Signs Flashcards
Asthma
Variability of symptoms
Hyper-expanded chest
Breathless on exertion
Different triggers
COPD
40+ Smoker (20+ pack year) Breathless walking into clinic Cyanosis CO2 flap Accessory breathing muscle use Asbestos exposure PMH childhood asthma
ARDS
Abnormal CXR (fluid accumilation)
History of trauma, sepsis or pneumonia
Hypoxaemia
Fine crackles in both lungs
Hypersensitivity pneumonitis
Abnormal CXR (Opacities, honycombing)
Tachypnoea
Coarse crackles at end of inspiration
Cyanosis
Severe weight loss
Idiopathic pulmonary fibrosis
Sarcoidosis
Abnormal CXR (bilateral hilar lymphadebopathy) Multisystem disorder
Idiopathic pulmonary fibrosis
Cyanosis Respiratory failure Pulmonary hypertension Fine bilateral inspiratory crackles 50+ years
Pleural effusion
Chest exam on affected side: -Reduced chest expansion -Breath sounds -Vocal Resonance -Stony dull percussion Clubbing Cervical lymphadenopathy Raised JVP Tracheal deviation Peripheral oedema
Pneumothorax
Reduced chest exapnsion, hyper-resonance and diminished breath sounds on affected side
In a tension pneumothorax the trachea moves away from affected site
In a non-tension pneumothorax the trachea moves towards the affected side
Pulmonary embolism
Cyanosis Tachypnoea Tachycardia Reduced BP Oedema Signs of RH failure Pyrexia
DVT
Fever
Pulmonary hypertension
Left parasternal heave Loud S2 Soft pan systolic murmur with tricuspid regurgitation RH failure Ascites Hepatomegaly
Tonsilitis/Pharyngitis
Painful cervical lymphadenopathy
Fever
White plaques in oral candidiasis
Erythema nodosum
Otitis Media
Erythema
Bulging eardrum
Glandular Fever
Palatal petachiae in throat
Acute bronchitis
Smoker or COPD
Cough develops to produce yellow/green sputum
Mild Fever
Neutrophil Leukocytosis
Pneumonia
Pyrexia Tachypnoea Central Cyanosis Dullness on percussion of affected lobe Bronchial breath sounds Inspiratory crepitations Increased vocal resonance
Bronchiectasis
Finger clubbing
Course inspiratory crepitations
Lung abscess
Persisting or worsening pneumonia
May be finger clubbing
Raised inflammatory markers
May see abscesses on CXR or CT
Empyema
Rising/elevated inflammatory markers
Exudative fluid w/ pH >7.2
Small cell carcinoma
Finger clubbing
Decreased breath sounds, wheeze and crackles on auscultation
Dullness to percussion
History of smoking or asbestos exposure
Non-small cell lung cancer
Finger clubbing
Decreased breath sounds, wheeze and and crackles on auscultation
Dullness to percussion
History of smoking and asbestos exposure
Cystic Fibrosis
Finger clubbing Presents in early childhood Worse at apices Low BMI Extensive crepitations Pancreatic insufficiency Diabetes Positive Guthrie test
TB
Patches of crepitations
Shadowing on CXR
Positive Mantoux test
Sleep apnoea
Obese Middle aged Male Pulmonary hypertension Type 2 respiratory failure
