respi pathologies

Question 1

what respiratory conditions is clubbing associated with?

Answer 1

lung cancer
lung abscess
pulmonary fibrosis
cystic fibrosis
bronchiectasis

Question 2

what causes weakness in finger abduction?

Answer 2

compression of C8/T1 nerve root by pancoast tumour

Question 3

what does flapping tremor indicate in COPD?

Answer 3

CO2 retention

Question 4

what may wrist tenderness and swelling be a sign of?

Answer 4

hypertrophic pulmonary osteoarthropathy (associated with lung cancer)
periosteal inflammation of distal ends of long bones

Question 5

what are indications of Horner’s syndrome?

Answer 5

1. miosis (constriction of pupil)
2. ptosis (drooping of eyelids)
3. anhidrosis (no facial sweating)

Question 6

what causes Horner’s syndrome?

Answer 6

compression of sympathetic trunks

Question 7

what causes positive pemberton’s sign?

Answer 7

SVC obstruction

Question 8

what is observed in a positive pemberton’s sign?

Answer 8

1. facial plethora (redness)
2. inspiratory stridor (oedema compressing on nasal passages, larynx, pharynx)
3. cyanosis
4. non-pulsatile elevation of JVP

Question 9

when does trachea deviation away from side of pathology?

Answer 9

pneumothorax, pleural effusion

Question 10

in a collapsed lung (atelectasis), how does trachea deviate?

Answer 10

towards collapsed lung

Question 11

what is neutrophil elastase?

Answer 11

enzyme that breaks down alveolar wall, breaks down elastin fibres

Question 12

what does alpha-1 antitrypsin do?

Answer 12

coats lung and protects them from neutrophil elastase

Question 13

what are two conditions associated with COPD?

Answer 13

1. chronic bronchitis (inflammation of bronchi)
2. emphysema (destruction of alveoli)

Question 14

what is asthma?

Answer 14

chronic reversible inflammatory lung disease
increased airway hyperresponsiveness

Question 15

what are examples of atopic diseases?

Answer 15

asthma, eczema, hay fever

Question 16

what type of asthma is allergic, exercise-induced asthma?

Answer 16

T2 asthma

Question 17

what type of asthma is obesity-related and smoking-related neutrophilic asthma?

Answer 17

non-T2 asthma

Question 18

what type of asthma is late-onset eosinophilic asthma?

Answer 18

T2 asthma

Question 19

what are some symptoms/signs of asthma?

Answer 19

symptoms: acute shortness of breath, expiratory wheezing
signs: harrison’s sulcus, use of accessory muscles

Question 20

what are the main risk factors of developing COPD?

Answer 20

alpha-1 antitrypsin deficiency
smoking

Question 21

how does smoking cause COPD?

Answer 21

cigarette smoke irritates airways –> chronic inflammation –> activated neutrophils/macrophages secrete neutrophil elastase –> break down alveolar wall –> emphysema

Question 22

in what conditions are tracheal tug observed?

Answer 22

asthma and COPD

Question 23

what is pink frothy sputum suggestive of?

Answer 23

acute pulmonary oedema

Question 24

what is irreversible dilation of the bronchial tree called?

Answer 24

bronchiectasis

Question 25

what is the most common causative agent of CF in early childhood?

Answer 25

S. aureus

Question 26

what is the most common causative agent of CF beyond childhood?

Answer 26

Pseudomonas aeruginosa

Question 27

what is the difference between closed and open pneumothorax?

Answer 27

closed: air enters pleural space via hole in lung open: air enters pleural space via hole in chest wall

Question 28

what is a tension pneumothorax?

Answer 28

injury acts as a one way valve --> air enters pleural space but cannot get out --> shifting of mediastinal structures, trachea deviation

Question 29

what condition gives stony dull lung bases on percussion?

Answer 29

pleural effusion

Question 30

what are symptoms present in pneumothorax?

Answer 30

pleuritic chest pain, dyspnoea

Question 31

what is the blunting of costophrenic angles on CXR suggestive of?

Answer 31

pleural effusion

Question 32

what is the main cause of lung abscess?

Answer 32

aspiration of respiratory/gastric secretion (usually in unconscious patients)

Question 33

what is the bat wing sign on CXR indicative of?

Answer 33

acute pulmonary oedema

Question 34

what conditions give hyperresonant percussion note?

Answer 34

COPD, pneumothorax

Question 35

what conditions give dull percussion note?

Answer 35

pneumonia

Question 36

does pneumonia caused increased or decreased vocal resonance?

Answer 36

increased vocal resonance (sound travels better through fluid)

Question 37

why does pleural effusion cause decreased vocal resonance?

Answer 37

lung is further away from chest wall, disrupts normal transmission of sound

Question 38

what is acute pulmonary oedema?

Answer 38

fluid build up in alveoli

Question 39

what signs are seen on CXR in pulmonary embolism?

Answer 39

no remarkable findings

Question 40

what is a definitive diagnosis method for pulmonary embolism?

Answer 40

CT pulmonary angiogram

Question 41

A lung abscess can be a result of all of the following except: a. Septic emboli b. Bronchiectasis c. Right-sided endocarditis d. Viral pneumonia

Answer 41

d) viral pneumonia

Question 42

what is pulsus paradoxus?

Answer 42

exaggerated fall in blood pressure upon inspiration

Question 43

Clinical signs of pneumonia may include: a. Dull Percussion note b. Crackles c. Altered bronchial breath sounds d. Increased vocal resonance

Answer 43

all of the above