Respiratory system 5/5

Question 1

What some common differentials for someone who presents with a recent cough, shortness of breath and sharp chest pain on inspiration?

Answer 1

COVID19
Community acquired pneumonia (this is the most common and probably most likely)
Pneumothorax
Pulmonary embolism
Congestive cardiac failure
COPD

Question 2

What is the common initial treatment for community acquired pneumonia

Answer 2

Antibiotics

Question 3

What makes an x ray brighter?

Answer 3

More dense materials like bone

Question 4

Define consolidation

Answer 4

When small airways and alveolar air spaces are filled with material thats denser than air

Question 5

What materials can cause consolidation?

Answer 5

Cells (pus), fluid, blood, tissue (eg cancer)

Question 6

How does consolidation show up on a x ray?

Answer 6

Opacification (the material is more dense than air)

Question 7

If an asthmatic comes in with respiratory issues, what are some important questions to ask?

Answer 7

What was the onset like
Are they compliant to their medication?
Have they had any recent flares
have they had any ITU admissions related to their asthma

Question 8

What sound is fluid to percussion?

Answer 8

Dull

Question 9

What sound is air to percussion?

Answer 9

Resonant

Question 10

What does pneumothorax cause upon examination?

Answer 10

Reduced expansion of chest
Vocal fremitus will be abnormal
Breath sounds will be reduced
Percussion will be resonant

Question 11

What is a tension pneumothorax?

Answer 11

When air is let into the pneumothorax area but cannot get out

Question 12

Why is tension pneumothorax concerning?

Answer 12

It can collapse great vessels in mediastinum as it deviates to that direction as it continually expands

Question 13

What will show on an x ray in pneumothorax?

Answer 13

Lung field marking will be very reduced, it will also be darker as the xrays are going through air not tissue

Question 14

What is the safe triangle used in?

Answer 14

Insertion of chest drains

Question 15

What are the borders of the safe triangle?

Answer 15

Lateral border of pectoralis major
Level of the nipple (5th intercostal space)
Anterior border of latissimus dorsi

Question 16

What must you be careful to avoid during insertion of a chest drain and how is this done?

Answer 16

Avoid the neurovascular bundle by inserting the drain along the superior surface of the inferior rib

Question 17

Define pneumothorax

Answer 17

Collection of air between parietal and visceral pleura of the lung

Question 18

What are different classifications of pneumothorax?

Answer 18

They can be spontaneous, tension or traumatic and also primary or secondary

Question 19

What is pursed lip breathing?

Answer 19

When patients breath out with pursed lips, COPD patients may do this naturally as they feel less breathless breathing this way

Question 20

What will be seen in the xray of someone with COPD?

Answer 20

Lungs will be darker as they are hyper inflated
More ribs will be visible
Scalloping of the diaphragm

Question 21

How will a tumor show on xray?

Answer 21

Opacity

Question 22

What can develop due to local invasion from a lung tumor?

Answer 22

Horner’s syndrome