Clinical Case Y1S2 Flashcards
(18 cards)
Hypertension, control?
HT
diuretic and vasodilating drugs
Normal blood pressure range
BP 120/80 mmHg
Normal pulse rate
60-100 bpm in adults
Normal respiratory rate
12-18 breaths per minute in adults
Normal T range
36.5-37.3 C
Normal O2 saturation
95 or more
Normal lung sounds, aka?
vesicular: When air flows smoothly through the airways
Abnormal lung sounds can be caused by?
Caused by: swelling, blockages or mucus in the airways
Wheezes:
my notes
sibilant wheezes:
high-pitched, shrill, continuous sound, caused by an obstructed, narrowed airway usually heard on EXpiration may be heard in asthma, emphysema, chronic bronchitis
sonorous wheezes (rhonchi):
snoring, gurgling quality to them or are similar to a low-pitched moan, more prominent on EXpiration
can be caused by blockages to the main airways by mucous secretions, lesions or foreign bodies
common conditions: Pneumonia, chronic bronchitis and cystic fibrosis
Wheezes -
official version:
high frequency whistling noise, very specific to airway narrowing.
Focal or unilateral wheezes typically indicate focal pneumonia.
Diffuse or bilateral wheezes could mean upper airway bronchospastic disease or diffuse multifocal pneumonia.
Rales (crackles):
my notes
fine crackles:
fine, short, high-pitched intermittent crackling sounds, similar to the sound of hair being rubbed b/w the fingers near the ear
can be caused from air passing through fluid, pus or mucus
coarse crackles:
lower-pitched and moist-sounding, like pouring water out of a bottle or ripping open velcro
sign of adult respiratory distress syndrome (ARDS), early congestive heart failure, asthma or pulmonary oedema
commonly heard in the bases of the lung lobes during INspiration
Rales -
scratch sound quality evident when fluid fills up in the alveolar and interstitial spaces.
These sounds can be focal and coarse in localized areas of pulmonary oedema or consolidation in pneumonia.
Diffuse and fine crackles are more typical of pulmonary fibrosis, but can also be present in atypical types of pneumonia.
Types of tests available for COVID-19 detection (2)
- Real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) from a nasopharyngeal swab sample (includes viral particles => viral RNA detection). PCR: amplifies the viral cDNA to produce many copies => highly sensitive
Viral RNA =reverse transcriptase=> cDNA =DNA polymerase=> cDNA (35-40 copies)
- Antigen tests (rapid tests/self tests): viral antigen detection
from nasal/ nasopharyngeal swab
Sensitivity of diagnostic test:
- the proportion of people with the disease that have a positive test
sensitivity/detection rate - ability of a test to correctly identify (detect) someone with the disease OR the probability that someone with the disease is detected by test
sensitivity = true positives / (true positives + false negatives)
Specificity of a diagnostic test:
- the proportion of people without the disease that have a negative test => ability of a test to correctly identify someone without the disease OR the probability that someone without the disease is identified as such (tests negative) by test
specificity = true negatives / (false positives + true negatives)
Difference b/w COVID diagnostic tests:
rapid tests have good specificity but rather low sensitivity/detection rate
PCR tests have both good sensitivity and specificity
whiteness seen in the lungs =
Density of the lungs increases
potential chest radiograph findings in covid-19 pneumonia
The chest radiograph may be normal in up to 63% of people with covid-19 pneumonia, particularly in the early stages.
Changes include ground glass (68.5%), coarse horizontal linear opacities, and consolidation. These are more likely to be peripheral and in the lower zones, but the whole lung can be involved.
Ground glass appearance is common in earlier presentations and may precede the appearance of consolidation. Bilateral lung involvement is most common (72.9%).
