Diagnosis- Respiratory Flashcards
- Which of the following conditions is described below?
A respiratory condition characterised by variable airway obstruction due to chronic inflammation, smooth muscle hyperplasia and mucus hypersecretion. It presents with an FEV1:FVC ratio of less than 0.7:1 on spirometry.
- Chronic Obstructive Pulmonary Disease (COPD)
- Cystic Fibrosis (CF)
- Asthma
- Bronchiectasis
Asthma
An 81-year-old female presents with a 2-day history of dyspnoea, a productive cough (thick green sputum), fever and confusion. She has a Chest X-ray carried out at her local hospital. Based off her history and the X-ray below, diagnose her condition
- Left-sided pleural effusion
- Right-lower lobe pneumonia
- Right-sided tension pneumothorax
- Interstitial Lung Disease
- Right-lower lobe pneumonia
- Which of the following is the most common bacterial pathogen in Community-Acquired Pneumonia?
- Pneumocystis jirovecii
- Escherichia coli
- Pseudomonas aeruginosa
- Streptococcus pneumoniae
Streptococcus pneumoniae
- A 2-year-old infant is brought into A&E at 3am by his mother who is very concerned about his breathing. She mentions he has had a very high fever of 39.5 oC for the past 24 hours, but overnight developed a high-pitched, harsh wheezing sound when he breathes in. She also noticed he is drooling excessively. What is your diagnosis?
- Epiglottitis
- Croup
- COPD exacerbation
- Rhinovirus
Epiglottitis
Epiglottitis is a clinical emergency. The clinical picture for epiglottitis includes a very high fever (sometimes in excess of 40 oC, sudden onset dyspnoea +/- stridor, distress and dysphagia/sialorrhoea (excessive drooling). Treatment involves maintaining airway patency and IV antibiotics. It is caused by bacterial infection by Haemophilus influenza B.
- A 33-year-old male presents to primary care with a 4-week history of a non-productive cough, which has recently been accompanied by a fever (38.1 oC) and night sweats. Upon further questioning, the GP uncovers the patient was homeless for the majority of his twenties and was a previous IVDU. The GP sends the patient to A&E for a chest X-ray which can be seen below. What is your diagnosis?
- Bilateral upper lobe pneumonia
- Hypersensitivity pneumonitis
- Left-sided pneumothorax
- Tuberculosis
Tuberculosis
A 64-year-old woman presents to A&E with sudden onset dyspnoea, pleuritic chest pain and haemoptysis. She has recently driven home from a holiday to the Scottish Highlands. The A&E SHO performed a D-dimer blood test which was positive. What is the most likely diagnosis in this case?
- Pneumothorax
- Myocardial Infarction
- Pulmonary Embolism
- Pneumonia
Pulmonary Embolism
What is the best imaging modality to confirm your diagnosis of PE?
- Chest X-ray
- Full Blood Count
- Transoesophageal Echocardiogram
- CTPA
CTPA
, a positive D-dimer is not necessarily indicative of a PE. Therefore, a positive D-dimer + symptoms of a PE warrants performing a CT Pulmonary angiogram – CT which looks at the pulmonary arteries to check for occlusion.
A 56-year-old male with Type II Diabetes Mellitus, hypercholesterolaemia and a BMI of 55 kg/m2 presents to his GP with a 3-month history of fatigue and morning headaches. He mentions during the consultation that he recently lost his job at an accountancy firm because he was caught sleeping at his desk multiple times throughout the day. What is the most likely diagnosis?
- Microcytic anaemia
- Obstructive Sleep Apnoea
- Chronic sinusitis
- Narcolepsy
Obstructive Sleep Apnoea
, OSA is the best fit in this example due to the patient’s weight and underlying conditions.
A 26-year-old male, who has recently taken up smoking, is brought in by ambulance to the local A&E department. He was sat down at home watching Bridgerton on Netflix, when he suddenly developed left-sided chest pain and dyspnoea. Upon examination in A&E, the F2 doctor on call finds reduced breath sounds unilaterally and hyper-resonance upon percussion to the left chest wall. His findings were consistent with a pneumothorax. The same doctor performs some basic blood tests and finds his LFT’s (Liver Function tests) to be deranged. What is the underlying cause of his pneumothorax?
- Wilson’s disease
- a-1 Antitrypsin deficiency
- Mesothelioma
- Idiopathic Pulmonary Fibrosis
a-1 Antitrypsin deficiency
- Please interpret the following ABG (arterial blood gas)
pH 7.26 (7.35-7.45)
PaO2 7 kPa (11-13)
PaCO2 9.4 kPa (4.7-6.0)
HCO3- 23 mEq/L (22-26)
Base excess -1 (-2 to +2)
- Uncompensated Respiratory Acidosis
- Uncompensated Metabolic Acidosis
- Partially compensated Respiratory Acidosis
- Uncompensated Respiratory Alkalosis
Uncompensated Respiratory Acidosis
What is the most common mutation in Cystic Fibrosis
G551D
N1303K
ΔF508
R117H
ΔF508
Pneumothorax will NOT present with:
Air trapping
Hypertension
Hypoxia
Tachycardia
Hypertension
Type 1 pneumocytes produce surfactant
True
False
False
What CFTR mutation class is ΔF508
Class 1
Class 2
Class 3
Class 4
Class 2
Asthma will present with an increased FEV1:FVC ratio
True
False
False
The intrapleural pressure in the lungs is always negative
True
False
True
