Week 6

Question 1

Chest XR Interpretation

Answer 1

Airway, apices
Bones
Cardiac
Diaphragms
Extras
Frame

Question 2

Bronchial Pulmonary Dysplasia

Answer 2

common in premature infants

tachypnea, grunting, increased respiratory effort, retractions, irritability

Question 3

Pectus Excavatum

Answer 3

congenital

depression over breast bone

Question 4

Pectus Carinatum

Answer 4

Pigeon chest

opposite of depression- bowing of breast bone

Question 5

Croup

Answer 5

laryngo-tracheal-bronchitis
usually viral
generally worse at night 
inflammation of larynx, subglottic area 
barking or seal-like cough

Question 6

Pneumonia in Infants

Answer 6

inflammation of lung tissue
usually viral (over 5 yo)
crackles or rhonchi 
a negative CXR does not rule out!
very clinical dx

Question 7

Readiness to quit smoking

Answer 7

o	Ask about tobacco use
o	Advise to quit
o	Assess willingness to make a quit attempt 
o	Assist in quit attempt 
o	Arrange follow up

Question 8

fremitus

Answer 8

decreased when voice is higher pitched or soft when transmission of vibrations is impeded

Question 9

Causes of decreased fremitus

Answer 9

thick chest wall
obtructed bronchus 
COPD
pleural effusion 
fibrosis 
air (pneumothorax)
tumor

Question 10

Percussion: Flat

Answer 10

soft intensity
high pitched
short duration
ex: thigh

Question 11

Percussion: Dull

Answer 11

medium intensity
medium pitch
medium duration
ex: liver

Question 12

Percussion: Resonant

Answer 12

loud intensity
low pitch
long duration
ex: lung

Question 13

Hyperresonant

Answer 13

very loud intensity
low pitch
long duration

Question 14

Tympanitic

Answer 14

loud intensity
high pitch
long duration
ex: gastric air bubble

Question 15

Vesicular sounds

Answer 15

soft
low pitch
heard through inspiration

Question 16

Bronchovesicular sounds

Answer 16

intermediate intensity
with inspiratory + expiratory
detecting easier during expiration

Question 17

Bronchial sounds

Answer 17

louder, harsher, higher in pitch

short silence between inspiratory + expiratory

Question 18

Tracheal sounds

Answer 18

loud, harsh sounds

Question 19

Crackles- conditions heard in

Answer 19

Pneumonia
Interstitial Lung Disease 
Atelectasis 
Heart failure 
Bronchitis 
Bronchiectasis

Question 20

Fine late inspiratory crackles

Answer 20

abnormal lung tissue

Question 21

Pleural rubs- conditions heard in

Answer 21

Pleurisy
pneumonia
pulmonary embolism

Question 22

Causes of Chest Pain

Answer 22

Angina pectoris
MI
pericarditis
Aortic dissection
Pleuritic pain
GERD
Diffuse esophageal spasm 
costochondritis
Anxiety

Question 23

Causes of Dyspnea

Answer 23

Left sided heart failure 
Chronic bronchitis
COPD
Asthma 
Interstitial Lung Disease 
Pneumonia
Pneumothorax
PE
Anxiety with hyperventilation

Question 24

Laryngitis

Answer 24

dry cough

often with viral rhinosinusitis

Question 25

Acute Bronchitis

Answer 25

cough, dry or productive

acute, viral without fever

Question 26

Mycoplasma & Viral Pneumonia

Answer 26

dry hacking cough

may become productive of mucoid sputum

Question 27

Bacterial Pneumonia

Answer 27

sputum is mucoid, purulent, may be blood-streaked,

Question 28

Postnasal drip

Answer 28

chronic cough, sputum is mucoid or purulent

associated with allergic rhinitis

Question 29

bronchiectasis

Answer 29

chronic cough

purulent sputum, may be bloody

recurrent bronchopulmonary infections common

Question 30

GERD

Answer 30

chronic cough

wheezing

early morning hoarseness, repeated attempts to clear throat

Question 31

crackles

Answer 31

discontinuous nonmusical sounds

small airways are deflated during expiration, pop open with inspiration

Question 32

Fine crackles

Answer 32

softer, high pitched

mid to late inspiration

Question 33

Coarse crackles

Answer 33

lower frequency, longer duration

early inspiration, last through expiration

popping sounds over lobe

COPD, asthma, pna, bronchiectasis

Question 34

Wheezes

Answer 34

continuous musical sounds

occur during rapid airflow

Question 35

Rhonchi

Answer 35

variant of wheezes, lower in pitch

may disappear with coughing

Question 36

Stridor

Answer 36

continuous high pitch, high frequency

musical sound

during airflow through narrowing of tract

Question 37

Pleural Rub

Answer 37

discontinuous, low frequency , grating sound

d/t inflammation as it slides against pleura

nonmusical sound

biphasic

Question 38

Mediastinal Crunch

Answer 38

precordial crackles

synchronous with heartbeat

LL position, d/t air in mediastinum