Duke PA Pulmonology History, Physical, Exam
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| Most common acute cause of cough in non-smoker | Viral infections
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| Cough due to acute respiratory tract infections resolves within _______ weeks in the vast majority of patients. | 3
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| Persistant cough accompanied by excessive mucus secretions increases the liklihood of _____ | COPD
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| what is suspected when acute cough is accompanied by vital sign abnormalities (tachycardia, tachypnea, fever) | Pneumonia
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| Rales, decreased breath sounds, fremitus, and egophany are findings suggestive of what | air space consolidation
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| Rales, decreased breath sounds, fremitus, and egophany are findings suggestive of what | Community aquired pneumonia
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| Wheezing and rhonchi are suggestive of what in the abscence of asthma | acute bronchitis
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| normal jugular venous pressure and negative hepatojugular reflux decrease the liklihood of what | biventricular CHF
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| Get a chest radiograph if you suspect what | pneumonia
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| The most likely causes of cough with a clear chest x-ray and the abscence of ACEI's | postnasal drip, asthma, GERD
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| The perception of uncomfortable breathing | Dyspnea
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| Rapid onset, severe dyspnea in the abscence of other clinical features should raise the suspicion for | pneumothorax, pulmonary embolism, or increased left ventricular end-diastolic pressure
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| Is accompanied by chest pain and occurs mainly in young, thin adult males | Spontaneous pneumothorax
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| Most patients with pleuritic chest pain in the outpatient clinic have pleurisy due to | acute viral respiratory tract infection
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| Most cases of dyspnea with wheezing are due to | Acute bronchitis
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| pursed lip breathing, use of extra respiratory muscles and barrel shaped chest are indicative of | obstructive airway disease
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| asymmetric excursion | pneumothorax
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| metabolic acidosis | Kussmaul respirations
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| breathing is first rapid and shallow but as acidosis worsens, breathing gradually becomes deep, slow, labored and gasping | Kussmaul respirations
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| Focal wheezing raises suspicion of | foreign body or other bronchial obstruction
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| Testing of ______ can help distinguish cardiac from non-cardiac causes of dyspnea in the ED. | BNP
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| Pulse ox values below ____% almost always represents clinically important hypoxemia. | 94
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| Urgent and emergent conditions causing acute dyspnia include | pneumonia, COPD, asthma, pneumothorax, pulmonary embolism, cardiac disease, metabolic acidosis, cyanide toxicity, methemoglobinemia, CO poisoning
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| The expectoration of blood that originates from below the vocal chords | hemoptysis
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| Most cases of hemoptysis in the outpatient setting are due to | infection (bronchitis, pneumonia, tuberculosis)
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| Flexible bronchoscopy is indicated for which patients | smokers, over the age of 40, greater than 1 week history of hemoptysis
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| Characteristic findings in a patient with chronic obstruction of the upper airway | Inspiratory stridor, intercostal retractions on inspiration, palpable thrill over larynx, wheezing localized to the neck.
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| Local parenchymal collapse | atelectasis
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| the trachea bifurcates into the mainstem bronchi at which levels anteriorly and posteriorly | Sternal angle, T4 process
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| the lower border of the lung lies at T __ level posteriorly | 10
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| the lower border of the lung lies at __th rib level in the midclavicular line. | 6
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| the lower border of the lung lies at __th rib level in the midaxillary line. | 8
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| sensation of tingling or "pins and needles" around lips or in the extremities sometimes brought on by shortness of breath | paresthesias
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| Musical respiratory sounds that may be audible to the patient or others | wheezes
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| A reflex response to stimuli that irritate receptors in the larynx, trachea, or large bronchi. | cough
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| hemoptysis is seen most often in those with | cystic fibrosis
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| Audible stridor is a sign of | airway obstruction in the larynx or trachea
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| decreased fremitus can be caused by | obstructed bronchus, COPD, pleural effusion/fibrosis, pneumothorax, infiltrating tumor, very thick chest wall, soft voice.
