Shortness Of Breath COPY

Question 1

Signs of dyspnea in pediatric patients

Answer 1

. Nasal flaring

. Retractions

Question 2

Signs of dyspnea in adult patients

Answer 2

. Accessory muscle use

. Tripod position

Question 3

Non-adherence to medications can trigger ____

Answer 3

Acute decompensation of chronic disease

Question 4

Orthopnea is assoc. w/ what disease?

Answer 4

Heart failure

Question 5

Paroxysmal Nocturnal Dyspnea is assoc. w/ what disease?

Answer 5

Heart failure

Question 6

Weight gain and swelling in ankles/legs assoc. w/ dyspnea can be caused by what disease?

Answer 6

Heart failure

Question 7

Highly suggestive signs assoc. w/ dyspnea

Answer 7

. Dullness to percussion of lungs (pneumonia, pleural effusion)
. Rales in lungs 
. S3 galllop 
. Edema of lower extremities
. JVD

Question 8

Abnormalities of lung parenchyma causing rales

Answer 8

. Pneumonia
. Interstitial lung disease
. Pulmonary fibrosis
. Pulmonary edema 
. Atelectasis (clear w/ cough)

Question 9

Abnormalities of airways that can cause rales

Answer 9

. Bronchitis (clear w/ cough)

. Bronchiectasis

Question 10

Fine crackles

Answer 10

. Sudden inspiratory opening of small airways held closed by surface forces during previous expiration

Question 11

Coarse crackles

Answer 11

. Bonuses of gas passing through airways as they open and close intermittently

Question 12

S3 gallop

Answer 12

. Extra heart sound during diastole (when heart is filling)

. Inc. blood volume causes fluid overload and heart failure

Question 13

Pitting edema

Answer 13

. Fluid overload
. Occurs during prolonged standing, immobilization, venous insufficiency, HF,and drugs (CCB)
. Caused by nephrotic syndrome, cirrhosis, and malnutrition

Question 14

Nonpitting edema

Answer 14

. Impaired lymph drainage

. Caused by: tumor, fibrosis, inflammation, lymph node disruption, capillary leak, hypothyroid (myxedema)

Question 15

Internal jugular pulsation

Answer 15

. Rarely palpable
. Inward deflection
. Eliminated by light pressure 
. Height changes w/ position
. Height falls w/ inspiration

Question 16

Carotid artery pulsation

Answer 16

. Palpable
. Single outward movement
.  Not eliminated by light pressure 
. Height unchanged by pulsation 
. Height not effected by inspiration

Question 17

Measuring jugular venous pressure

Answer 17

. Over 8 cm above sternal angle is abnormal
. Measure w/ right internal jugular because it is a direct drop into right atrium at whatever angle is needed to see highest point of pulsation of right jugular vein (doesn’t change w/ position)

Question 18

Measuring jugular venous distension

Answer 18

over 3cm above sternal angle is abnormal

Question 19

Etiology of evaluated JVP

Answer 19

. Elevated right atrial pressure sign of HF or left Heart abnormality
.

Question 20

Neuromuscular differential for dyspnea

Answer 20

Myasthenia gravis

Question 21

Lung differential for dyspnea

Answer 21

Pulmonary embolus, pneumonia, COPD

Question 22

Blood differential for dyspnea

Answer 22

Anemia

Question 23

Heart differential for dyspnea

Answer 23

HF, MI, aortic stenosis

Question 24

Blood tests for HF

Answer 24

. BNP. CMP
. CBC
. TSH
. Troponin
. lipid panel
. Urinalysis 
. GlycoHb

Question 25

Imaging for HF w/ anatomical basis

Answer 25

. Chest X-ray (cardiomegaly, cephalization, Kelley B lines, pleural effusion) . Echo . Angio

Question 26

Imaging for HF w/ physiological basis

Answer 26

. ECG . Echo . Stress testing

Question 27

What on chest X-ray supports HF diagnosis

Answer 27

. Cardiomegaly . Cephalization . Kerley B line . Pleural effusion