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Pulmonology > Approach to Pulm > Flashcards

Approach to Pulm Flashcards

(45 cards)

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1
Q

The carina bifurcates at what spinous level?

A

T4-T5

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1
Q

Describe Cheyne-Stokes Respirations and what conditions you might see them in.

A

Crescendo/decrescendo respirations with pauses of apnea. Could be caused by a stroke/brain injury. Common condition

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1
Q

Describe Wheezes and what conditions you might hear them in?

A

Inspiratory and expiratory High pitched and musical in quality (narrowed airway) Might see in Asthma, brochospasm

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3
Q

What condition might cause rusty colored sputum?

A

Pneumococcal pneumonia

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4
Q

A line drawn between the inferior lungs crosses what spinous process?

A

T10

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4
Q

A flat/dull percussion sound generally indicates what pathology?

A

Pleural Effusion or Lobular Pneumonia

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4
Q

What are pulmonary angiograms useful in detecting in the lungs?

A

Definitive diagnosis for pulmonary embolism.

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5
Q

What constitutes a good sputum sample?

A

Contamination = 10-25 squamous epithelial cells (inadequate) Alveolar macrophages 1 dominant pathogen

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7
Q

Where is the sternal angle (angle of Louis) located?

A

Approx 5 cm inferior to jugular notch T4 Level Posteriorly Second costal cartilage/space anteriorly

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7
Q

What conditions might you hear fine crackles in?

A

Fine (rubbing of hair) - diffuse interstitial disease, fibrosis, atelectasis, pneumonia, CHF

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7
Q

What are ultrasounds useful in detecting in the lungs?

A

Small amounts of pleural fluid, walled off compartments (loculations) within pleural effusions, distinguishing between pleural thickening

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8
Q

A hyperresonant percussion sound generally indicates what lung conditions?

A

Emphysema or Pneumothorax

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9
Q

Describe Crackles in the lungs.

A

On inspiration. High pitch and discontinuous

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10
Q

What space do you put a chest tube in?

A

4th Intercostal

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10
Q

A sudden onset of hemoptysis can be indicative of what condition?

A

Pulmonary Embolus

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11
Q

What area of the back does the scapula span?

A

2-7th rib

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12
Q

What is a VQ scan?

A

A scan that evaluates both airflow and blood flow in the lungs. Done by breathing in radioactive xenon.

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13
Q

Which lung lobes are more prominent anteriorly?

A

The upper lobes

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14
Q

What intercostal space is the nipple located at in men?

16
Q

What level is the xyphoid at?

18
Q

What pathogens might cause foul smelling sputum?

19
Q

Describe Rhonchi and what conditions you might hear them in.

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A

Snoring or gurgling quality. Pneumonia, Consolidation

20
Q

What landmark lies at T3?

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A

Jugular notch

20
Q

What are CTs good for when viewing the lungs?

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A

Viewing lung tumors, mediastinal masses, soft tissue disorders

21
What condition might cause purulent pus (yellow, green) sputum?
Acute/Chronic bronchitis (yellow to brown associated with G- bacteria)
22
A line drawn between the inferior angle of the scapula crosses what vertebral bodies?
T7-T8
24
What is the Pulmonary Embolus triad?
hemoptysis, dyspnea, chest pain
25
What condition might cause bloody sputum?
Tuberculosis
26
Describe Kussmaul's respirations and what condition you might see them in.
Fast breathing, full tidal volume, metabolic acidosis (DKA)
27
Describe a mediastinal crunch and what conditions you might hear them in.
Precordial crackles synchronous with heart beat. Pneumomediastinum, called Hamman's sign
29
A slightly blood tinged sputum (hemoptysis) might be indicative of what conditions?
Sinusitis, bronchitis, pneumonia. non-emergent
30
Describe Ataxic (Biot's) Respirations and what conditions you might see them in.
Fast breathing, full tidal volume, with apnea between episodes. Could be caused by a medullary lesion.
31
Persistent hemoptysis can be indicative of what conditions?
Tuberculosis Cancer
31
What procedures can be done through a bronchoscope?
Direct visualization of airways Collection of various samples Brushings, transbronchial needle aspiration, endobronchial biopsy, transbronchial biopsy
32
A healthy/resonant percussion sound generally indicates what lung conditions?
Normal lungs or Bronchitis
33
What conditions might you hear course crackles in?
Course (blowing bubbles in water) - severe COPD Louder, lower in pitch, not quite as brief
34
What might heavy hemoptysis be indicative of?
Vascular origin
35
When is a VQ scan useful?
Decreased perfusion and normal ventilation = PE Blood clots is suspected in areas that have good airflow but poor blood flow.
37
Describe Apneustic respirations and what conditions you might see them in.
steady respirations with normal inspirations, but shallow expirations. Could be caused by midbrain/pons lesions, CHF, renal failure, or sleeping (child/elder)
40
Which lung lobes are more prominent posteriorly?
The lower lobes
41
What sounds might be abnormal with consolidation?
Bronchophony - 99 Egophony - ee Whispered pectoriloquy - 99 whispered
42
What is the x-ray pneumonic?
A - Airway, Adenopathy B - Bones, Breast C - Cardiac Shadow D - Diaphragm E - Everything else (soft tissue) F - Fields (lung, vascular)
43
What condition might cause pink-tinged, foamy or frothy white sputum?
Pulmonary edema
44
Describe Stridor and what conditions you might hear them in.
Inspiratory wheeze from upper airway obstruction (croup) Epiglotitis, extubation reaction. Might need to emergency crike them!
45
Describe a pleural (friction) rub and what conditions you might hear them in.
Sound generated from inflammed pleural surfaces rubbing together. Pleuritic chest pain

Pulmonology (4 decks)

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