random (harder)
A clinician uses the sternal angle (Angle of Louis) as a key bony landmark on the anterior chest wall. Which rib attaches at this specific anatomical level?
2nd rib
what is commonly associated with traumatic rib fractures
flail chest
During a physical examination, a clinician percusses over the lower posterior lung field and notes a dull tone where resonance is normally expected. Which underlying pathology best accounts for this percussion finding?
lobar pneumonia
soft intensity, relatively low pitch, with inspiratory sounds lasting longer than expiratory sounds - heard over most lung fields
vesicular sounds
A patient presents with a persistent cough that began 5 weeks ago following a upper respiratory illness. Based on clinical duration categories, how should this cough be classified?
subacute cough (3-5 weeks)
If bronchial breath sounds—which are loud, high-pitched, and have an expiratory component lasting longer than inspiration—are heard over the peripheral lower lung fields, what pathology should be suspected?
replacement of air-filled alveoli by fluid or consolidated lung tissue - because the sound transmission from the larger airways is enhanced
increased AP-to-lateral ratio >.9, what chest configuration is present
barrel chest
increased tactile fremitus over posterior lung indicates which disease
pneumonia
A clinician auscultates breath sounds over the majority of both peripheral lung fields. The expiratory phase lasts longer than inspiration and is loud and high pitched. which type of breath sounds is being heard?
bronchial
A patient exhibits an unpredictable, highly irregular respiratory pattern featuring random shallow and deep breaths interspersed with irregular pauses. Which clinical condition is most frequently associated with this breathing pattern?
brain injury or meningitis
An examiner places the diaphragm of a stethoscope over the 1st and 2nd intercostal spaces anteriorly on a healthy adult. Which normal breath sound quality and timing ratio should be expected at this location?
bronchovesicular breath sounds - intermediate pitch and intensity, with equal inspiratory and expiratory
lower portion of chest is depressed inward, compressing the mediastinal structures and causing heart murmur
pectus excavatum
When performing whispered pectoriloquy on a patient with localized pulmonary consolidation, what sound pattern is auscultated over the affected area?
the whispered words are heard clear and distinct
discontiguous, explosive popping sounds that alter or clear following a cough
coarse crackles
5 As framework on smoking cessation
Ask (about tobacco use), Advise (to quit), Assess, Assist (in quit attempt) and Arrange (follow up)
A patient with a history of hypertension presents with severe dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Physical exam reveals bilateral basilar crackles and wheezing. Which underlying condition is most consistent with this presentation?
left sided heart failure
sternum is displaced anteriorly, increasing AP diameter with depressed adjacent costal cartilages
pectus carinatum
what does unilateral hyper resonance indicate
large pneumothorax or air filled bulla
a low-frequency, grating sound audible over the axilla during both inspiration and expiration that does not clear when the patient coughs. Which adventitious breath sound is present?
pleural friction rub
A patient presents with sudden onset unilateral chest pain and dyspnea. Physical examination of the affected hemithorax reveals hyperresonance to percussion, absent tactile fremitus, and markedly diminished breath sounds. Which condition is most strongly suggested by this constellation of findings?
pneumothorax
A 22-year-old tall, thin male presents to the emergency department with sudden-onset shortness of breath and right-sided pleuritic chest pain. What physical exam finding would be expected on the affected side? percussion? tactile fremitus?
hyperresonance on percussion and decreased tactile fremitus
A patient involved in a motor vehicle collision develops severe chest pain. Physical examination reveals precordial crackles that occur synchronously with the heartbeat rather than the respiratory cycle. What is this sign called?
Hammans sign
A clinician percusses a patient's chest wall and hears hyperresonance uniformly across both lung fields. Which condition best explains this percussion finding?
COPD
Over which anatomical region are bronchovesicular breath sounds considered a normal finding?
near mainstem bronchi: the 1st and 2nd interspaces anteriorly and between the scapulae posteriorly
What are the USPSTF guidelines for annual LDCT screening - ages and pack years
55-80 with a 20 pack year smoking history who currently smoke or quit within the past 15 years