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Rapid, deep labored breathing

Kussmaul breathing (DKA, Metabolic acidosis)

Deep breathing alternating w/ apnea

Cheyne-Stokes breathing (heart failure, brain damage)

Cavitations on CXR

Infections (lung abscess, TB)

caseating granulomas, Apical infiltrates, Fever, Chills, dry cough, night sweats


Pleural thickening on CXR


Hilar mass on CXR

Lung Ca

Eggshell pattern on CXR

Silicosis (Sandblasters)

Ground glass appearance on CXR

Asbestosis (shipbuilders, building demolition)

Reticular to nodular pattern on CXR

Coal Miner's lung

Patchy fibrosis on CXR

Farmers lung

Non caseating Granulomas and inflammation of alveoli, small bronchi and small blood vessels


Dyspnea after surgery, travel (airplane), LE Fx. May have c/o calf pain also.


Lung scan with perfusion defects


Venous stasis, vessel wall injury, hypercoagulability

DVT/PE (Virchow's triad)

Pediatric with barking cough, stridor

viral croup (Tx w/ racemic epi and glucocorticosteroids if stridor at rest)

Pediatric wheezing

lower respiratory FB, asthma

Drooling, sniffing position, tripod, toxic


Thumbprint sign


Steeple sign

viral croup (laryngotracheobronchitis)

Inspiratory stridor

FB, viral croup

Premature infant with respiratory distress

Hyaline Mb Disease

Preemie CXR w/ hypoexpansion (ATX), air bronchograms

Hyaline Mb Disease

Smoker, chronic productive cough. NO hemoptysis or weight loss

Bronchitis (COPD)

Smoker, DOE, cough


Hyperinflation on CXR, tear drop heart


Wheezing, prolonged expiration

Asthma, COPD

Airway edema with eosinophils, neutrophils, lymphocytes


Fever, cough, sputum. Crackles, decreased breath sounds, dullness to percussion, +egophony, pectoriloquy. CXR - infiltrates or consolidation


>35yo with PNA. Rusty colored or yellow-green sputum. Acute onset F/C

Strep. Pneumonia

<35 yo, college students. Fever, cough, +/- sputum, chills, muscle aches

Mycoplasma or chlamydia pneumonia

Bullous myringitis

Mycoplasma pneumonia

PNA w/ Smokers, COPD

H. influenza

PNA w/ DM, immunocompromised, EtOH, current jelly sputum.


PNA w/ Water, late summer, construction site. Diarrhea. Toxic looking


PNA from Nursing homes, chronic care facility. Purulent sputum

Staphylococcus aureus

PNA & HIV+, AIDS, Immunocompromised. Sx out of proportion to exam. Diffuse interstitial & alveolar infiltrates

Pneumocystis jerovecii (TMP-SMX = Drug of choice)

PNA & decreased mental status, poor dental hygiene, dentures, foul smelling sputum, bronchiectasis. Patchy infiltrates in dependant lung zones

Aspiration PNA

Pediatric with Hx recurrent lung infections, pancreatitis, reproductive problems, FTT, thick, green sputum

Cystic fibrosis (Staph & Pseudomonal infections usually cause of death)

Sweat chloride test

Cystic fibrosis

Cystic fibrosis w/ PNA

Pseudomonas aueroginosa causative agent

< 2 days post-op with fever


Stab wound or broken ribs, hyperresonance to percussion, decreased breath sounds, tympany


Stab wound, dullness to percussion, decreased breath sounds.


Tall, skinny, male, band student, acute onset one-sided chest pain, dyspnea

Spontaneous PTX

Stab wound to chest. Hypotension, tracheal shift

Tension PTX

Poor sleeping, obese, daytime fatigue & drowsy, snoring, HTN, PM wakening

Obstructive sleep apnea

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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