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Clinical Physical Diagnosis > Respiratory part II > Flashcards

Respiratory part II Flashcards

1
Q

Croup Prodrome sx (5)

A
  1. mild uri
  2. nasal congestion
  3. sore throat
  4. cough
  5. low-grade fever
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2
Q

Croup later sx (3)

A

1 stridor
2 hoarse voice
3 seal bark-like cough

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3
Q

Croup course

A

3-5d, resolves 4-7 days

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4
Q

Croup PE

A

distress from airway obstruction

mild expiratory wheezing

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5
Q

Croup sever PE

A

tachypnea
tachycardia
inspiratory stridor

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6
Q

DDx Croup (SOB and stridor)

A

Epiglottitis
Forgein Body
Diptheria
Retropharyngeal abscess

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7
Q

Acute Bronchitis sx

A

Cough > 5 days with sputum production

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8
Q

Acute Bronchitis PE (5)

A 
low fever
wheezing suggests bronchospasms
Rhonchi
Normal percussion 
no changes in transmitted voice tests
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9
Q

Acute bronchitis ddx (5)

A 
1 chronic bronchitis (if chronic)
2 pneumonia (usually sicker)
3 post-nasal drip
4 GERD
5 asthma
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10
Q

Pneumonia org?

which is most concerning

A

Viral, bacterial, fungal

Bacterial is most concerning

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11
Q

4 classifications of pneumonia

A
  1. community-acquired
  2. Nosocomial pneumonia
  3. Ventilator-associated pneumonia
  4. Healthcare-associated pneumonia
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12
Q

Bacterial pneumonia PE (5)

A 
1 looks sick
2 high fever
3 + egophony
4 dullness to percussion
5 pallor
6. tachycardia
7 bradycardia
8 rhonchi
9 increased tactile fremitis
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13
Q

Bacterial pneumonia general sx

A
  1. rapid breathing
  2. SOB
  3. abdominal pain
  4. severe fatigue
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14
Q

Bacterial organisms pneumonia

A 
Pneumococcus- bloody rust sputum, shaking and chills
Pseudomonas- green sputum
Haemophilus- green sputum
Klebsiella- current jelly
Legionella- HA, malaise, n/v, anorexia,
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15
Q

Work up pneumonia

A

CXR-dense shadow with demarcated borders

CBC

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16
Q

Prognosis of bacterial pneumonia

A

3-5 days of tx if uncomplicated

17
Q

Bacterial pneumonia complications

A
  1. lung abscess
  2. pleural effusion
  3. empyema
18
Q

Pneumonia: Age

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. any
  2. any, but typically older kids and young adults
  3. any
19
Q

Pneumonia Sputum

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. copious, rusty, purulent, blood-streaked–many PMNs on gram stain
  2. Scant, Thin, Microscopic exam; no bacteria
  3. Scant, thin, sparse organism, PMNs and macrophages, clumps of resp epithel. cells
20
Q

Pneumonia URI

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. Precedes
  2. Concorrent
  3. Precedes
21
Q

Pneumonia Fever

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. High
  2. Low/absent
  3. Varies
22
Q

Pneumonia Onset

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. Rapid
  2. Gradual/mild
  3. Gradual
23
Q

Pneumonia Myalgia

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. Absent
  2. Present
  3. Varies
24
Q

Pneumonia Toxic Appearance

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. Present
  2. Absent
  3. Absent
25
Q

Pneumonia CXR

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. Pulmonary infiltrate, consolidation, unilateral
  2. Varies interstitial pneumonia
  3. WNL, may be diffuse lower lobe infiltrate, may be consolidation
26
Q

Pneumonia WBC

  1. Bacterial
  2. Viral
  3. Mycoplasma
A
  1. 15,000+ count
  2. Low, WNL or slight inc
  3. WNL or slight inc
27
Q

Mycoplasma Pneumonia dx (4)

A

PCR
EIA serology
NO bacteria found on gram-stained sputum sample
CXR may have no findings or some diffuse infiltrate

28
Q

Pneumocystis jirovecii pneumonia

bacterial, viral, fungal?

29
Q

Pneumocystis jirovecii is often deadly in what population?

A

AIDS infected

30
Q

Complications of pneumocystis jirovecii? (2)

A

Spontaneous pneumothorax

hypoxemia

31
Q

Coccidioidomycosis is also known as?

A

San Joaquin Valley fever and desert rheumatism

32
Q

Etiology of coccidioidomycosis?

A

soil fungus in arid conditions

33
Q

Sxs coccidioidomycosis?

A
  1. self-limited respiratory tract infection, occurs 1-3 weeks after exposure–MOST subclinical
  2. non-specific complaints–fever, cough,chest pain
  3. Disseminates in immunocompromised and when it does to CNS—meningitis; headaches
34
Q

Coccidiodomycosis work-up

A

CBC- eosinophilia, lymphocytosis, monocytosis
CXR: Infiltrates can range from segmental or lobar to diffuse reticulonodular
Skin testing, delayed-type hypersensitivity rxn may become pos in 1-3 wks

35
Q

Diagnosis of Coccidioidomycosis

A

Clinical suspicion and hx of possible exposure or travel to an endemic area

36
Q

Allergic Bronchopulmonary Aspergillosis sputum

A

brown flecks in it

37
Q

Allergic Bronchopulmonary Aspergillosis picture

A

pt already has asthma and then develops cough, wheezing, dyspnea worse, low fever

38
Q

Histoplasmosis also known as

A

spelunkers lung

39
Q

Histoplasmosis sx
Acute
Chronic
Disseminated

A

A-fatigue, fever, chills, chest pain, dry cough ~10 d post exp)
Ch- persistent or relapsing
Dis-

Clinical Physical Diagnosis (4 decks)

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