Signs

Question 1

What are rhonchi? What are they caused by?

Answer 1

Rhonchi are breath sounds heard throughout inspiration and expiration

• ‘Gurgling, snoring’ sounds eg. like scuba diving
• Due to secretions in the airways
• Go away with coughing
• Due to COPD, bronchiectasis, pneumonia, bronchitis etc

Question 2

What are crackles? What are they caused by?

Answer 2

Crackles aka rales aka creps. They can be fine or coarse
Coarse:
-Usually found in inspiration + expiration
-Low pitched popping sound - like shovelling rocks lol
-Due to excess fluid in lungs
-eg. pulmonary oedema, bronchiectasis, pneumonia, COPD

Fine:

• Usually inspiratory. Fibrosis are late, COPD early
• High pitched - like stepping on fresh snow
• eg. pulmonary fibrosis, CCF, COPD

Question 3

What are the causes of clubbing?

Answer 3

Various causes in different systems:

• Respiratory: Ca, bronchiectasis, CF, fibrosis
• Cardiac: CHD
• GI: cirrhosis, IBD, coeliac
• Other: thyroid acropachy

Question 4

What are reticular and reticulonodular shadowing/opacification? What can they be caused by?

Answer 4

Reticular: predominantly linear opacification

• Fibrosis eg. IPF, RA, drugs
• Pulmonary oedema
• Interstitial pneumonia eg. PCP

Reticulonodular: linear and nodular (dots)

• Can be same causes as reticular
• Interstitial lung disease