Exam (elaborations)
SCS - Red Margins (1)
SCS - Red Margins (1)
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SCS - Red MarginsWhere would you insert a needle for tension pneumothorax? - ANS-2nd intercostal space
Where would you insert a chest tube? - ANS-4th intercostal space
Where is the lower margin of an endotracheal tube on a chest X-ray? - ANS-T4
Inserting a needle should be done at which margin of the ribs and why? - ANS-The superior
margin because there are neuro vascular structures running along the inferior margin
Where would you perform a thoracentesis? - ANS-T7-T8 intercostal space, immediately superior
to 8th rib
Aspiration pneumonia is common in which lung lobe? - ANS-Right middle or lower (right main
bronchus is more vertical)
Pleural fluid that is a transudate is seen in which conditions? - ANS-HF, cirrhosis, nephrotic
syndrome (NOT inflammatory)
Pleural fluid that is an exudate is seen in which conditions? - ANS-Inflammatory! Pneumonia,
malignancy, tuberculosis, pancreatitis, PE
Pleuritic pain feels like what? - ANS-Sharp/stabbing pain across the parietal pleura
Wheezing vs stridor? - ANS-W: lower resp disorders
S: upper resp disorders
A cough with pink frothy sputum points to what? - ANS-Left HF, mitral stenosis
Common causes of an acute cough - ANS-Viral upper resp infections. Also bronchitis,
pneumonia, LHF, asthma, foreign body, smoking, ACE
Common causes of sub-acute cough - ANS-Post infection, pertussis, acid reflux, bacterial
sinusitis, asthma
Common causes of chronic cough - ANS-Post nasal drop, asthma, GERD, chronic bronchitis,
bronchiectasis
Translucent white/gray sputum is called what? Common in? - ANS-Mucoid sputum; viral
infections and CF
, Yellow/green sputum is called what? Common in? - ANS-Purulent sputum; bacterial pneumonia
Foul smelling sputum is common in what? - ANS-Lung abscess, bronchiectasis
Fever + productive cough points to what? - ANS-Pneumonia
Wheezing points to what? - ANS-Asthma
Chest pain, dyspnea, and orthopnea points to what? - ANS-Acute coronary syndromes
Daytime sleepiness and snoring points to what? - ANS-Obstructive sleep apnea
Tachypnea is what? Increases likelihood of? - ANS-RR >25; pneumonia and cardiac disease
Pallor and sweating point to what? - ANS-Acute coronary syndrome (MI, HF)
Cyanosis is what? It points to? - ANS-Blue lips/mucous membranes; hypoxia
Barrel chest may point to what condition? - ANS-COPD
Asymmetrical chest expansion points to what? - ANS-Pleural effusions
Intercostal muscle retraction points to what? - ANS-Asthma, COPD, upper airway obstruction
Unilateral lag during inspiration points to what? - ANS-Pleural disease from asbestosis or
scoliosis, phrenic nerve damage, pleural effusion, lobar pneumonia
Decreased fremitus is a sign of what? - ANS-Thick chest wall: COPD, pleural effusion, fibrosis,
pneumothorax, tumour
Unilateral decreased fremitus points to what? - ANS-Pleural effusion, pneumothorax, neoplasm
Unilateral increased fremitus points to what? - ANS-Pneumonia (unilateral)
Dullness on chest percussion indicates what? Common in? - ANS-Fluid filled lungs (replacing
air); lobar pneumonia, pleural effusion, hemothorax, empyema, fibrous tissue, tumour
Hyper resonance on percussion indicates what? Common in? - ANS-Hyperinflation of lungs;
COPD, asthma, pneumothorax, air filled bulla
The technique of diaphragmatic excursion tends to do what compared to the actual movement
of the diaphragm? - ANS-Overestimate
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