Respiratory Flashcards
Below what arterial oxygen saturation level is central cyanosis usually visible?
<90% if normal Hb level
Common causes of dry cough?
Asthma Lung cancer ILD LVF Medications (ACEI)
Causes of stridor?
Obstruction of extra-thoracic airways
- foreign body
- epiglottitis
- tumour
- inflammation
Respiratory causes of clubbing?
IPF
Lung cancer
Bronchiectasis / CF
What is Horner’s Syndrome?
What is relevance for Resp exam?
Ptosis
Meiosis
Anhydrosis
Can be due to Pancoast lung carcinoma with compression of sympathetic nerves in neck
Cause of tracheal tug?
Airflow obstruction with lung hyperexpansion
Causes of asymmetrical reduced chest expansion?
Consolidation Collapse Effusion PTx Fibrosis
Causes of bilateral reduced chest expansion?
COPD Restrictive lung disease - ILD - Obesity - kyphoscoliosis
Where should liver dullness to percussion usually begin?
5th rib midclavicular line
Causes of bronchial breath sounds?
Consolidation from infection or tumour
Collapse
Above effusion
Causes of reduced intensity of breath sounds?
COPD
Effusion
Collapse
PTx
Consolidation = clinical findings?
Palpation -> reduced chest expansion on affected side
Percussion -> dullness locally
Auscultation -> coarse inspiratory crackles locally / bronchial breath sounds
Vocal resonance -> increased
Lung collapse = clinical findings?
Trachea -> deviated towards collapse
Palpation -> reduced chest expansion on affected side
Percussion -> dull locally
Auscultation -> reduced breath sounds, crackles that clear with coughing
Pleural effusion = clinical findings?
Trachea -> if large can be deviated away
Palpation -> reduced chest expansion on affected side
Percussion -> stony dull locally
Auscultation -> reduced breath sounds, crackles above
Vocal resonance -> reduced
How can you differentiate between transudate and exudate?
Light’s criteria =
- Pleural fluid protein to serum protein ratio >0.5
- Pleural fluid LDH to serum LDH ratio >0.6
- Pleural fluid level >2/3 of upper value for serum LDH
What are causes of pleural effusion?
Exudate (High protein).
- Malignancy
- Infection
- Autoimmune / inflammatory
- Infarction
Transudate (Low protein <30g)
- CCF
- Liver cirrhosis / ascites
- Nephrotic syndrome / CKD
- Myxoedema
ILD = clinical findings?
General -> clubbing, CTD features
Palpation -> reduced chest expansion bilat
Percussion -> normal
Auscultation -> fine late-inspiratory crackles in affected zones
Causes of ILD -> upper lobes?
Upper = SCHART
- Silicosis / sarcoid
- Coal worker’s pneumoconiosis
- Histiocytosis
- Ank spond / ABPA
- Radiotherapy
- TB
Drugs which cause ILD?
Methotrexate
Bleomycin
Nitrofurantoin
Amiodarone
How many ribs should be seen in a normal CXR?
Up to 6 anterior
Up to 10 posterior
Causes of ILD -> lower lobes?
Lower = BRASID
- Bronchiectasis
- RA
- Asbestosis
- Systemic sclerosis
- IPF
- Drugs
