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Year 3 - OSCE Resp > Resp Exam > Flashcards

Resp Exam Flashcards

(58 cards)

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1
Q

What paraphernalia are you looking for when inspecting from the side of a bed?

A 
Inhalers
Sputum pots
Immunosuppressants 
Nebulisers 
Peak flow charts 
Thoracotomy scars
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2
Q

What would immunosuppressants suggest?

A

Pulmonary fibrosis

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3
Q

What would sputum pots suggest?

A

Bronchiectasis

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4
Q

What is bronchiectasis?

A

Chronic infection of bronchi leading to chronic dilation of the lungs

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5
Q

What are you inspecting for on the patient?

A 
Pigeon chest
Pectus excavatum 
Scoliosis
Kyphosis
Barrel chest 
Wheeze
Stridor 
Cyanosis
SOB
Cough
Cachexia
Use of accessory muscles 
Cushingoid appearance (steroid use)
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6
Q

What is stridor and what is it caused by?

A

High pitched wheezing

Obstruction

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7
Q

What are you looking out for on the hands? (ask patient to hold hands out)

A 
Cyanosis 
Thinning of skin (steroid use) 
Tar staining
Clubbing 
Wasting of small muscles
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8
Q

What do you call the test that specifically looks for the presence of clubbing?

A

Schamroth’s window test

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9
Q

What are the respiratory causes of clubbing?

A 
Suppurative conditions (ones that produce pus) 
Fibrosis / interstitial lung disease 
Lung cancer
Sarcoidosis 
TB
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10
Q

What do you test for on the arms?

A

Temperature (compare temp on both sides)

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11
Q

What else do you test for in the arms?

A

CO2 retention

Salbutamol use

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12
Q

Tremor of the hands would suggest?

A

Salbutamol use / b2 agonist use

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13
Q

CO2 retention flap is called

A

Asterixis

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14
Q

Explain a positive asterixis sign

A

Hypercapnia is often caused by hypoventilation; not enough o2 to brain

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15
Q

Rate and rhythm of radial pulse and respiratory rate

What is the normal respiratory rate per min?

A

12-20 breaths per minute

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16
Q

What could a raised JVP suggest?

A

Cor pulmonale

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17
Q

Briefly explain cor pulmonale

A

Cor (heart) pulmonale (lungs)
Pulmonary hypertension causes right ventricular hypertrophy as the heart finds it difficult to pump against the increased blood pressure, but this can lead to heart failure due to the narrowing of the space

?diastolic heart failure?

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18
Q

What are you looking for on the face?

A 
Cushingoid appearance 
Central cyanosis
Conjunctival pallor 
Plethora (redness of face)
Facial swelling
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19
Q

What would redness of the face indicate?

A

Polycythemia; can lead to respiratory distress

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20
Q

What would facial swelling indicate?

A

Lung cancer obstructing superior vena cava

or superior vena cava syndrome

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21
Q

What are you looking for on the mouth?

A

Central cyanosis
Angular stomatitis
Dental hygiene
Dehydration

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22
Q

What are you looking for when examining the trachea?

A

Distance from sternum - should be 2finger lengths

Deviation

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23
Q

Describe when you would see a reduced distance between the trachea and the sternum and state the name of this

A

Tracheal tug - reduced if pt has a hyperexpanded (barrel chest)

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24
Q

Give the name of a condition where patients often have tracheal tug

25
Explain barrel chest in patients with COPD / emphysema
Emphysema - damage to alveolar walls so air can't get out, therefore lungs are chronically overinflated, resulting in a barrel chest
26
The trachea deviates towards which direction with a collapsed lung?
Towards the collapsed lung (less holding it away)
27
The trachea deviates towards which direction with a pneumothorax or pleural effusion?
Away from the the lung with air or fluid
28
What do you call normal breath sounds?
Vesicular breathing
29
What kind of sound would suggest upper airway obstruction?
Stridor
30
What conditions sound wheezey?
Asthma and COPD sometimes viral wheezes
31
In what condition(s) can you hear COARSE crackles?
Pneumonia | Pulmonary oedema
32
In what condition(s) can you hear FINE crackles?
``` Pulmonary fibrosis Bronchitis Pneumonia CHF Atelectasis (lung collapse) ```
33
If there is increased vocal resonance (when the patient says '99'), what could this suggest?
Consolidation Lobar collapse Tumour
34
If there is decreased vocal resonance (when the patient says '99'), what could this suggest?
Pleural effusion
35
Give three causes of lymphadenopathy
Tumour Infection Sarcoidosis
36
Give two causes of reduced chest expansion
Lung cancer | Pneumonia
37
What are the four sounds during percussion?
Resonant Hyper-resonant Dull Stony dull
38
What might dull percussion suggest?
Consolidation or collapse | dull - solid
39
What might stony dullness percussion suggest?
Pleural effusion | stony dull - fluid
40
What might hyper-resonant percussion suggest?
Pneumothorax | hyper resonant - air
41
Which condition does not caues clubbing?
COPD
42
Most common cause of CO2 retention?
COPD
43
If the patient has warm hands, what may this suggest?
Hypercapnia (co2 retention)
44
Poor capillary refill may suggest?
Sepsis
45
What is pulsus paradoxus
Pulse volume decreases when patient breathes in | Sign of severe asthma or COPD
46
What is pulsus paradoxus and when is it seen?
Pulse volume decreases when patient breathes in | Sign of severe asthma or COPD
47
PLethoric complexion
Invades sympathetic plexus
48
If the chest bulges out, what's it called?
Pectus carinatum
49
Chest inspection
``` Are the patients in respiratory distress? Shape of chest -asymmetry Hyperexpansion (barrel chest) Pectus carinatum Pectus excavatum ``` Scars: Thoracotomy scar Median sternotomy scar Chest drains
50
Chest inspection
``` Are the patients in respiratory distress? Shape of chest -asymmetry Hyperexpansion (barrel chest) Pectus carinatum Pectus excavatum ``` Scars: Thoracotomy scar Median sternotomy scar Chest drains Dry skin Hyperkeratosis Telangiectasia
51
List 3 causes of apex beat displacement
Right ventricular hypertrophy Large pleural effusion Tension pneumothorax
52
Reduced chest expansion
Pulmonary fibrosis
53
Asymmetrical chest expansion
Pneumonia Pleural effusion Pneumothorax
54
Pleural rub - what does it sound like and causes
Someone walking on snow Mesothelioma Systemic disease like lupus or RA
55
After auscultation of the front what do you examine?
``` Lymph nodes Inspect for kyphosis and scoliosis Palpate chest expansion Percuss Auscultate ``` Sacral oedema Peripheral oedema
56
Explain how a malignant lymph node would feel
Rubbery Hard Fixed
57
Explain three causes of a lymph node enlargement
Sarcoidosis TB Lung cancer Upper respiratory track infection
58
List some examinations to do at the end of the resp exam
SPOT X ``` Sputum Peak flow Oxygen Temperature X ray ABC Spirometry Bronchoscopy ```

Year 3 - OSCE Resp (6 decks)

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