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Name 2 things that are dull.
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What has ipsilateral shift of trachea.
Atelectasis
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What two things have contralateral shift of trachea?
Pleural effusion, pneumothorax
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Hyper-resonant or tympanic breath sounds.
Pneumothorax
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Restriction:
Difficulty getting air in or out?
- In
- Small volumes of air move in rapidly
- Small volumes of air rapidly move out
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Obstructive:
Difficulty getting air in or out?
- Out
- Air gets trapped in alveoli and small airways
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OR:
Fine inspiratory crackles
Minimal or no wheezing
Muscular atrophy
Restriction
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OR:
Pulsus paradoxus
Accessory Muscles
Obstruction
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OR:
Increased thoracic volume
Obstruction
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Normal FEV1/FVC ratio (although both are reduced)
Restriction
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Name Restrictive Diseases
- Idiopathic ....
- Thoracic cage deformities
- Pneumoconiosies
- Sarcoidosis
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Obstructive Diseases
- Asthma
- COPD
- Bronchectasis
- Cystic Fibrosis
- Sarcoidosis
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ABG notation
pH/pCO2/paO2
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A typical exam finding consistent with restrictive lung disease is
Dry inspiratory crackles
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A 20 year old with severe scoliosis will typically have which finding on pulmonary function test?
Decreased FVC (restrictive disease)
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Restrictive lung disease typically presents in 3 different ways- lung parenchymal/pleural abnormalities, thoracic cage/spine abnormalities, and
Neuromuscular weakness
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Both restrictive and obstructive lung diseases cause a sensation of dyspnea. In a mild exacerbation of asthma, the obstruction is primarily a result of inflammation. This inflammatory changes in the lung induce dypsnea by causing
Inability to exhale easily
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Lateral film taken with
left side against cassette
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Penetration: You should be able to see the ____ through the heart and mediastinum
spine
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Things that ensure CXR is technically adequate.
- Inspiration
- Penetration
- Rotation
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When you lose the AP window between the aortic arch and PA it could be a sign of ____.
aortic aneurism
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Chelazia (eye)
Stopped up oil gland
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Left diaphragm has heart on top of it, not translucent like the right one.
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Major fissure starts at T4
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What part of lung sits next to the right atria?
Right middle lobe
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What part of the lung sits next to the left ventricle?
Left Upper Lobe Lingula
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2 same densities in direct contact
intraparenchymal
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When part of the lung is consolidated, air may be seen inthe bronchi. This is an?
Air bronchogram
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Lobar or segmental density, no loss of lung volume
Consolidation
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Adjacent lobes or the opposite lung is hyperinflated.
Compensation
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Chronic inflammatory disorder of the airways in which many cells and cellular elements play a role.
Asthma
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3 Main Characteristics of Asthma
- Reversible Airway Obstruction
- Airway inflammation
- Airway hyperreactivity
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Name 4 things found in sputum of asthma patients.
- Curschmann's Spirals
- Charcot-Leyden Crystals
- Creola Bodies
- Eosinophils
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Clumps of airway epithelial cells
Creola Bodies
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Protects from eosinophils in asthma
Charcot-Leyden Crystals
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Small airways casts
Curschmann's Spirals
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Mainstay for asthma control?
Inhaled corticosteroids
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Only asthma treatment medication with survival advantage, most effective medication for preventing exacerbation
Inhaled corticosteroids
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Leukotriene modifiers (montelukast) are useful in
aspirin induced asthma
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Prevents mast cell degranulation
Cromolyn
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Affects calcium uptake in smooth muscles, IV form used in ED for acute exacervations of asthma
Mg Sulfate
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Samter's Triad
- Asthma
- Aspiring Sensitivity
- Nasal polyps
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