Clinical Examination And Signs Of Common Resp Diseases Flashcards Preview

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Flashcards in Clinical Examination And Signs Of Common Resp Diseases Deck (35)
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1
Q

What does SQITARS stand for?

A
Site
Quality 
Intensity 
Timing
Aggravating factors
Relieving factors
Secondary symptoms
2
Q

What are the 7 principle symptoms for respiratory conditions?

A
Chest pain
Breathlessness
Cough 
Sputum 
Haemoptysis 
Wheeze 
Hoarseness
3
Q

Describe pleuritic chest pain

A

Can be anywhere in the chest
Sharp
Made worse by deep inspiration and coughing

4
Q

Give some causes of pleuritic chest pain

A

Lobar pneumonia
PE
Infarction
Pneumothorax

5
Q

Define dyspnoea

A

An awareness that it is taking an abnormal amount of effort to breathe

6
Q

Give some common causes of breathlessness

A
Unfit
Infection 
Pleural effusion 
COPD
Anaemia
7
Q

How do we assess how bad dyspnoea is?

A

MRC dyspnoea score

1 - 5

8
Q

Give some characteristics that can describe coughing

A
Throat clearing 
Barking
With blood 
Painful 
Productive
9
Q

What is the likely cause of a cough lasting < 3 weeks?

A

Upper/lower resp tract infection

10
Q

What are some causes of a cough lasting > 3 weeks?

A
COPD
Asthma 
Reflux
Lung carcinoma 
Medication (ACEi)
11
Q

Give some causes of haemoptysis

A
Bronchitis 
Bronchial carcinoma
Pneumonia
Pulmonary infarction 
TB
12
Q

Give some causes of a wheeze

A

Asthma
COPD
Foreign body

13
Q

What gives hoarseness of voice?

A

Transient inflammation of vocal cords

Recurrent laryngeal nerve palsy (LHS)

14
Q

What drugs can give a wheeze as a side effect?

A

Beta blockers

15
Q

When we stand back and observe the patient in resp exam, what are we looking at?

A

Comfort
Breathing - fast, laboured, accessory muscle use
Medication/machines/oxygen around

16
Q

How can lung cancer give wasting of hands?

A

Apical lung tumours
T1 nerve root compression
Atrophy of muscles of hands

17
Q

What is a pigeon chest?

A

Prominent sternum/costal cartilage

18
Q

What is a funnel chest?

A

Depression of lower end of sternum

19
Q

What happens to vocal resonance with consolidation?

A

Increases

We can hear 99 more clearly through the stethoscope

20
Q

What investigations might you state for completion at the end of a resp exam?

A

Peak flow
Sputum exam and culture
Temperature

21
Q

What do we call the normal breathing sounds?

A

Vesicular

22
Q

Why might we get reduced chest movements on one side?

A

Pain
Lung collapse
Fluid
Obstruction

23
Q

Why might we get reduced chest movement on both sides of lungs?

A
Stiff lungs (ILD)
Hyperinflated (COPD, severe asthma)
24
Q

Why do you get reduced/absent breath sounds?

A

Air or fluid between lung and chest wall

25
Q

When is vocal resonance increased?

A

When bronchial breathing is present

26
Q

What is tactile vocal fremitus?

A

Palpable vocal resonance

27
Q

Describe how lobar pneumonia would appear in the clinical examination

A
Central trachea
Reduced chest movements on affected side
Dull percussion of affected area
Bronchial breath sounds 
Increased vocal resonance 
Crackles 
\+/- pleural ribs if spread to pleura
28
Q

Describe how pleural effusion would appear in the resp clinical exam

A
Mediastinum shifted away 
Reduced chest movements on affected side
Stony dullness over area 
Vesicular breast sounds (reduced intensity on affected side)
Reduced vocal resonance
29
Q

Describe how pneumothorax would appear in the resp clinical exam

A
Mediastinum shifted away 
Reduced chest movements on affected side
Hyperresonant over affected area
Reduced/absent breath sounds on affected side
Reduced vocal resonance
30
Q

Describe how lobar/lung collapse would appear in the resp clinical exam

A

Mediastinum pulled to affected side
Decreased chest movements on affected side
Percussion - normal or dull
Breath sounds decreased or absent where affected
Reduced vocal resonance

31
Q

Describe how localised lung fibrosis would appear in the resp clinical exam

A
Mediastinum pulled towards affected side
Chest movements reduced on affected side
Percussion = normal/dull
Vesicular breath sounds (+ crackles)
Normal or increased vocal resonance - because trachea is closer to affected part (pulled)
32
Q

Describe how diffuse lung fibrosis would appear in the resp clinical exam

A
Central mediastinum 
Symmetrically reduced chest movements 
Normal percussion 
Vesicular breath sounds (+ crackles) 
Normal/increased vocal resonance
33
Q

Describe how COPD/asthma would appear on a clinical resp exam

A

Central mediastinum
Chest movements reduced on both sides (already hyperinflated)
Resonant percussion (bullae may be hyperresonant)
Wheezing
Vesicular breath sounds
Normal vocal resonance

34
Q

Where does the liver normally start?

A

5th ICS

35
Q

What can happen to the liver in COPD?

A

May be pushed down by lungs
May be palpable in the abdomen
Lungs may stay resonant further down