacement: causes

A
  • TOWARDS side of lesion: upper lobe collapse, upper lobe fibrosis, pneumonectomy
  • AWAY from the side of the lung lesion (uncommon): massive pleural effusion, tension pneumothorax

Upper mediastinal masses such as goitre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chest wall deformity types

A

Pectus carinatum: pigeon chest (outward bowing of the sternum and costal cartilages)

Pectus excavatum: funnel chest (localised epression of the lower edge of the sternum)

Kyphoscoliosis: exaggerated forward curvature. Idiopathic (80%), secondary to poliomyelitis, Marfan’s.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Consolidation: CFx

A
  • Reduced expansion on affected side
  • Vocal fremitus: increased on affected side
  • Percussion: dull
  • Breath sounds: bronchial; can have medium, late or pan-inspiratory crackles as the pneumonia resolves
  • Vocal rub: increased
  • Pleural rub: may be present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Collapse: CFx

A

TRACHEA: displaced towards collapsed side
EXPANSION: reduced on the affected side with flattening of the chest wall on the same side
PERCUSSION: dull over the collapsed area
BREATH SOUNDS: reduced, with or without bronchial breathing above the area of collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Collapse: causes

A

INTRALUMINAL: mucus (e.g post op, asthma, CF), foreign body, aspiration
MURAL: bronchial carcinoma
EXTRA MURAL: peribronchial lymphadenopathy, aortic aneursym

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pleural effusion: CFx

A 
TRACHEA: displaced away if massive
EXPANSION: reduced on the affected side
PERCUSSION: stony dullness
BREATH SOUNDS: reduced or absent. May have bronchial breathing over effusion due to compression of overlying lung. 
VOCAL RESONANCE: reduced
17
Q

Pleural effusion: causes

A

TRANSUDATE: cardiac failure, hypoalbuminaemia (nephrotic syndrome, CLD), hypothyroidism, Meigs syndrome
EXUDATE: pneumonia, neoplasm (bronchial carcinoma, metastatic carcinoma, mesothelioma), TB, pulmonary infarction, subphrenic abscess, acute pancreatitis, CTD, drugs (cytotoxics), irradiation, trauma
HAEMOTHORAX: severe trauma, rupture of a pleural adhesion containing a blood vessel
CHYLOTHORAX: trauma or surgery to the thoracic duct, carcinoma or lymphoma involving the thoracic duct
EMPYEMA: pneumonia, lung abscess, bronchiectasis, TB, penetrating chest wound

18
Q

Pneumothorax: CFx

A

EXPANSION: reduced on the affected side
PERCUSSION: hyperresonance
BREATH SOUNDS: reduced or absent
Subcut emphysema

19
Q

Pneumothorax: causes

A

SPONTANEOUS: bullae rupture, emphysema with rupture of bullae, iatrogenic. Rarely asthma, lung abscess, bronchial carcinoma, eosinophilic granuloma, ILD, Marfan’s.
TRAUMATIC

20
Q

Bronchiectasis: CFx

A

SYSTEMIC: fever, cachexia, sinusitis (70%), clubbing, cyanosis (if severe)
SPUTUM: voluminous, purulent, blood stained
ASCULT: coarse pan-inspiratory or late inspiratory crackles over the affected lobe

If severe: copious sputum, clubbing, widespread crackles, signs of airway obstruction, signs of respiratory failure and cor pulmonale.

21
Q

Bronchiectasis: causes

A

CONGENITAL: primary ciliary dyskinesia, cystic fibrosis, congenital hypogammaglobulinaemia
ACQUIRED: infections in childhood, localised disease such as foreign body / bronchial adenoma / TB, allergic bronchopulmonary aspergillosis (proximal bronchiectasis)

22
Q

COPD: CFx

A

GENERAL: pursed lip breathing, barrel shaped chest, use of accessory muscles.
PALPATION: reduced chest expansion (<5cm), hyperinflated chest
PERCUSSION: hyperresonant
BREATH SOUNDS: decreased, early inspiratory crackles

Signs of RV failure in severe disease

23
Q

Pulmonary fibrosis: CFx

A

GENERAL: dyspnoea, cyanosis, clubbing
PALP: slightly reduced expansion
ASCULT: fine late inspiratory or pan-inspiratory crackles

Signs of associated CTD

24
Q

Pulmonary fibrosis: causes

A

UPPER LOBE: (SCHART)

  • Silosis, sarcoidosis
  • Coal workers pnuemoconiosis
  • Histiocytosis
  • Anklyosing spondylitis, allergic bronchopulmonary aspergillosis
  • Radiation
  • Tuberculosis

LOWER LOBE: (RASCO)

  • RA
  • Abestosis
  • Scleroderma
  • Cryptogenic fibrosing alevolitis
  • Drugs (busulphan, bleomycin, nitrofurantoin, hydralazine, MTX, amiodarone)
25
Q

Sarcoidosis: CFx

A

LUNGS: usually no signs, if severe pulmonary fibrosis
SKIN: lupus pernio (violaceous patches on the face, nose, fingers and toes), granulomata in old scars, erythema nodosum on the shins.
EYES: ciliary injection, anterior uveitis
LYMPH NODES: generalised lymphadenopathy
LIVER AND SPLEEN: enlarged (uncommon)
PAROTIS: enlarged (uncommon)
CNS: peripheral neuropathy (uncommon)
MSK: arthralgia, swollen fingers
HEART: heart block presenting as syncope, cor pulmonale (rare)
Signs of hypercalcaemia

26
Q

PE: CFx

A

GENERAL: tachycardia, tachypnoea, fever
LUNGS: pleural friction rub if infarction has occured
MASSIVE PE: elevated JVP, RV gallop, RV heave, TR murmur, increased P2

awesomesauce fracp (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions