resp PCD

Question 1

What are the primary anatomical components of the respiratory system?

Answer 1

Nose, pharynx, larynx, trachea, bronchi, bronchioles, lungs, and alveoli.

Question 2

Where does gas exchange occur in the lungs?

Answer 2

In the alveoli.

Question 2

What controls breathing?

Answer 2

Respiratory centers in the brainstem and chemoreceptors.

Question 2

What are common causes of hemoptysis?

Answer 2

Bronchitis, bronchiectasis, TB, lung cancer, pulmonary embolism.

Question 3

What type of sputum is typical in pulmonary edema?

Answer 3

Frothy sputum.

Question 4

What defines dyspnea?

Answer 4

A subjective sensation of shortness of breath.

Question 5

What should you consider in a patient with a chronic cough?

Answer 5

GERD, post-nasal drip, chronic bronchitis, ACE inhibitor use.

Question 6

What is pleuritic chest pain?

Answer 6

Sharp pain worsened by breathing or coughing.

Question 7

What is the difference between central and peripheral cyanosis?

Answer 7

Central: lips/tongue; Peripheral: fingers/toes.

Question 8

What symptoms are associated with obstructive sleep apnea?

Answer 8

Daytime sleepiness, snoring, morning headaches, witnessed apneas.

Question 9

What does asymmetric chest expansion suggest?

Answer 9

Underlying pathology such as pneumothorax or consolidation.

Question 10

What is tactile fremitus and what does increased fremitus indicate?

Answer 10

Vibration felt during speaking; increased in consolidation.

Question 11

What breath sounds are normal in peripheral lung fields?

Answer 11

Vesicular breath sounds.

Question 12

What condition is associated with crackles (rales)?

Answer 12

Pneumonia, pulmonary fibrosis, CHF.

Question 13

What percussion finding is typical in pleural effusion?

Answer 13

Dullness to percussion.

Question 14

What does a positive egophony test suggest?

Answer 14

Lung consolidation (“ee” becomes “ay”).

Question 15

What are rhonchi associated with?

Answer 15

Mucus in larger airways, typically bronchitis.

Question 16

What does whispered pectoriloquy indicate?

Answer 16

Lung consolidation if whispered sounds are louder.

Question 17

What are the hallmark symptoms of asthma?

Answer 17

Wheezing, chest tightness, cough, dyspnea.

Question 18

What exam finding might you see in a severe asthma attack?

Answer 18

Decreased breath sounds due to air trapping.

Question 19

What causes atelectasis?

Answer 19

Obstruction (e.g. mucus plug) or compression (tumor, effusion).

Question 20

What physical sign may indicate large volume atelectasis?

Answer 20

Tracheal deviation toward the affected side.

Question 21

What are typical signs of pneumonia on physical exam?

Answer 21

Crackles, bronchial breath sounds, dullness to percussion, egophony.

Question 22

What are the symptoms of pneumonia?

Answer 22

Fever, chills, cough with sputum, pleuritic chest pain.

Question 23

What distinguishes lung abscess sputum?

Answer 23

Foul-smelling, purulent sputum.

Question 24

What are common risk factors for lung abscess?

Answer 24

Aspiration, poor dental hygiene

Question 25

What causes pleuritic chest pain in pleurisy?

Answer 25

Inflammation of the pleura.

Question 26

What sound may be heard in pleurisy?

Answer 26

Pleural friction rub.

Question 27

What are the signs of pneumothorax?

Answer 27

Sudden dyspnea, hyperresonance, absent breath sounds.

Question 28

What is a hallmark sign of tension pneumothorax?

Answer 28

Tracheal deviation away from the affected side.

Question 29

What are the physical exam findings in Normal lungs?

Answer 29

Percussion: Resonant Trachea: Midline Breath Sounds: Vesicular (normal) Adventitious Sounds: None (maybe a few transient inspiratory crackles at bases) Tactile Fremitus/Voice Sounds: Normal

Question 30

What are the findings in Left-Sided Heart Failure?

Answer 30

Percussion: Resonant Trachea: Midline Breath Sounds: Vesicular Adventitious Sounds: Late inspiratory crackles at bases; possibly wheezes Tactile Fremitus/Voice Sounds: Normal

Question 31

What are the findings in Chronic Bronchitis?

Answer 31

Percussion: Resonant Trachea: Midline Breath Sounds: Vesicular Adventitious Sounds: Scattered coarse crackles; wheezes or rhonchi possible Tactile Fremitus/Voice Sounds: Normal

Question 32

What are the findings in Lobar Pneumonia (Consolidation)?

Answer 32

Percussion: Dull over affected area Trachea: Midline Breath Sounds: Bronchial over involved area Adventitious Sounds: Late inspiratory crackles Tactile Fremitus/Voice Sounds: Increased (egophony, bronchophony, whispered pectoriloquy)

Question 33

What are the findings in Partial Lobar Obstruction (Atelectasis)?

Answer 33

Percussion: Dull Trachea: May shift toward involved side Breath Sounds: Usually absent Adventitious Sounds: None Tactile Fremitus/Voice Sounds: Usually absent (may be increased in right upper lobe)

Question 34

What are the findings in Pleural Effusion?

Answer 34

Percussion: Dull to flat Trachea: Shifted to opposite side (if large) Breath Sounds: Decreased/absent; bronchial near top of effusion Adventitious Sounds: Possible pleural rub Tactile Fremitus/Voice Sounds: Decreased/absent (increased near top if large)

Question 35

What are the findings in Pneumothorax?

Answer 35

Percussion: Hyperresonant or tympanic Trachea: Shifted to opposite side (if tension pneumothorax) Breath Sounds: Decreased to absent Adventitious Sounds: None or pleural rub Tactile Fremitus/Voice Sounds: Decreased to absent

Question 36

What are the findings in COPD?

Answer 36

Percussion: Diffusely hyperresonant Trachea: Midline Breath Sounds: Decreased/absent with delayed expiration Adventitious Sounds: Crackles, wheezes, rhonchi (esp. if chronic bronchitis) Tactile Fremitus/Voice Sounds: Decreased

Question 37

What are the findings in Asthma?

Answer 37

Percussion: Resonant to diffusely hyperresonant Trachea: Midline Breath Sounds: Often obscured by wheezes Adventitious Sounds: Wheezes, possibly crackles Tactile Fremitus/Voice Sounds: Decreased

Question 38

How can you differentiate Pleural Effusion

Answer 38

Percussion: Pleural Effusion: Dull to flat Lobar Pneumonia: Dull Trachea: Pleural Effusion: Shifted away if large Lobar Pneumonia: Midline Breath Sounds: Pleural Effusion: Decreased/absent (bronchial only at top) Lobar Pneumonia: Bronchial over affected area Adventitious Sounds: Pleural Effusion: Possibly pleural rub Lobar Pneumonia: Late inspiratory crackles Tactile Fremitus/Voice Sounds: Pleural Effusion: Decreased/absent Lobar Pneumonia: Increased (egophony, bronchophony, whispered pectoriloquy)