Investigations Flashcards
1
Q
What do bronchial breath sound like and what conditions are they heard?
A
- Loud and tubular
- High-pitched
- Inspiratory and expiratory phases equal
- Heard in: consolidation, lobar collapse, lung cavity
2
Q
What are the features of a wheeze?
A
- Continuous and musical quality
- Expiratory usually
- Indicates narrowing of bronchospasm or secretions in small airways
- High pitch (polyphonic) or sibilant using due to small airways - bronchospasm e.g. asthma
- Low pitch or sonorous (rhonchi) when small airways narrow due to secretions e.g. chronic bronchitis
- Monophonic - obstructing pathology
3
Q
Cracles/crepitations
A
- Peripheral airway collapse on expiration - interstitial fibrosis or secretions/fluid
- During inspiration, rapid air entry abruptly opens the smaller airways and alveoli
- Mid-inspiratory - pulmonary oedema
- Late inspiratory - pulmonary fibrosis, pulmonary oedema, COPD, lung abscess
- Biphasic in bronchiectasis
4
Q
ABG results and their conditions
A
- low pH and low HCO3 = metabolic acidosis
- low pH and high pCO2 = respiratory acidosis
- high pH and high HCO3 = metabolic alkalosis
- high pH and low pCO2 = respiratory alkalosis
5
Q
What are the common causes of metabolic acidosis?
A
- DKA
- Lactic acidosis
- Renal failure
- Chronic diarrhoea
6
Q
What causes respiratory acidosis?
A
- Pneumonia
- COPD exacerbation
- life-threatening asthma (decompensated)
- opiate overdose
- neuromuscular disease
- benzodiazepines overdose
- obesity hypoventilation syndrome
7
Q
What is the common causes of respiratory alkalosis?
A
- Hyperventilation
- PE
- CNS disorders: stroke, haemorrhage, encephalitis
- altitude
- pregnancy
8
Q
What is type 1 respiratory failure?
A
- Hypoxia
- Low pO2
- Normal or low pCO2
9
Q
What is type 2 respiratory failure?
A
- Ventilatory failure
- Low pO2
- Raised pCO2
10
Q
Differentials of wheezing
A
Bronchitis Broncholitis COPD CF Pneumonia Aspirating
