Macleod's

Question 1

Define acute and chronic cough

Answer 1

Acute cough lasts <3/52

Chronic cough lasts >8/52

Question 2

Severe asthma or chronic obstructive pulmonary disease (COPD) causes what type of cough?

Answer 2

A prolonged wheezy cough and often a paroxysmal dry cough after a viral infection that lasts several months.

Question 3

What does a feeble non-explosive bovine cough with hoarseness suggest?

Answer 3

A lung cancer which invades the left recurrent laryngeal nerve, causing left vocal cord paralysis.

Question 4

What does nocturnal cough disrupting sleep indicative of?

Answer 4

It is a feature of asthma.

Question 5

What does coughing during and after swallowing liquids suggestive of?

Answer 5

Coughing during and after swallowing liquids suggests neuromuscular disease of the oropharynx.

Question 6

What is the reason for cough syncope?

Answer 6

Raised intrathoracic pressure impairs venous return to the heart and reduce cardiac output.

Question 7

What do these types of stridor indicate:
A) Inspiratory stridor
B) Biphasic stridor
C) Stridor on expiration

Answer 7

A) Inspiratory stridor indicates narrowing at the vocal cords
B) Biphasic stridor suggests tracheal obstruction
C) Stridor on expiration suggests tracheobronchial obstruction

Question 8

What is the colour of the sputum coughed up by patients with COPD?

Answer 8

Clear or “mucoid” sputum

Question 9

What condition produces pink frothy sputum?

Answer 9

Pulmonary oedema

Question 10

What condition produces rusty red sputum? Give the reason

Answer 10

early pneumococcal pneumonia, as pneumonic inflammation causes lysis of red blood cell

Question 11

What colour sputum is produced by asthmatic patients?

Answer 11

Yellow sputum (eosinophils) or white mucoid sputum

Question 12

Why are sputum green?

Answer 12

From dead neutrophils as lysed neutrophils produces a green-pigmented enzyme, verdoperoxidase

Question 13

What is the colour of the sputum for bronchiectasis?

Answer 13

Green purulent sputum

Question 14

What does bronchorrhea means? What is a common cause of bronchorrhea?

Answer 14

Bronchorrhea is the production of large volumes (>100ml) of watery sputum per day.
The common cause is chronic bronchitis. It can also indicate alveolar cell cancer.

Question 15

Blood-streaked clear sputum or clots in sputum for more than a week is indicative of?

Answer 15

Lung cancer

Question 16

What are the potential causes of coughing up large amounts of pure blood?

Answer 16

Lung cancer, tuberculosis or bronchiectasis

Question 17

Single episodes of haemoptysis associated with pleuritic chest pain and breathlessness is indicative of?

Answer 17

Pulmonary Thromboembolism and infarction

Question 18

What are the differential diagnosis for breathlessness presenting for months to years?

Answer 18

COPD, Pulmonary fibrosis and pulmonary tuberculosis

Question 19

What are the differential diagnosis for breathlessness presenting for weeks to months?

Answer 19

Anaemia, Pleural effusion, Respiratory neuromuscular disorders

Question 20

What are the differential diagnosis for breathlessness presenting for minutes?

Answer 20

Pulmonary thromboembolism, Asthma, pneumothorax, inhaled foreign body, acute left ventricular failure

Question 21

What are the differential diagnosis for breathlessness presenting for hours to days?

Answer 21

Pneumonia, asthma, exacerbation of COPD

Question 22

What does platypnoea means?

What are the potential causes?

Answer 22

Breathlessness on sitting up.

Right to left shunting through a patent foramen ovale, atrial septal defect, or large intrapulmonary shunt

Question 23

What does trepopnoea means?

Answer 23

Breathlessness when lying on one side.

Question 24

Which side does patient prefer to lie down on if they have trepopnoea caused by unilateral lung disease?

Answer 24

Patient will prefer the healthy lung down

Question 25

Which side does patient prefer to lie down on if they have trepopnoea caused by dilated cardiomyopathy?

Answer 25

Patient prefers right side down

Question 26

What are the causes of Paroxysmal Nocturnal Dyspnoea?

Answer 26

Asthma and left ventricular failure