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Peat Exam – Questions With Verified Answers
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Peat Exam – Questions With Verified Answers
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Peat Exam – Questions With Verified AnswersDrainage for the R lateral lung segment Right Ans - L SL with legs raised 18 in
Lower lobe drainage Right Ans - Prone with LE elevated 18 in
R middle lobe drainage Right Ans - supine with LE raised 12 in
Ant segment drainage Right Ans - supine with LE elevated 18 in
Leukocytosis Right Ans - total WBC count of greater than 11,000-15,000/mm3 (above normal range)
Leukopenia Right Ans - WBC count less than 4000
Normal range for WBC Right Ans - 4500-11,000/mm3
Percussion posteriorly over the costovertebral angle of back = Right Ans - Renal involvement if reproduction of pain in the back or flank = murpheys test
Distention of the costal margin Right Ans - Descriptive of an abnormal finding for the spleen, which is typically palpated below the L costal margin. (looks like a bulge on the L side)
Positive = mononucleosis and trauma - warrants immediate medical attention
Ankle-Branchial Index Right Ans - < 1.0 = decreased blood flow and ischemia in the limbs (with arterial aneurysm in LE, the affected artery is dilated, arterial thrombosis, occlusive artery disease)
1.0 = normal, indicating similar blood flow in the ankle and brachial arteries > 1.1 = arterial calcification, artery can't be fully compressed for valid measurement - most commonly found in pts with diabetes
Sputum types Right Ans - Asthma - eosinophilic Pneumococcal pneumonia - sputum is pinkish, blood-flecked or rusty. Treatment = antibiotics Chronic Bronchitis - neutrophilic, bronchodilators improve spirometry scores
Emphysema - absent or mucoid sputum (as opposed to sputum with a lot of neutrophils Exercises recommendations for pts with atrial septal defect Right Ans - Participation is limited to LOW-intensity sports
Ex tolerance is likely to be normal or only mildly impaired intense exertion accompanied by pulm HTN may result in cyanosis, HF, or pulm hemorrhage
Egophony Right Ans - When asked to say E, it'll sound like A. (it should remain e is normal) It is just a volume difference in the following conditions:
-Atelectasis & pneumothorax: decreased voice sounds -Consolidations: increased voice sounds
-Pleural effusion: Voice sounds will NOT be present over the effusion
Partial pressure of O2 range & CO2 Right Ans - 80-100 mmHg
35-45 mmHg
Hand placement for lung expansion Right Ans - - Anterior first 4 ribs = upper lobe excursion
- Anterior chest with thumbs over costal margin and fingers at xiphoid process = diaphragm - Posterior aspaect of thorax at upper trap = upper post lobes
- hands over lower anterior ribs = middle lobe
Cheyne-Stokes respiratory pattern Right Ans - -Irregular respiration pattern characterized by a period of apnea followed by gradual increasing depth and frequency of respiration. -Coma, BG disease, and occasionally CHF
Biot - irregular respiratory pattern characterized by highly variable respiratory depth and intermittent periods of apnea. -Acute neuro dysfunction, ataxic breathing
COPD exercise METs Right Ans - 4 METs = 120 HR = normal response COPD is expected to have an increased elevation of HR with exercise due to hypoxemia Chest percussion as an intervention Right Ans - Normal diastolic pulm artery pressure = 5-15 mmHg. 3 is pathologically low and indicates unstable hemodynamic status. Chest percussion = CONTRAINDICATED
Normal ICP = 0-10 mmHg. High = low cerebral perfusion and percussion would increase this even more = CONTRAINDICATED Coagulation is a precaution = Platelets of 30,000. 20,000 = contraindication
Normal PaO2 = fine
Hx of breast cancer Right Ans - Wells criteria for DVT
MAP norms Right Ans - 70-100 mmHg = normal <60 = not enough perfusion to vital organs Normal fasting blood glucose = 70-100
See Q 4.8 for practice with blood gasses
Chest Excursion norms Right Ans - Below normal: 0.4 - 0.8 (common in COPD)
Normal: 1-2 in
Lung Sounds Right Ans - Stridor - continuous monophonic high-pitched crowing sound heard during inspiration. It is usually causes by upper airway obstruction
High-pitched wheezes - continuous musical sounds of variable pitch and duration - heard on inspiration, expiration (most common), or both. Caused by narrow airways or stenosis
Plural rub = inspiratory and expiratory grating, creaking sounding like sandpaper rubbing together. Pleural inflammation
Crackles (rales) - discontinuous, nonmusical, crackling sounds similar in sounds to several hairs being rubbed together. Inspiration and usually caused by sudden opening of closed airways or movement of secretion
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