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MDT > Respiratory MDT > Flashcards

Respiratory MDT Flashcards

1
Q

ACUTE - <3months

  • Cough with midline burning chest pain
  • Cough starts dry then progresses to productive
  • Fever
  • Dyspnea
  • Hemoptysis (possible)
  • Wheezing (possible)
  • Crackles/Rales (possible)

RHONCI THAT CLEARS WITH COUGHING

Smokers

A

Acute Bronchitis

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2
Q

How to differentiate between pnuemonia and bronchitis?

A

Chest x-ray will show lower lobe infiltrate

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3
Q
  • blood in the nose
  • respiratory distress
  • adventitious lung sounds
  • clubbing of the fingers (cancer)
  • skin rash
  • bruits/murmurs that increase with inhalation
  • smoking
  • cough
  • fever
A

Hempotysis

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4
Q

Immediate tx for hemoptysis?

A
  • Adequate O2

PATIENT POSITION
* on the affected side (protect non-effected lung from spillover blood)

PATENT AIRWAY
(DEFINITIVE AIRWAY)
* Large bore ET tube 8 or greater for interventional and diagnostic bronchoscopy

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5
Q
  • acute/subacute Fever
  • cough with or without sputum
  • dyspnea
  • tachypnea
  • tachycardia
  • ill appearing
  • diminished O2 sats

Sounds:
* crackles/rales
DULLNESS TO PERCUSSION

Smell
* Foul smelling productive cough suggests anaerobic infection

  • constitutional symptoms
A

Pnuemonia

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6
Q

Labs for hemoptysis?

A

CBC - hct/hb , wbc

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7
Q
  • Secondary to penetrating injury most common
  • Decreased breath sounds on affected side
  • Dullness to percussion on affected side
  • Respiratory distress
  • Hypotension
  • Tachypnea
  • Hypoxia
  • Flattened neck veins
  • Narrow pulse pressure
A

Hemothorax

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8
Q

Tx for hemothorax?

A

Airway
O2
Suctioning

Chest tube thoracostomy 36fr – 40fr

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9
Q
  • Diminished breath sounds
  • Hyper resonance on affected side
  • Decreased chest movement on affected side
  • Chest pain
  • Tachypnea
  • Tachycardia
  • Dyspnea
  • Guarding
A

Pnuemothorax

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10
Q

Treatment for worsening pnuemothorax?

A

14 guage 3.25 inch over the needle catheter

2nd intercostal space mid clavicular line over the top of the rib

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11
Q
  • Tracheal deviation away from distress
  • Resp distress
  • Tachypnea
  • Tachycardia
  • Hyperresonance to percuss
  • Decreased or absent breath sounds
  • Neck veins may be distended
A

Tension Pneumothorax

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12
Q
  • Cough >3 months w/ 2 consecutive years

* Productive Chronic Cough

A

Chronic Bronchitis

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13
Q
  • Over distention of the lungs (Barrell chest)
  • Decreased intensity of breath and heart sounds
  • Prolonged expiratory phase
  • Wheezing – airway obstruction
  • Dyspnea
  • Chronic cough
  • Pursed lips, accessory muscle use, retractions
A

Emphysema/ COPD

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14
Q
  • Dyspnea with exertion
  • Wheezing
  • Breathlessness
  • Chest tightness
  • Cough (night or early morning)
  • Airway can become inflamed and constricted
A

Asthma

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15
Q

Daytime somnolence
Loud snoring with apneic events
never feel rested

  • Obese
  • Large neck
  • fat old white guy
A

Obstructive sleep apnea

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16
Q

Disposition for OSA?

A

retain

17
Q
  • sudden onset of intermittent chest pain, localized
  • fleeting pain
  • Dyspnea
  • possible friction rub on auscultation
  • HX of injury/illness

** Chest pain worsens with coughing, deep breathing, sneezing ***

  • PAIN REFERRED TO IPSILATERAL SHOULDER
A

Pleuritis - Possibly caused by COVID-19, or the flu

18
Q

Disposition of pleuritis?

A

MEDEVAC if unstable or need cxr to identify issues

19
Q

Complaint:
* Acute or worsening dyspnea at rest
(SEVERE DYSPNEA)

Presentation

  • Tachycardia
  • Cyanosis
  • Diaphoresis
  • Pink frothy sputum (fluid leaking from vasculature into the lungs)

Auscultation

  • Crackles/Rales
  • Rhonchi
  • Expiratory Wheezing
A

Pulmonary Edema

20
Q

Predisposition of venous thrombosis (especially lower extremities)
Fam hx of thromboses

  • ACUTE dyspnea (always PE as differential)
  • ACUTE Pleuritic chest pain
  • Tachycardia, Tachypnea
  • Cough
  • Anxiety
  • Hemoptysis
  • Low fever
  • Hypotension
  • Cyanosis
  • Pleural friction rub
  • A-fib

VIRCHOW’s TRIAD

A

Pulmonary Embolism

21
Q

Tx for Pulmonary Embolism?

A

Lovenox

22
Q
  • Crepitus
  • Localized pain
  • Pain with inspiration
  • Dyspnea
  • Shallow/Fast breathing

Obvious trauma or history of trauma

A

Rib fracture

23
Q

Tx for rib fracture?

A

Stable Patient:
Incentive Spirometry
Pain Meds
Deep breathing exercises

24
Q
  • Segment of chest is floating

Pain (worse than rib fracture)
Respiratory Distress
Crepitus

  • Tachypnea with shallow respirations secondary to pain
  • Paradoxical movement
A

Flail chest

25
Q

Tx and Disposition for flail chest

A

MEDEVAC

26
Q

GEN 7
Productive Cough >2-3wks
Lymphadenopathy

Questions to Ask:

  • household exposure
  • incarceration
  • drug use
  • Travel to endemic area

Percussion
* Dullness with decreased fremitus

Auscultation
* Crackles inspiration or with cough

Extrapulmonary
* Clubbing

A

Tuberculosis

27
Q

Disposition for TB?

A

Medevac

28
Q

Hx of blunt chest trauma
HYPOXIA

Hemoptysis
Evidence of chest injury
Crackles
Decreased Breath sounds

A

Pulmonary Contusion

29
Q

3 H’s

  • Hoarseness
  • Hemoptysis
  • Hypoxia

Subq Emphysema

Persistent pneumo

A

Trachealbrachial Injury

30
Q
  • severe airway obstruction
  • Stridor
  • foreign object visualized in oropharynx
  • respiratory distress
A

Acute respiratory distress

MDT (17 decks)

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