Question 1

Asthma

Accepted Answer

Wheezing cough
Dry or productive mucoid sputum with plugs

Question 2

Bronchitis

Accepted Answer

Chronic inflamm with cough and sputum production
Wheezing or rhonchi breath sounds
Productive mucoid or purulent sputum with infection
May have fever

Question 3

Cystic Fibrosis

Accepted Answer

May be obstructive, restrictive, or mixed
Rales, wheezing, and/or decreased breath sounds
Inability to gain weight
Productive of large amounts of mucoid, mucopurulent, or purulent sputum.
May have hemotysis, cyanosis, clubbing

Question 4

Emphysema

Accepted Answer

Permanent abnormal enlargement and destruction of air spaces. 
Barreled chest
Use of accessory ventilation muscles
Decreased breath sounds with or without wheezing
Dyspnea

Question 5

Pneumothorax

Accepted Answer

Decreased or absent breath sounds
Dry cough
May have local or referred pain
Tracheal deviation away from affected side
Hyperresonant and tympanic percussion sound.

Question 6

Tuberculosis (TB)

Accepted Answer

Slight nonproductive cough
Hemoptysis
Low grade fever
Chest wall pain
Possible chest x-ray changes

Question 7

Pulmonary Edema

Accepted Answer

Can be due to LV failure, aortic valvular disease, mitral valvular disease, narcotic overdose. 
Dyspnea on exertion or paroxysmal nocturnal dyspnea
Fatigue
Pink frothy sputum
Positive chest x-ray
Crackles

Question 8

Pulmonary Emboli

Accepted Answer

Without infarction = tachypnea, anxiety, restlessness, rales (crackles), wheezing, decreased breath sounds
With infaction = chest pain, hemoptysis, pleural friction rub, fever, positive chest x-ray

Question 9

Pleural Effusion

Accepted Answer

Exessive fluid netween visceral and parietal pleura
Decreased breath sounds over effusion
Bronchial breath sounds around perimeter
Mediastinal shift away from large effusion
Breathlessness, with large effusions
Chest x-ray shows fluid

Question 10

Atelectasis

Accepted Answer

Collapsed or airless alveolar unit
Decreased breath sounds
Dyspnea
Tachycardia
Increased temperature
Chest x-ray shows platelike streaks

Question 11

Angina Pectoris

Accepted Answer

Pain in chest, jaw, or L shoulder
Other symptoms = indigestion, dyspnea, dizziness, syncope, and anxiety.

Question 12

Cor Pulmonale

Accepted Answer

Failure or hypertrophy of RV resulting from disorders of lungs, pulmonary vessels, or chest wall. 
Usually chronic, but may be acute and reversible.

Question 13

Left Heart Failure

Accepted Answer

Forward; reduced CO
Undue tachycardia, cold intolerance, fatigue, orthopnea, paroxysmal noctural dyspnea, cough, bronchospasm. 
Increased pulmonary artery pressure and pulmonary edema with dyspnea on exertion, cough, 
S3 (gallop) heart sound heard

Question 14

Right Heart Failure

Accepted Answer

Backward; reduced venous return
Venous hypertension and stasis, weight gain, fatigue, fullness in abdomen, increased pulmonary artery pressures with peripheral edema (weight gain, venous stasis, pitting edema), anorexia
Pleural effusion (R>L)

Question 15

Respiratory Alkalosis

Accepted Answer

pH incr, PaCO2 decr, HCO3 WNL
Cause: alveolar hyperventilation
Signs: dizziness, syncope, tingling, numbness, early tetany

Question 16

Respiratory Acidosis

Accepted Answer

pH decr, PaCO2 incr, HCO3 WNL
Cause: alveolar hypoventilation
Signs: Early = anxiety, restlessness, dyspnea, headache. Late = confusion, coma, somnolence.

