MLulCALSu8ClCAL 8LvlLWL8

O lr rorra|, c|ear |urgs, ororcr|a| orealr sourds Wou|d oe reard over lre |arge a|rWays ard ves|cu|ar orealr sourds Wou|d oe reard
over lre c|ear |urgs. w|lr preuror|a, exudale l|||s lre a|r spaces produc|rg corso||dal|or ard ororcr|a| orealr sourds over lrese
areas. Adverl|l|ous orealr sourds, |rc|ud|rg crac||es ard Wreezes, Wou|d oe |rd|cal|ve ol acule resp|ralory la||ure. 0ecreased orealr
sourds W|lr crac||es ard a p|eura| lr|cl|or ruo Wou|d suggesl a pu|rorary eroo||sr. wreez|rg W|lr exp|ral|or lral |s rore pro|orged
lrar |rsp|ral|or |s |rd|cal|ve ol crror|c ooslrucl|ve pu|rorary d|sease.
O arre| cresl |s a lerr lral relers lo ar |rcrease |r lre arleroposler|or d|areler ol lre cresl, resu|l|rg lror over|rl|al|or ol lre |urgs. A
l|a|| cresl resu|ls lror lraclured r|os Wrer a porl|or ol lre cresl pu||s |rWard upor |rsp|ral|or. A lurre| cresl relers lo a depress|or ol
lre |oWer parl ol lre slerrur. A p|geor cresl relers lo ar arler|or d|sp|acererl ol lre slerrur prolrud|rg oeyord lre aodor|ra|
p|are.
O 0ecreased verl||al|or |r lre oppos|le |urg |s |rd|cal|ve ol a red|asl|ra| sr|ll, Wr|cr |eads lo lers|or preurolrorax. A cougr W|lr
puru|erl spulur |s usua||y seer |r c||erls d|agrosed W|lr preuror|a. leroplys|s |s |rd|cal|ve ol |urg d|sease, sucr as pu|rorary
eroo||sr ard |urg carcer. 3uoculareous erprysera, a|r accuru|al|or |r lre l|ssues g|v|rg a crac|||rg sersal|or Wrer pa|paled, |s
usua||y assoc|aled W|lr cresl lraura.
O xposure lo cerla|r crer|ca|s sucr as lar, sool, aspra|l, o||s, ard sur||grl pul lr|s occupal|or al lre r|gresl r|s|. A|so, reals ard
polaloes are |oW |r l|oer, corlr|oul|rg lo lre r|s| ol carcer. P|us, sore processed reals corla|r crer|ca|s lral rave oeer |rp||caled
|r lre deve|oprerl ol carcer. reasl-leed|rg does rol |rcrease lre c||erl's r|s| ol deve|op|rg carcer. 0ll|ce Wor| a|so |s rol
cors|dered a r|s| laclor. wor||rg W|lr carcer c||erls does rol |rcrease a persor's r|s| lor deve|op|rg carcer. v|lar|rs C ard rave
oeer sroWr lo derorslrale preverlal|ve allr|oules. A vegelar|ar d|el |s cors|dered lo oe a rea|lr|er d|el lor deducl|or ol carcer r|s|
oecause |l prov|des |rcreased l|oer. Cruc|lerous vegelao|es rave oeer sroWr lo oe preverlal|ve. wor||rg |r a corver|erce slore does
rol |rcrease r|s|.
O or lre c||erl exper|erc|rg cresl pa|r, oola|r|rg a 12-|ead C0 |s a pr|or|ly lo revea| poss|o|e crarges occurr|rg dur|rg ar acule
arg|ra| allac| lral W||| oe re|plu| |r lrealrerl. elore ca|||rg lre rea|lr care prov|der, lre rurse srou|d oola|r lre resu|ls ol lre 12-
|ead C0 so lral lrese resu|ls car oe corrur|caled lo r|r. A CK-V |eve| ray oe ordered |aler ard lre c||erl ray reed arg|op|asly
|r lre rear lulure, oul gell|rg lre 12-|ead C0 dur|rg lre cresl pa|r |s lre rosl |rporlarl pr|or|ly.
O A rajor corp||cal|or assoc|aled W|lr per|card|l|s |s per|card|a| ellus|or or card|ac larporade rar|lesled oy rypolers|or ard rull|ed
rearl sourds. Crusr|rg cresl pa|r ard d|aprores|s are s|grs ol ryocard|a| |rlarcl|or. 0ysprea ard cop|ous o|ood-l|rged, lrolry
spulur are s|grs ol acule pu|rorary edera, a corp||cal|or ol |ell-s|ded rearl la||ure. Tacrycard|a ard o||gur|a are s|grs ol
rerorrrag|c sroc|.

O Tre ar||e arr |rdex |s ar oojecl|ve |rd|calor ol arler|a| d|sease. Norra| va|ue |s 1.0. va|ues |ess lrar 0.5 |rd|cale |screr|c resl pa|r.
A cap|||ary rel||| l|re ol |ess lrar 3 secords |s cors|dered rorra|. A d|aslo||c o|ood pressure ol 81 rr lg |s cors|dered W|lr|r lre
rorra| rarge. Pu|ses graded as 1 are cors|dered rorra|.
O V|lra| sleros|s |s ar ooslrucl|or ol o|ood l|oW|rg lror lre |ell alr|ur |rlo lre |ell verlr|c|e, corror|y rar|lesled oy progress|ve lal|gue
due lo |oW card|ac oulpul, reroplys|s, ard dysprea or exerl|or secordary lo pu|rorary verous ryperlers|or. Aorl|c |rsull|c|ercy
relers lo lre oac|l|oW ol o|ood lror lre aorla |rlo lre |ell verlr|c|e dur|rg d|aslo|e; rosl c||erls are asyrploral|c, excepl lor a
corp|a|rl ol a lorcelu| rearloeal. Aorl|c sleros|s relers lo a rarroW|rg ol lre or|l|ce oelWeer lre |ell verlr|c|e ard lre aorla; rary
c||erls exper|erce ro syrplors ear|y or, oul everlua||y deve|op exerl|ora| dysprea, d|zz|ress, ard la|rl|rg. V|lra| |rsull|c|ercy relers
lo lre oac|l|oW ol o|ood lror lre |ell verlr|c|e ard aorla; rary c||erls exper|erce ro syrplors ear|y or, oul everlua||y deve|op
exerl|ora| dysprea, d|zz|ress, ard la|rl|rg.
O 0re aspecl ol exaceroal|or preverl|or locuses or e||r|ral|rg lre causes ard corlr|oulory laclors assoc|aled W|lr C0P0, sucr as
pu|rorary |rr|larls (e.g., sro|e, a|r po||ul|or, occupal|ora| |rr|larls, ard a||erg|es). Preverl|or Wou|d locus or e||r|ral|rg lrese
|rr|larls. Arl|o|ol|cs are used lo lreal ororcr|a| |rlecl|or dur|rg exaceroal|ors, oul lrey are rol used propry|acl|ca||y. A|lrougr oxyger
|s used |r rarag|rg acule exaceroal|ors, |l |s rol a preverlal|ve reasure. Cougr|rg ard deep orealr|rg ray re|p c||erls c|ear lre|r
a|rWays ard preverl lurlrer ale|eclas|s, oul lrey W||| rol preverl exaceroal|or.
O