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Flashcards in Resp History and Examination Deck (16)
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1
Q

Resp causes of clubbing?

A
Lung cancer (usually not small cell)
Mesothelioma
CF
Bronchiectasis
Fibrosing alveolitis/IPF
Empyema
Sarcoidosis
2
Q

Define a wheeze

A

musical sound produced as the result of continuous oscillation of opposing airway walls where airways are narrowed.

3
Q

causes of an inspiratory wheeze?

A

this implies severe airway narrowing

usually result of tumours, foreign bodies or scarring

4
Q

why do crackles/crepitations occur?

A

result of abrupt opening of the small airways during inspiration following their collapse on expiration

5
Q

what do early inspiratory crackles suggest?

A

small airways disease e.g. bronchiolitis

6
Q

what do mid-inspiratory crackles suggest?

A

pulmonary oedema

7
Q

why might a patient complaining of SOB also complain of a tingling in their fingers and around their mouth?

A

if breathless, may be blowing off lots of CO2 so hypocapnic, which causes dizziness, light headedness, tinging and chest tightness.

8
Q

causes of orthopnoea?

A
LV failure
large pleural effusion
morbid obesity
massive ascites
respiratory muscle weakness
9
Q

why might pts get breathless on sitting up, and what is this called?

A

platypnoea

due to R to L shunting through a PFO, ASD or a large intrapulmonary shunt.

10
Q

why might pts become breathless lying on 1 side?

A

trepopnoea
if unilateral lung disease, prefer to lie with healthy lung down
dilated cardiomyopathy, lie on R side
tumours compressing central airways or blood vessels

11
Q

causes of breathlessness that wakes people from sleep?

A

asthma- tend to wake between 3 and 5 am, and also have wheezing.
LV failure

12
Q

if suspecting asthma, what triggers should you consider asking about in the history?

A
dust, mould, (HDM- shaking bedding, hoovering?)
smoke
cold air
perfumes
fumes
pets
grass pollens- mowing the lawn, hayfever season
drugs- aspirin, NSAIDs
13
Q

causes of biphasic crackles (heard throughout inspiration and expiration)?

A

bronchiectasis- coarse crackles, gurgling quality, may change if secretions dislodged by coughing.

14
Q

causes of late inspiratory crackles?

A

pulmonary fibrosis-fine crackles
pulmonary oedema-medium crackles
bronchial secretions in: COPD, pneumonia, lung abscess, tubercular lung cavities (coarse)

15
Q

what is a tracheal tug and when is it found?

A

resting on the patient’s trachea, your fingers are moved inferiorly with each inspiration, this is found in severe hyperinflation.

16
Q

likely cause of ‘red-currant jelly’ sputum coughed up by pt?

A

klebsiella pneumonia