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| When it comes to percussion normal lungs are | resonant
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| Dullness replaces resonance when | air is displaced by fluid or solid tissue
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| These breath sounds are soft and low pitched. They are heard througout inspiration and continue without pause through expiration, and fade away 1/3 of the way through expiration | vesicular
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| These lung sounds are about equal in length in regards to inspiration and expiration. There may be a silent interval inbetween | bronchovesicular
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| These breath sounds are loud and higher in pitch, with a short silence between inspiration and expiration. Expiratory lasts longer than inspiratory | bronchial
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| these sounds suggest secretions in large airways | rhonci
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| Relatively low pitched with a snoring quality | rhonci
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| relatively high pitched with a hissing or shrill quality | wheezing
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| increased transmission of voice through chest wall suggests | air-filled lung has become airless
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| Pain that is described as sharp or knife like is usually | plueral pain
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| pectus carinatum | pidgeon chest
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| pectus excavatum | funnel chest
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| dyspnea that occurs in the supine position | orthopnea
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| Paroxysmal nocturnal dyspnea is associated with which condition | CHF
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| wheezing is generally associated with which condition | asthma
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| According to Cecil's the three most common causes of persistant cough are | postnasal drip, asthma, GERD
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| Massive hemoptysis is defined as more than ___ ml of blood in 24 hours | 500
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| this pain is usually reproducible with movement or palpation over the affected area | musculoskeletal chest pain
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| fremitus is increased in areas of | underlying lung consolidation
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| fremitus is decreased in areas of | pleural effusion
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| What may cause hyporesonance to percussion | pnemothorax or hyperinflation
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| a course rattle or fine velcro like sound | crackles
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| Heard in pulmonary edema, and interstitial fibrosis | crackles
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| A crunching sound timed with the cardiac cycle | Hamman's sign
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| Heard in patients with pneumomediastinum | Hamman's sign
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| Elasticity is usually measured as its inverse function ___________ | compliance
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| The change in lung volume produced by a given chang in transpulmonary pressure | compliance
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| This is decreased in diseases such as pulmonary fibrosis, and pulmonary edema because of they restrict lung volume expansion | compliance
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| This is increased in emphysema because of the loss of elastic recoil | compliance
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| How does the body control the narrow range of normal pH | elimination or retention of carbon dioxide
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| The PaCo2 in blood is inversely proportional to the ______ | minute ventilation
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| What is the strongest factor controlling ventilation | maintaining normal blood pH
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| The neuronal control of autonomic respiration resides in the _____ | medullary reticular formation
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| The PaO2 versus ventilation curve is a mirror image of the ______ for hemoglobin | oxygen dissociation curve
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| the volume of air which can be inhaled or exhaled from a person's lungs in one minute | minute ventilation
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| defined as ventilation inadequate to keep PaCO2 from rising above normal | hypoventilation
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| the portion of blood that goes from the right side of the heart to the left without an opportunity for exchange of oxygen and carbon dioxide | shunt
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| When pulmonary capillary blood traverses unventilated lung units | physiologic shunt
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| the maximal amount of air that can be exhaled after maximum inhalation | forced vital capacity
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| "ee" sounds like "ay" | egophany
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| "99" sounds louder and clearer | bronchophany
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| Whispered sounds are clearer | whispered pectoriloquy
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| usually clears with coughing | rhonci
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| does not clear with coughing | crackles
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| cough lasting <3 weeks | acute cough
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| cough lasting >3 weeks | persistant cough
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| most common cause of cough in smokers | low-grade chronic bronchitis
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| according to Pat the most common cause of acute cough in non-smokers | URI
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| Which ribs may be fractured due to cough | 5-7
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| most common cause of hemoptysis in the US | airways disease
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| most common cause of hemoptysis in developing countries | tuberculosis
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| Enlargement and dilatation of the bronchioles | bronchiectasis
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| what dose Amy Winehouse have | crack lung
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