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Respiratory exam signs Flashcards

1
Q

What might cachexia on resp exam mean?

A
  • Malignancy
  • Emphysema
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2
Q

What might a cushingoid appearance on respiratory examination indicate?

A

Steroid use

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3
Q

What might be a respiratory cause of speech abnormalities?

A

Recurrent laryngeal nerve palsy

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4
Q

What might cause stridor?

A

Large airway obstruction

  • Foreign body
  • Mediastinal mass/carcinoma
  • Retrosternal thyroid
  • Anaphylaxis
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5
Q

What might gurgling indicate on respiratory examination?

A

Resp secretions

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6
Q

What might a fine trmor in the hand in a patient with a respiraotry condition indicate?

A

B2 agonist use

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7
Q

What might a flapping tremor in someone with a respiratory condition indicate?

A

CO2 retention

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8
Q

What might sweaty/warm/clammy hands indicate?

A

CO retention

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9
Q

What are causes of finger clubbing?

A
  • Cyanotic heart disease
  • Lung causes
    • Abscess
    • Bronchiectasis
    • CF
    • Don’t say COPD
    • Empyema
    • Fibrosis
    • TB
    • Mesothelioma
  • Ulcerative colitis + Crohn’s
  • Bronchogenic carcinoma
  • Billiary cirrhosis
  • Infective endocarditis - subacute
  • Neoplasm
  • Gastrointestinal malabsorption syndrome(Coeliac disease)
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10
Q

What might tachycardia represent in asthma/COPD/infection/PE?

A

Hypoxia

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11
Q

What might a bounding pulse indicate?

A

CO retention

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12
Q

What might cause a plethoric face in a respiratory patient?

A
  • COPD - secondary polycythaemia
  • Cushing’s syndrome
  • SVC obstruction
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13
Q

What might cause telangiectasia/microstomia in a respiratory patient?

A

Systmeic sclerosis

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14
Q

What might cause a butterfly rash in a respiratory patient?

A

SLE

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15
Q

What might cause the following in a respiratory patient?

A

Lupus pernio - Sarcoidosis

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16
Q

What might cause the following in a respiratory patient?

A

Lupus vulgaris - TB

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17
Q

What would you look for in the neck on a respiratory examination?

A
  • JVP height
  • Tracheal deviation
  • Cricosternal distance/tracheal tug
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18
Q

When might JVP be raised in a respiratory patient?

A

Cor pulmonale

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19
Q

WHich side does can the trachea deviate in a pneumothorax?

A

Contralateral side

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20
Q

What side might the trachea deviate in lung collapse

A

Ipsilateral side

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21
Q

What might cause pectus carinatum in a respiratory patient?

A

Childhood resp disease

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22
Q

What might a barrel chest indicate in a respiratory patient?

A
  • Asthma
  • COPD
23
Q

What can cause asymmetrical chest movement indicate?

A
  • Fibrosis
  • Collapsed lung
  • Pneumonectomy
  • Pleural effusion
  • Pneumothorax
24
Q

What might generalised in-drawing intercostal muscles indicate?

A

Hyperinflation

25
What might cause localised in-drawing of intercostal muscles?
Bronchial obstruction
26
What might a dull percussion note indicate on percussion of a chest?
Consolidation or collapse
27
What might stony dull percussion indicate on percussion?
Pleural effusion
28
What might cause a hyperresonat chest indicate on percussion?
Increased air space - pneumothorax or emphysema
29
What might increased vocal resonance indicate?
Consolidation
30
What might decreased resonance indicate?
Effusion/pneumothorax
31
What are causes of decreased air entry on auscultation?
* **Emphysema** * **Pneumothorax** * **Pleural effusion** * **Collapse**
32
What might cause a wheeze on auscultation?
* **Asthma** * **COPD** * **Anaphylaxis** * **Cardiac wheeze**
33
What might cause fine inspiratory crackles?
Pulmonary oedema
34
What might cause fine end-inspiratory crackles?
Pulmonary fibrosis
35
What might cause bronchial breathing on auscultation?
Consolidation
36
What might cause a plerual rub?
* **Pleurisy** * **PE** * **PLeural malignancy** * **Pneumonia**
37
What would you check for in the legs in a respiratory exam?
* **Oedema** - cor pulmonale * **Swelling/tender** - DVT
38
How would you complete a respiratory exam?
* **Look at observations** * **Perform peak flow if asthmatic**
39
What are signs of pulmonary fibrosis?
* **Oxygen therapy** * **Dry cough** * **Tachypnoea** * **Reduced expansion** * **Clubbing** * **Fine end-expiratory crackles**
40
What else would you looked for if you saw signs of pulmonary fibrosis?
* **Signs of aetiology** * **Signs of complications** - Steroid use (cushingoid), loud P2/RV (cor pulmonale)
41
What are signs of aetiology of pulmonary fibrosis?
* **Hand deformity** - RA * **Clubbing** - IPF * **Clerodactyly/telangiectasia** - Slceroderma * **Butterfly rash** - SLE * **Lupus pernio** - Sarcoid * **Kyphosis** - Ankylosing spond.
42
What are signs of COPD?
* **Inhalers bedside** * **Accessory muscle use** * **Barrel chest** * **Tar-stained fingers** * **Tachypnoea** * **Pursed lip breathing** * **Tracheal tug** * **Indrawing of lower intercostals** * **Hyper-resonance** * **Quiet breath sounds/wheeze/prolonged exp. phase**
43
What are signs that someone has had a pneumonectomy?
* **Unilateral chest flattening** * **Thoracotomy scar** * **Tracheal deviation** * **REduced expansion** * **Dull to percussion** * **Reduced breath sounds** * **Bronchial breathing in upper zone**
44
What are signs of aetiology in someone who has had a pneumonectomy?
* **Cachexia** * **Clubbed** * **Tar-stained fingers**
45
What are signs of somone having had a lobectomy?
* **Thoracotomy scar** * **May be no other signs** * **May be some reduced expansion, dullness to percussion and reduced AE**
46
What are signs of aetiology that you might look for in someone with lobectomy?
* **Cachexia, clubbed, tar-stain** - lung cancer * **Wet cough, coarse crepitations** - bronchiectasis * **Signs of COPD -** bullectomy
47
What are signs of a pleural effusion?
* **Stony dull** * **Reduced air entry** * **Reduced vocal resonance** * **Reduced expansion**
48
What signs of aetiology would you look for in someone with suspected pleural effusion?
* **RA** - hand deformity * **Mesothelioma** - Clubbing/radiation marks * **SLE** - butterfly rash * **Malignancy** - lymphadenopathy * **Cirrhosis** - signs of chronic liver disease * **HF** - pulmonary/peripheral oedema
49
What are signs of bronchiectasis?
* **Productive cough** * **Inspiratory clicks** * **Clubbing** * **Coarse, late expiratory crepitations**
50
What are signs of aetiology of bronchiectasis?
* Young/thin - **CF** * Curved yellow nails and lymphoedema - **yellow nail syndrome** * Lymphadenopathy - **malignancy** * Dextrocardia - **Kartagener's**
51
What are signs of kyphoscoliosis?
* **Increased throacic forward curvature or lateral curvature** * **Reduced spine flexion/extension** * **Rib hump** * **Reduced chest expansion**
52
What are signs of lung cancer?
* **Cachexia** * **Clubbing** * **Tar-stained** * **Hard irregular lymphadenopathy** * **Radiation burns**
53

Examination findings (23 decks)

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