Respiratory Flashcards Preview

Hugh's MD2 Foundation > Respiratory > Flashcards

Flashcards in Respiratory Deck (27):
1

What is the cut off for deoxygenated haemoglobin for cyanosis to be present?

50g/L

2

Describe pleural pain

Sharp, localised

Worse on inspiration and coughing

Radiates from front to back or up to shoulder (if pathology is at the diaphragm)

3

What are some DDx of SOB

Anaemia

COPD

Heart Failure

Renal Failure

Diabetic ketoacidosis

Anxiety

Asthma

PE

TB

Malignancy

Pneumonia with significant effusion

Pneumothorax 

4

What are the three physiological mechanisms for the sensation of dyspnoea?

Increased drive to breath

Increased load (work of breathing)

Decrease muscle strength

5

A force expiratory time over what time is significant?

>6s

6

What is ARDS? What does it commonly follow?

Acute respiratory distress syndrome

Serious trauma

7

What are some clinical signs of COPD?

Cachexia

Cyanosis

Hyperinflation

Rhonchi (wheezes)

Plethoric facies

Hoover's sign

Resp distress

Signs of pulmonary HTN

Prolonged force expiratory time

8

A decreased percussion note can reflect what?

Consolidation

Pleural effusion

Dense fibrosis

Elevated hemidiaphragm

9

Rhonchi or wheeze implies the pathology is in which section of the lung?

The airways

10

What is bronchiectasis?

Permenant widening of bronchi which are flabby and scarred

11

How do you tell the difference between obstructive and restrictive lung disease from spirometry?

The forced expiratory ratio (FEV1/FEC) while be reduced in obstructive lung disease

The FER will be maintained in restrictive lung disease but the FVC will be reduced

12

How do you calculate the A-a gradient?

A-a gradient = (150 - (1.25 x PaCO2)) - PaO2

13

What are two possible prequels to empyema?

Pneumonia

Direct spread from the diaphragm

14

An increased percussion note generally reflects what?

Pneumothorax

Hyperinflation

15

When is stridor usually heard?

On inspiration

16

What is a normal A-a gradient?

7-14

17

What is Hoover's sign?

Lower intercostal muscle retract due to flattening of diaphragm caused by lung hyperinflation

18

How can you tell the difference between the two types of crepitations?

Bubbling through fluid will be heard througout inspiration and expiration

The popping open of alveoli will only be heard at late inspiration

19

How can you differentiate pleural effusion and consolidation on clinical exam?

Both will be dull to percussion but pleural effusion will have reduced breath sounds while consolidation will have increased

20

What is ABPA?

Allergic Bronchopulmonary Aspillergosis

21

What are some signs of pulmonary hypertension?

RV heave and palpable S2

Loud H2

4th Heart slow

Pulmonary flow murmur

22

What are the three main respiratory causes of clubbing?

Suppurative lung disease (eg bronchiectasis, TB)

Bronchogenic Cancer

Chronic lung fibrosis - idiopathic and asbestosis but not sarcoidosis

23

What is the difference between cyanosis and pallor?

Cyanosis occurs when there is significant amounts of deoxygenated haemoglobin 

 

Pallor occurs when there is reduced Hb concentration in blood (anaemia)

24

Does COPD classically cause crepitations?

No

25

When measuring chest expansion with a tape measure, what is the normal measurement for expansion and what is reduced?

~4cm is normal

26

Outline a systematic approach to the causes of dyspnoea?

Respiratory

Cardiovascular

Metabolic/anaemic

MSK/Chest wall

Psychogenic

27

Why might you get a loud P2 in PCP infection?

Widespread pulmonary infection > V-Q mismatch > A-V shunting > Pulmonary HTN (reduced capillary bed) > Loud P2