chest conditions

Question 1

what is the cause of asthma?

Answer 1

inflammation of the bronchi leading to contraction of smooth muscle and mucus secretion

Question 2

what triggers asthma?

Answer 2

cold air
animal fur
upper respiratory tract infection
pollution

Question 3

what are s&s of asthma?

Answer 3

SOB
cough
tight chest

Question 4

which tests are done for asthma?

Answer 4

spirometry
peak expiratory flow rate

Question 5

what are the treatment options for asthma?

Answer 5

reliever inhalers (blue): relax the smooth muscles (short and long acting β2 agonist)
preventer inhalers (brown): reduce inflammation, oedema and mucus secretion (corticosteroids)

Question 6

what conditions does COPD consist of?

Answer 6

emphysema: damaged alveoli, leading to alveolar collapse
chronic bronchitis: inflammation of the bronchi leading to a chronic cough

Question 7

what is the primary cause of COPD?

Answer 7

smoking

Question 8

what are the s&s of COPD?

Answer 8

SOB
coughing
breathlessness on exertion
use of accessory breathing muscles
pursed lips
hyper-inflated chest
reduced chest expansion
tachypnoeic (>20 breaths per minute)
downwardly placed liver
underweight
wheezing

Question 9

which test is done for the diagnosis of COPD?

Answer 9

spirometry

Question 10

what is the management for COPD?

Answer 10

refer to GP
advice of smoking
pulmonary rehabilitation
inhalers (same as asthma)

Question 11

what is costochondritis?

Answer 11

inflammation of the cartilage (costo-chondral, sternal and clavicular)

Question 12

what is the main cause of costochondritis?

Answer 12

upper respiratory tract infection

Question 13

what are s&s for costochondritis?

Answer 13

anterior chest wall pain
sharp pain
worse on breathing, coughing, sneezing and physical activity

Question 14

what is the treatment for costochondritis?

Answer 14

settles with time
contraindication for manipulation

Question 15

what is angina?

Answer 15

chest pain caused by reduced blood flow to the heart

Question 16

what is the difference between stable and unstable angina?

Answer 16

stable angina is precipitated by predictable factors
unstable angina occurs at any time

Question 17

what are the s&s for angina?

Answer 17

discomfort in L chest, neck, shoulder, jaw and arm
precipitated by exertion/emotion
relieved by rest or Glyceryl Tri-Nitrate within 5 minutes

Question 17

what is the diagnostic test for angina?

Answer 17

blood test for troponins

Question 18

what is the management for angina?

Answer 18

lifestyle modification
medication: statins, glyceryl Tri nitrate, β blockers, nitrates
surgery: angioplasty, coronary bypass graft

Question 19

what happens in a myocardial infarction?

Answer 19

reduced or complete cessation of blood flow to a portion of the myocardium

Question 20

what are s&s for myocardial infarction?

Answer 20

crushing/tightness/heavy feeling in chest (someone sitting on chest)
pain in L chest, shoulder, jaw and arm (more painful than angina)
sweating, nausea, dyspnoea, fatigue, palpitations

Question 21

what is the diagnostic test for MI?

Answer 21

blood test for troponins and creatine kinase

Question 22

what is the management for MI?

Answer 22

lifestyle modification
aspirin
β blockers
ACE inhibitors
statins
omega 3

Question 23

what are s&s of pancoast tumour?

Answer 23

unilateral persistent arm pain/numbness (commonly in upper medial arm and 4th and 5th digit)
weakness of hand
horner’s syndrome
persistent cough, SOB, fatigue, weightloss, night sweats

Question 24

what is pericarditis?

Answer 24

inflammation of the pericardium (sac around the heart)

Question 25

what is the main cause of pericarditis?

Answer 25

recent viral infection

Question 26

what are the s&s for pericarditis?

Answer 26

proceeding viral symptoms: malaise, fever, muscle aches pleuritic chest pain (sharp, stabbing, aching) pain in shoulder arm and lower scapular pleuritic rub on examination

Question 27

what aggravates and reliefs the pain in pericarditis?

Answer 27

aggravates: lying down, inspiration and coughing reliefs: leaning forward

Question 28

what diagnostic test is used for pericarditis?

Answer 28

echocardiogram (shows fluid in the pericardial sac)

Question 29

what is pneumonia?

Answer 29

acute inflammation of the alveoli and the terminal brochioles

Question 30

what side effect can pneumonia have?

Answer 30

consolidation (fluid) in the lungs

Question 31

what are s&s of pneumonia?

Answer 31

SOB at rest cough sputum with blood weakness malaise muscle pain signs of infection: fever, tachycardia, sweating

Question 32

what might be found on respiratory examination in pneumonia?

Answer 32

signs of infection decreased chest expansion on one side absent breath sound on one side dull percussion auscultation: early: crackles, late: bronchial breathing friction rub

Question 33

what is a pneumothorax?

Answer 33

air trapped between lung and chest wall

Question 34

what age group/population type is most at risk for pneumothorax?

Answer 34

young thin males

Question 35

what are s&s of pneumothorax?

Answer 35

sudden, sharp, stabbing unilateral chest pain SOB pain worse on coughing and inspiration

Question 36

what might be found on respiratory examination in pneumotharox?

Answer 36

unilateral decreased chest expansion unilateral reduced/absent breath sound unilateral hyper-resonant percussion tachycardia bronchial breathing (tubular sound, as if blown through a pipe)

Question 37

what is the management for tension pneumothorax?

Answer 37

refer to A&E

Question 38

what is a pulmonary embolis?

Answer 38

obstruction in the pulmonary arterial tree

Question 39

what is the most common cause of a pulmonary embolism?

Answer 39

deep vein thrombosis

Question 40

what are s&s of pulmonary embolism?

Answer 40

sharp/stabbing pleuritic chest pain sudden SOB and pain cough with blood tachycardia hypotension increased respiratory rate pleural rub

Question 41

which tests are used for the diagnosis of pulmonary embolism?

Answer 41

D-dimer blood test ultrasound computed tomographic angiography

Question 42

what is the managment for pulmonary embolism?

Answer 42

anticoagulants (heparin, oral coagulants) prophylaxis

Question 43

what are the symptoms of a rib fracture?

Answer 43

tenderness and swelling local spasm pain on breathing, coughing, sneezing (pleuritic sharp pain)

Question 44

why do we need to refer patients with fractured rib to GP or A&E?

Answer 44

risk for pneumothorax and haemothorax

Question 45

what is Tietze's syndrome?

Answer 45

inflammation of the cartilage of the anterior portion of the chest

Question 46

which ribs are most commonly affected in Tietze's syndrome?

Answer 46

rib 2-3

Question 47

what are s&s of Tietze's syndrome?

Answer 47

pain and swelling of the costosternal, sternoclavicular or costochondral joints pain resolves in weeks but swelling persists