Things to know for the OSCE Resp Exam Flashcards
What are the respiratory signs of clubbing
- lung cancer
- pulmonary fibrosis
- bronchiectasis
- cystic fibrosis
- tuberculosis
- abscess
- empyema
What is a falling tremor indicative of
- ask patient to hold out their hands in front of them extended at the wrist for 30s
- CO2 retention
What medication can cause a fine tremor of the hand
- over use of beta agonists - salbutamol
What is bounding pulse indicative of
co2 retention
What are the respiratory cause of pulses paradoxes
- severe acute asthma/COPD
What are the signs of Horner syndrome
- Ptosis, mitosis, exophthalmos
- caused by compression of the sympathetic chain in chest cavity - Poncoast tumour, sarcoidosis, fibrosis
What can cause red sclera
- anterior uveitis - TB, sarcoidosis
What causes tracheal deviation away from the area
- Pneumothorax - large pleural effusion
What is causes tracheal deviation towords the area
- lung collapse
- pneumonectomy
What lung condition can still present with reduced symmetrical chest expansion
pulmonary fibrosis
What lung condition can cause asymmetrical reduced chest expansion
- pneumothorax
- pneumonia
- pleural effusion
What causes dull percussion
- increases density
- consolidation
- collapse
- pulmonary oedema
- abscess
What can cause stony dull percussion
pleural effusion
What can cause hyper-resonance
- over areas of reduced density
- pneumothorax
- emphysematous bullae
- COPD
What breathing type is normal
Vesicular
What causes bronchial breathing
- Caused by increased density of matter in the peripheral lung allowing sound from the larynx to the stethoscope unchanged
- hollow/blowing quality - consolation, lung abscess at chest wall, dense fibrosis, squashed lung above pleural effusion
What causes local lung volume reduction
- effusion
- tumour
- pneumothorax
- pneumonia
- lung collapse
What can cause global volume reduction
- COPD or asthma
What causes a polyphonic wheeze
- asthma
- COPD
When is a wheeze caused
on expiration
What causes a monophonic wheeze
- foreign body
- carcinoma
What causes stridor
- high-pitched extra-throacic breath sounds - upper airway obstruction
When are crackles heard
Inspiration
What is the difference between fine and coarse crackles
Coarse - early expiration = fluid and infection
fine - late expiration = fluid and fibrosis
What causes hyperresonance vocal resonance
- consolidation
- collapse
What causes decreased resonance in vocal resonance
- fluid
- air - pleural effusion and pneumothorax
What investigations would you carry out
- full set of abs
- cardiovascular examination
- peak flow
- sputum MC&S
- ABG
- CXR
