Resp/HEENT, King, 10 questions on exam part II

Question 1

what do you insepct in oral cavity

Answer 1

teeth, gums, buccal mucosa, tongue surfaces, hard palate, posterior oropharynx

Question 2

What is thrush

Answer 2

oral infeciton from candida albicans

Question 3

what patients is thrush seen in

Answer 3

infants
immunosuppressed
patients on antibiotic Tx
patients on chemoTx
usually complain of irritation of the mouth and altered taste

Question 4

What is a geographic tongue

Answer 4

loss of papillae
linked to vit B deficiency
no Tx necessary

Question 5

what is a fissured tongue

Answer 5

genetic condition

asymptomatic and noticed on routine examination

Question 6

hairy leukoplakia

Answer 6

HIV
pipe smoking and chewing toabacco or snuff
may resemble thrush
usually painless
rarely undergoes malignant transformation

Question 7

characteristic oral carcinoma

Answer 7

generally aggressive cancers
chronic alcohol and smoking
delayed Dx because inadequate examination

Question 8

What type is tonsillar carcinoma and characteristics?

Answer 8

squamous cell
usually linke to HPV cells
often present late in the course of disease, few early Sx

Question 9

what is torus palatinus

Answer 9

hard bony growth in center of roof of mouth
not a tumor but rather a benign bony growth called exostosis
commonly in F >30
rarely needs Tx
sometimes removed to fit dentures

Question 10

What commonly causes tonsillitis

Answer 10

strep pyogenes

risk of rheumatic fever

Question 11

Tx tonsillitis

Answer 11

antibiotics to prevent rheumatic fever or tonsillar abscess formation

Question 12

colors of respiratory appearance

Answer 12

cyanotic (hypoxemia)
pink (emphysema, CO2 toxicity)
pallor (anemia)

Question 13

general appearance respiratory System includes

Answer 13

rate, effort, accessory mm use, cough, wheeze, nicotine staining of fingers

Question 14

what is included in inspection respiratory system

Answer 14

tracheal position, deformities of thorax, barrel chest or not

Question 15

what can displace trachea

Answer 15

mass or pneumo

Question 16

what is funnel chest and what causes it

Answer 16

pectus excavatum
depression of lower portion of sternum
compression of heart and great vessels can cause murmurs

Question 17

what is barrel chest

Answer 17

AP diameter is increased with age and COPD

lateral / AP chest diamtere is less than 2:1

Question 18

What is pectus carinatum

Answer 18

pigeon chest
sternum displaced anteriorly increasing AP diameter
adjacent costal cartilages are depressed

Question 19

palpation of respiratory exam inclues what

Answer 19

tenderness may indicate rib fracture
decreased motion with respiration may indicate bronchial obstruction or pleural effusion
subcutaneous emphysema is seen with pneumothorax
tactile fremitus is helpful in Dx consolidation

Question 20

describe reason for asuculatation lungs

Answer 20

majority info for PE

listengin to moving air so anything that alters the architecture will alter the flow

Question 21

What are the fissures in R lung

Answer 21

horiztontal and oblique

Question 22

what is the fissure in L lung

Answer 22

oblique

Question 23

What will lungs sound like in pneumonia

Answer 23

dec bs over affected area
sounds will be bronchial not vesicular
primary rhonci but sometimes wheezing

Question 24

percussion in pneumonia

Answer 24

dullness

Question 25

special tests for pneumonia

Answer 25

``` bronchophony (increased) tactile fremitus (increased) ```

Question 26

what does COPD sound like

Answer 26

dec bs thorughout lung fields | primarily wheezing but may have rhonci

Question 27

what is percussion like in COPD

Answer 27

hyperresonance

Question 28

what are special tests for COPD

Answer 28

``` bronchophony (dec) tactile fremitus (dec) ```

Question 29

What will CHF sound like in resp PE

Answer 29

dec bs in dependent portions lung | rales (Crackles)

Question 30

percussion in CHF lungs

Answer 30

unchanged or dec over dependent prtions

Question 31

special tests CHF in lungs

Answer 31

``` bronchophony (unchanged) tactile fremitus (unchanged) ```

Question 32

what will pneumo sound like in lungs

Answer 32

bs dec or absent on affected side

Question 33

percussion pneumo

Answer 33

marked hyperresonnance

Question 34

special tests pneumo

Answer 34

bronchophony | tactile fremitus both decreased

Question 35

what with pleural effusion sound like on PE

Answer 35

dec or absent on affected side

Question 36

what will percussion give in pleural effusion

Answer 36

dullness on affected side

Question 37

special tests for pleural effusion

Answer 37

``` bronchophony (unchanged) tactile fremitus (decreased) ```