Resp Presentations

Question 1

bronchiectasis

Answer 1

chronic productive cough
dyspnoea
wheezing
pleuritic chest pain
chronic infections in childhood
Reduced/absent breath sounds at areas distal to places of obstruction, coarse crackles on inspiration and expiration
Signet ring on CT

Question 2

sarcoidosis

Answer 2

20-40 year old, female of afro(caribbean) descent
dry cough
shortness of breath
nodules on skin (erythema nodosum)
Dry crackles
Bilateral hilar lymphadenopathy on CXR

Question 3

what is lofgren’s syndrome

Answer 3

erythema nodosum
bilateral lymphadenopathy
polyarthralgia
(sign of sarcoidosis)

Question 4

IPF

Answer 4

unexplained exertional dyspnoea
chronic dry cough
velcro-like crackling on inspiration
Fine-end inspiratory crackles
fibrosis of lung bases
Hypoxia
Ground-glass on CXR

Question 5

extrinsic allergic alveolitis

Answer 5

history mentions:
works on a farm
works with birds
works with coffee

Question 6

bronchiolitis

Answer 6

coryzal symptoms
respiratory distress
dyspnoea
tachypnoea
typically age <1 year old, mostly <6 months

Question 7

ARDS

Answer 7

Acute severe SOB
Tachypnoeic
Tachycardic
Hypoxaemia

Question 8

pneumothorax

Answer 8

typically tall, thin, white male
Smokers
People with preexisting lung diseases
Pleuritic chest pain and sudden SOB
Usually during sports
Reduced/absent breath sounds

Question 9

TB

Answer 9

Typical presentation of cancer
May have been abroad or of asian descent
Immunocompromised
HIV, AIDS, immunosuppressive therapy
Bilateral hilar lymphadenopathy on CXR
ZN stain +ve for acid-fast bacilli

Question 10

pleural effusion

Answer 10

Pleuritic chest pain, worse on breathing/coughing
Dyspnoea
Decreased breath sounds and dullness to percuss of affected side
Dry cough
Stony dull to percuss

Question 11

pneumonia

Answer 11

coryzal symptoms
Cough (can be productive or non-productive)
Chest pain
swinging fever

Question 12

croup

Answer 12

6 months - 6 years, mostly <3 y/o
Barking cough
Hoarseness
Stridor
Symptoms worse at night

Question 13

CF

Answer 13

Constant rest infections in childhood
In children: failure to thrive, meconium ileus, rectal prolapse
Chronic sinusitis
Cor pulmonae, resp failure

Question 14

asbestosis

Answer 14

Pleural plaque disease
Hx of asbestos exposure eg construction, shipyard worker
Crepitation on auscultation
Dyspnoea
Cough

Question 15

pulmonary hypertension

Answer 15

Elevated MAP
PMHx of pulmonary vascular disease, hypoventilation, and left heart disease
SOB, fatigue, syncope
Raised JVP
Parasternal heave
Loud S2, presence of S3, pan systolic and end diastolic murmurs

Question 16

OSA

Answer 16

excessive daytime sleepiness
Lack of concentration
Snoring
Keep waking up in middle of night
Obese
Apnoeic episodes

Question 17

pneumonia, pet parrot

Answer 17

chlamoydophila pitacci

Question 18

pneumonia, drinker or immunocompromised

Answer 18

klebsiella

Question 19

pneumonia, been abroad/water tanks/swimming pools/Spain

Answer 19

legionella

Question 20

aspiration pneumonia

Answer 20

issues swallowing, excessive alcohol, stroke

Question 21

community acquired pneumonia

Answer 21

typically strep pneumonea

Question 22

hospital acquired pneumonia

Answer 22

staph aureus

Question 23

pneumonia, coxiella

Answer 23

farming

Question 24

diphtheria

Answer 24

been abroad
severe sore throat with grey-white membrane on pharynx

Question 25

epiglottitis

Answer 25

drooling in children

Question 26

anaerobic bacteria in lung

Answer 26

caveating lesions in CXR foul smelling sputum

Question 27

lung abscesses

Answer 27

foul smelling sputum recurrent fever a history of stroke finger clubbing may follow pneumonia

Question 28

small cell lung cancer

Answer 28

presents with dry cough, weight loss, SOB smoker hypokalaemia

Question 29

squamous cell lung cancer

Answer 29

presents with dry cough, weight loss, SOB inspiratory monophonic wheeze on auscultation caveating mass on CXR smoker hyperkalaemia and weak bones

Question 30

adenocarcinoma

Answer 30

presents with dry cough, weight loss, SOB hypertrophic pulmonary osteoarthropathy non-smoker

Question 31

rust coloured sputum

Answer 31

s. pneumonia

Question 32

green sputum

Answer 32

pseudomonas, haemophilus

Question 33

red currant jelly sputum

Answer 33

klebsiella

Question 34

foul smelling and bad-tasting sputum

Answer 34

anaerobes

Question 35

respiratory acidosis

Answer 35

deceased pH increased PaCO2 increased HCO3

Question 36

respiratory alkalosis

Answer 36

increased PH decreased PaCO2 decreased HCO3

Question 37

metabolic acidosis

Answer 37

decreased pH decreased PaCO2 decreased HCO3

Question 38

metabolic alkalosis

Answer 38

increased pH increased PaCO2 increased HCO3

Question 39

asthma vs COPD

Answer 39

asthma typically younger, dry cough COPD typically older, smoker, productive cough

Question 40

positive ziehl-nielsen stain, granulomas

Answer 40

TB

Question 41

tension pneumothorax

Answer 41

deviated trachea, chest pain usually following trauma eg road traffic accident

Question 42

ARDS

Answer 42

bilateral diffuse infiltrates bilateral lung crackles (with no other signs of heart failure)