Respiratory

Question 1

Some things you look for at the bed side

Answer 1

Sputum pot, inhalers, nebuliser

Question 2

What might cause wasting of the intrinsic muscles

Answer 2

T1 nerve invasion by an apical lung cancer

Question 3

Cause of a fine tremor

Answer 3

Beta agonists eg. Salbutamol

Question 4

Flapping asterixis is seen when

Answer 4

Respiratory failure

Question 5

Bounding pulse could mean

Answer 5

CO2 retention

Question 6

When is pulses paradoxus seen

Answer 6

Sever obstructive airways disease and cardiac tamponade

Question 7

What is cardiac tamponade

Answer 7

Effusion in the pericardium

Question 8

Raised JVP indicates

Answer 8

Cor pulmonale

Question 9

Raised non pulsatile JVP seen when?

What other features

Answer 9

Superior vena cava obstruction due to lung cancer

Oedema of the face and neck

Question 10

What is horner’s syndrome?

Signs

Answer 10

Damage to the sympathetic trunk
Miosis (constricted pupil), ptosis (a weak, droopy eyelid), apparent anhidrosis (decreased sweating), with or without enophthalmus (inset eyeball).

Question 11

What is chemosis

Possibly due to

Answer 11

Eye irritation

Hypercapnia 2* to COPD

Question 12

Facial swelling is seen in

Answer 12

SVC obstruction

Question 13

Which way does the trachea deviate with pathology ? Eg. Of each

Answer 13

Towards pulmonary fibrosis or collapse

Away from effusion or tension pneumothorax

Question 14

When would tactile vocal femitus be increased? Decreased?

Answer 14

Consolidation (sound travels quicker through solid)

Effusion / pneumothorax

Question 15

Lungs hyper resonant ?

Dull?

Answer 15

Pneumothorax

Consolidation / effusion

Question 16

When would you hear corse crackles?

Fine crackles?

Answer 16

Consolidation / oedema

Pulmonary fibrosis

Question 17

Cachexia features of

Answer 17

Malignancy , TB

Question 18

Stridor is obstruction of

Answer 18

Large airways

Question 19

Respiratory causes of clubbing

Answer 19

Cancer, fibrosing alveolits, abscess, bronchiectasis, empyema

Question 20

Wasting of small muscles of hand could be

Answer 20

Lung cancer involving brachial plexus

Question 21

Red, warm, clammy palms may indicate

Answer 21

Co2 retention

Question 22

Horners syndrome could be due to

Answer 22

Apical lung cancer compressing sympathetic nerves in neck

Ipsilateral pupil contraction And partial ptosis (drooping eyelid

Question 23

Raised JVP due to?

Respiratory cause

Answer 23

Right heart failure

Cor pulmonale

Question 24

Causes of pectus carinatum (pigeon chest)

Answer 24

Childhood asthma or rickets

Question 25

Causes of pectus excavatum (funnel chest)

Answer 25

Congenital

Question 26

Normal air entry sound is

Answer 26

Vesicular

Question 27

What are bronchial breath sounds ? | Associated with?

Answer 27

Loud inspiratory and blowing expiratory | Long consolidation and pulmonary fibrosis

Question 28

Cause of wheezes

Answer 28

Exhalation sounds caused by narrowed airways

Question 29

Early inspiratory crackles indicate

Answer 29

Obstruction in central airways

Question 30

Late inspiratory crackles indicate?

Answer 30

Shrunk lungs - lung fibrosis, pneumonia, heart failure

Question 31

What is pleural rub? How may it differ from secretary cause of crackles

Answer 31

Creaking sound of inflamed parietal pleura rubbing over visceral Remains unchanged after coughing and often has localised pain

Question 32

When would you get ankle oedema with respiratory disease

Answer 32

Cor pulmonale

Question 33

Mid axillary scar | Posterior chest scar

Answer 33

Chest drain | Lobectomy

Question 34

Bluish discolouration of nails indicated o2 sats of

Question 35

Flapping tremor seen in

Answer 35

Co2 retention - type 2 resp failure eg. COPD

Question 36

Raised JVP indicates

Answer 36

Pulmonary hypertension Fluid overload .....

Question 37

Barrel chest seen in

Answer 37

COPD

Question 38

Types of percussion sound

Answer 38

Resonant - normal Dull - consolidations , fluid tumour, collapse Stony dull - pleural effusion Hyper resonant - reduced density eg. Pneumothorax

Question 39

Auscultation sounds

Answer 39

Wheeze - asthma / COPD Coarse crackles - pneumonia / fluid Fine crackles - pulmonary fibrosis

Question 40

Lymph nodes raised in respiratory exam

Answer 40

Tb / lung ca

Question 41

To finish resp exam

Answer 41

``` O2 sats Provide o2 if indicated Request CXR if abnormality noted Peak flow assessment. Arterial blood gas if indicated Full cv exam if indicated ```