Clinical Case 2: Respiratory disease

Question 1

Give 6 common presenting symptoms of respiratory disease:

Answer 1

1) chest pain

2) wheeze

3) sputum

4) cough

5) breathlessness

6) haemoptysis

Question 2

Name a good way to quantify the amount of sputum brought up by a patient:

Answer 2

in teaspoons

Question 3

Why is it important to ask about nasal bleeding when investigating haemoptysis?

Answer 3

nose bleeds can trickle back down the throat and cause haemoptysis

Question 4

Give three common markers for respiratory malignancy and chronic infection:

Answer 4

1) weight loss

2) malaise

3) fevers

Question 5

Give the basic order of taking a history:

Answer 5

1) history of presenting complaint

2) past medical history

3) systematic enquiry

4) drug history (including allergies)

5) social history

Question 6

What drug history should you take when discovering a patient is bleeding?

Answer 6

are you taking anticoagulants or over the counter aspirin?

Question 7

What type of drug is salbutamol?

Answer 7

B2 adrenoreceptor agonist

Question 8

How does salbutamol treat asthma?

Answer 8

it acts on B2 receptors to relax muscles of the airways and therefore allow airflow

Question 9

Give 3 side effects of using salbutamol inhalers:

Answer 9

1) Tremor

2) palpitations

3) dizziness

Question 10

What common respiratory symptoms won’t be seen in pulmonary embolism? (4)

Answer 10

1) phlegm

2) wheeze

3) weight loss

4) fatigue

Question 11

True or false: you won’t see a temperature in lung cancer

Answer 11

True

Question 12

What causes clubbing of nails?

Answer 12

chronic hypoxia causing increased sponginess of the nail bed

Question 13

What respiratory diseases are associated with clubbing? (3)

Answer 13

1) cystic fibrosis

2) tuberculosis

3) lung cancer

Question 14

Give the four steps of a general chest exam for respiratory disease:

Answer 14

1) look

2) feel

3) percuss

4) auscultate

Question 15

What does peripheral oedema in respiratory disease potentially indicate?

Answer 15

heart failure

Question 16

What percussion sounds are heard in lung cancer, chest infection and pulmonary embolus?

Answer 16

dull sound

Question 17

What sounds may you here upon auscultation for a chest infection?

Answer 17

crackles and wheeze

Question 18

How is pleural effusion treated?

Answer 18

thoracentesis (chest drain)

Question 19

Why should the fluid from a pleural effusion be kept after taking a chest drain?

Answer 19

it can be sent to the lab to check for infection of cancer