Pulmonology
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| Rapid, deep labored breathing | Kussmaul breathing – DKA, Metabolic acidosis
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| Deep breathing alternating w/ apnea | Cheyne-Stokes breathing – heart failure, brain damage
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| Cavitations, patchy infiltrates on CXR | Infections – lung abscess, TB (Gohn focus)
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| Pleural thickening on CXR | Mesothelioma
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| Hilar mass on CXR | Lung Ca
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| Eggshell pattern on CXR | Silicosis (Sandblasters)
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| Ground glass appearance on CXR | Asbestosis (shipbuilders, building demolition)
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| CXR: reticular-nodular pattern, diffuse rounded opacities; Upper lung zones are primarily affected | Coal Miner’s lung
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| Patchy fibrosis on CXR | Farmers lung
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| Pediatric wheezing | lower respiratory FB, asthma
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| Thumbprint sign | Epiglottitis
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| Steeple sign | FB, viral croup (laryngotracheobronchitis)
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| Inspiratory stridor | FB, viral croup (laryngotracheobronchitis)
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| Premature infant with respiratory distress | Hyaline Mb Disease
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| CXR of premature infant w/ hypoexpansion (ATX), air bronchograms: | Hyaline Mb Disease
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| Smoker, chronic productive cough. NO hemoptysis, weight loss = | Bronchitis (COPD)
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| Smoker, DOE, cough = | COPD
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| Hyperinflation on CXR, tear drop heart | Emphysema
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| Wheezing, prolonged expiration | Asthma
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| Airway edema with eosinophils, neutrophils, lymphocytes | Asthma
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| Pediatric with Hx of recurrent lung infections, pancreatitis, reproductive problems, FTT = | Cystic fibrosis (Staph & Pseudomonal infections usually cause of death)
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| < 2 days post-op with fever = | Atelectasis
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| Stab wound, hyperresonance to percussion, decreased breath sounds, tympany = | Pneumothorax
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| Stab wound, dullness to percussion, decreased breath sounds = | Hemothorax
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| Tall, skinny, male, band student, acute onset one-sided chest pain, dyspnea = | Spontaneous PTX
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| Stab wound to chest. Hypotension, tracheal shift = | Tension PTX
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| Poor sleeping, obese, daytime fatigue & drowsy, snoring, HTN, PM wakening | Obstructive sleep apnea
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| s/p thoracic trauma. Multiple rib fractures. Chest wall moves in with inspiration, out with expiration. | Flail chest (pain control, incentive spirometry, pulmonary toilet, intubation)
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| Irreversible dilation of bronchi resulting from damage of airway wall: | bronchiectasis; usuallu 2/2 repeat infxn; dz of airways (not parenchyma)
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| ARDS on CXR = | bilateral widespread pulmonary infiltrates
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| CXR: infiltrates in mid or lower lung fields, hilar adenopathy, cavitation = | tuberculosis
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| CXR with upper lobe infiltrates, esp apical / posterior segments, cavitation common = | reactivated TB
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| Saddle Nose deformity = | Wegener’s Granulomatosis
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| A change in structure and function of the right ventricle of the heart as a result of a respiratory disorder = | cor pulmonale
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| In Pulmonary HTN, mean pulmonary pressure is __ at rest | >25 mmHg
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| Patients with pulmonary hypertension also have: | low cardiac output
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| The most common secondary cause of pulmonary hypertension = | connective tissue disease (scleroderma)
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| This should be performed in all patients suspected of pulmonary hypertension: | right ventricular catheterization
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| Median survival after diagnosis of pulmonary hypertension = | 3 years
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| ARDS on CXR = | bilateral widespread pulmonary infiltrates
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| On CXR: infiltrates in mid or lower lung fields, hilar adenopathy, cavitation = | tuberculosis
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| CXR with upper lobe infiltrates (especially apical & posterior segments); cavitation common = | reactivated TB
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| Viral pneumonia on CXR = | diffuse interstitial infiltrates & hyperinflation
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| Mycoplasma pneumoniae on CXR = | interstitial or bronchopneumonic infiltrates, frequently in the middle or lower lobes
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| Hampton's hump on CXR = | shallow wedge-shaped opacity in lung periphery with its base against pleural surface
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| Hampton's hump on CXR: Dx = | PE
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| Westermark sx on CXR = | oligemia (vasoconstriction) distal to a PE
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| Deer antler on CXR (large branching opaque mass, usually in L upper abdomen) = | PNA 2/2 proteus
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| PNA on CXR = | segmental infiltrates, atelectasis, pleural effusions; possible empyema
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| Pleura anatomy | Visceral (no sensory nerves) covers lungs, parietal (+sensory nerves) outside that & covering inside of chest wall
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| Decreased breath sounds & tactile fremitus, decreased diaphragmatic excursion on affected side, DTP, egophony = | pleural effusion
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| CXR in chronic bronchitis = | increased AP diameter, thickened bronchial markings, large right side of heart
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| CXR in emphysema = | low flat diaphragm, increased retrosternal space, pruning of vascular markings, long narrow heart, bullae
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| Most sensitive CXR view for smaller pleural effusion: | Lateral. PA may miss up to 300mL
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| ILD on CXR | Early: ground-glass appearance; later: nodular, linear, and/or honeycombed appearance
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| Respiratory failure (hypoxia) on CXR = | small "white" lungs, patchy, diffuse infiltrates, signs of consolidation, and/or lobar atelectasis
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| Respiratory failure (hypercapnia) on CXR = | hyperinflation, large "black" lungs, bullae, increased vascular markings (COPD); in NM dz / drug toxicity, may see small black lungs & hypoinflation
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| Volume to which lungs can be expanded with greatest inspiratory effort | TLC (total lung capacity)
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| volume of air inhaled and exhaled in a minute | MV (minute volume)
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| Part of TV that does not participate in alveolar gas exhange | Dead space
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Created by:
Abarnard
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