Question 17

Metabolic Alkalosis

Accepted Answer

pH incr, HCO3 incr, PaCO2 WNL
Causes: bicarbonate ingestion, vomiting, diuretics, adrenal disease
Signs: vague symptoms weakness, mental dullness, possibly early tetany

Question 18

Metabolic Acidosis

Accepted Answer

pH decr, HCO3 decr, PaCO2 WNL
Causes: diabetic, lactic, or uremic acidosis, prolonged diarrhea
Signs: secondary hyperventilation, nausea, lethargy, coma

Cardio Pulm Diff Dx

Differential Diagnoses in Cardiovascular and Pulmonary Systems

Question	Answer
Asthma	Wheezing cough Dry or productive mucoid sputum with plugs
Bronchitis	Chronic inflamm with cough and sputum production Wheezing or rhonchi breath sounds Productive mucoid or purulent sputum with infection May have fever
Cystic Fibrosis	May be obstructive, restrictive, or mixed Rales, wheezing, and/or decreased breath sounds Inability to gain weight Productive of large amounts of mucoid, mucopurulent, or purulent sputum. May have hemotysis, cyanosis, clubbing
Emphysema	Permanent abnormal enlargement and destruction of air spaces. Barreled chest Use of accessory ventilation muscles Decreased breath sounds with or without wheezing Dyspnea
Pneumothorax	Decreased or absent breath sounds Dry cough May have local or referred pain Tracheal deviation away from affected side Hyperresonant and tympanic percussion sound.
Tuberculosis (TB)	Slight nonproductive cough Hemoptysis Low grade fever Chest wall pain Possible chest x-ray changes
Pulmonary Edema	Can be due to LV failure, aortic valvular disease, mitral valvular disease, narcotic overdose. Dyspnea on exertion or paroxysmal nocturnal dyspnea Fatigue Pink frothy sputum Positive chest x-ray Crackles
Pulmonary Emboli	Without infarction = tachypnea, anxiety, restlessness, rales (crackles), wheezing, decreased breath sounds With infaction = chest pain, hemoptysis, pleural friction rub, fever, positive chest x-ray
Pleural Effusion	Exessive fluid netween visceral and parietal pleura Decreased breath sounds over effusion Bronchial breath sounds around perimeter Mediastinal shift away from large effusion Breathlessness, with large effusions Chest x-ray shows fluid
Atelectasis	Collapsed or airless alveolar unit Decreased breath sounds Dyspnea Tachycardia Increased temperature Chest x-ray shows platelike streaks
Angina Pectoris	Pain in chest, jaw, or L shoulder Other symptoms = indigestion, dyspnea, dizziness, syncope, and anxiety.
Cor Pulmonale	Failure or hypertrophy of RV resulting from disorders of lungs, pulmonary vessels, or chest wall. Usually chronic, but may be acute and reversible.
Left Heart Failure	Forward; reduced CO Undue tachycardia, cold intolerance, fatigue, orthopnea, paroxysmal noctural dyspnea, cough, bronchospasm. Increased pulmonary artery pressure and pulmonary edema with dyspnea on exertion, cough, S3 (gallop) heart sound heard
Right Heart Failure	Backward; reduced venous return Venous hypertension and stasis, weight gain, fatigue, fullness in abdomen, increased pulmonary artery pressures with peripheral edema (weight gain, venous stasis, pitting edema), anorexia Pleural effusion (R>L)
Respiratory Alkalosis	pH incr, PaCO2 decr, HCO3 WNL Cause: alveolar hyperventilation Signs: dizziness, syncope, tingling, numbness, early tetany
Respiratory Acidosis	pH decr, PaCO2 incr, HCO3 WNL Cause: alveolar hypoventilation Signs: Early = anxiety, restlessness, dyspnea, headache. Late = confusion, coma, somnolence.
Metabolic Alkalosis	pH incr, HCO3 incr, PaCO2 WNL Causes: bicarbonate ingestion, vomiting, diuretics, adrenal disease Signs: vague symptoms weakness, mental dullness, possibly early tetany
Metabolic Acidosis	pH decr, HCO3 decr, PaCO2 WNL Causes: diabetic, lactic, or uremic acidosis, prolonged diarrhea Signs: secondary hyperventilation, nausea, lethargy, coma

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