Respiratory System

Question 1

Types of cough (9)

Answer 1

Dry- pleural ds, mediastinal lesion
Productive - Suppurative lung ds
Brassy/Gander/ Leopard growl- intrathoracic space occupying lesions, aortic aneurysm, metallic sound
Bovine- recurrent laryngeal nerve irritation
Paroxysmal/sudden - BA, WHOOPING, FBS, CH BRONSHITIS
BARKING- croup, epiglottis
SPLUTTERING- TEF
HACKING- smoker, laryngitis
Otogenic- Arnold’s nerve irritation wax fb

Question 2

Color of cough with expectoration 🗣🫁

Answer 2

YELLOW- bacterial
GREEN- pseudomonas
Red/ CURRANT JELLY- Klebsiella sticky
White- allergy, asthma, viral
Charcoal/BLACK/GRAY- occupational , environmental (melanoptysis
Brown- CLD, CF, Bronchiectasis
ANCHOVY SAUCE BROWN- ruptured amebic liver abscess
Orange- tropical eosinophilia
Rusty prudent- pneumococcal pneumonia
Yellow black granules- ACTINOMYCOSIS
BLOOD TINGED FROTHY- CHF/ PUL EDEMA

Question 3

Nocturnal cough 😷
CLAT BP

Answer 3

Chronic bronchitis
LHF
Aspiration
Tropical eosinophilia
Bronchial asthma
Post nasal drip

Question 4

Hemoptysis PARENCHYMAL causes🗣️🩸

Answer 4

TB- RASMUSSEN ANEURYSM_dilation of pul A. In tubercular cavity

Klebsiella pneumonia
ABPA
Trauma to parenchyma

Question 5

Thin built

Answer 5

Pneumothorax
TB
HIV
Malignancy

Question 6

PICKWIKIAN SYNDROME / OBESITY HYPOVENTILATION SYNDROME

Answer 6

Obesity
Hypoxia
Pul htn
Too well built

Question 7

Kartageners syndrome
🌟 RBS Male

Answer 7

Recurrent sinusitis with ciliary dyskinesia
Bronchiectasis
Situs inversus
Male infertility

Question 8

Kartageners syndrome
🌟 RBS Male

Answer 8

Recurrent sinusitis with ciliary dyskinesia
Bronchiectasis
Situs inversus
Male infertility

Question 9

Samters triad 🌟EBA

Answer 9

Ethmoidal polyp
Bronchial asthma
Aspirin sensitivity

Question 10

Churg Strauss syndrome 🌟 GAVE

Answer 10

Granuloma
Asthma
Allergic rhinitis
Vasculitis
Eosinophillia

Question 11

Hutchinsons index🌟

Answer 11

Normal transverse to AP dia of chest =7:5

Question 12

Barrel chest 🌟

Answer 12

COPD, emphysema
Transverse : AP dia = 1:1
Exaggerated thoracic kyphosis
Wide subcostal angle

Question 13

Flial chest 🌟

Answer 13

Paradoxical movement of chest in fracture of more than 3 ribs

Question 14

Vertebral level of inf angle of scapula

Answer 14

T7

Question 15

Hoover sign

Answer 15

COPD ,ch airway obstruction
Paradoxical indrwaing of lateral part of ribcage /costal margin

Question 16

Broadbents sign

Answer 16

Indrwaing of lower ant chest wall with each ventricular systole

Question 17

Cough center

Answer 17

Medulla
Nucleus tractus solitarius

Question 18

Post tussive syncope

Answer 18

Question 19

MCC of chronic cough

Answer 19

Chronic cigarette smoking

Question 20

Acute cough causes ….resp? 🌟 TBVAP 🌟FABW …non resp ??

Answer 20

RESPIRATORY CAUSES …..
tracheobronchitis
Bronchioliyis
Viral pneumonitis
Acute bronchitis
Pulmonary embolism
Foreign body
Asthmatic bronchitis
Bronchial athma
Whooping cough

NON RESP CAUSES -
LVF
GERD

Question 21

Causes of chronic cough 🌟 SAVE LIVES

Answer 21

Question 22

Normal daily production of cough

Answer 22

10-15 ml per day

Question 23

Bronchorrea

Answer 23

More than 100 ml per day of expectoration

Causes :
Bronchiectasis
Bronchoalveolar ca
Op poisoning
PAP

Question 24

Three layer sputum

Answer 24

Top - frothy sputum
Middle - mucoid sputum
Lowest - pus cells

Seen in bronchiectasis

Question 25

Postural variation of secretions seen in

Answer 25

Bronchiectasis Lung abscess

Question 26

Causes of HEMOPTYSIS

Answer 26

Bronchial PARENCHYMAL Vascular Cardiovascular Hematological

Question 27

Bronchial causes of HEMOPTYSIS

Answer 27

Bronchitis Bronchiectasis Bronchial cancer

Question 28

Rasmussen aneurysm

Answer 28

Dilatation of pulmonary artery in a tuberculous cavity

Question 29

Vascular disease causing hemoptysis

Answer 29

Pulmonary infarction PAN Good pasteurs dis Pulmonary HTN Idiopathic pulmonary hemosiderosis

Question 30

Cardiovascular causes of HEMOPTYSIS

Answer 30

Acute LV failure Mitral stenosis Aortic aneurysm Pulmonary embolism

Question 31

Difference between HEMOPTYSIS AND HEMATEMESIS

Answer 31

Question 32

Massive hemoptysis DEFN

Answer 32

Coughing blood >=150 ml per episode Or >=600 ml per day

Question 33

Causes of massive hemoptysis

Answer 33

Pulmonary tb Pulmonary embolism Lung abscess Bronchogenic ca Bronchiectasis Cystic fibrosis Mitral stenosis Pul AV malformations Necrotizing pneumonia

Question 34

Causes of dyspnea

Answer 34

OBSTEUCTIVE - COPD , asthma ,foreign body , tumor DECREASED COMPLIANCE- PULMONARY EDEMA , FIBROIS, allergic alveolitis ReSTRICTIVE chest expansion CAUSE - Ankylosing spondylitis , kyphoscoliosis , respiratory paralysis

Question 35

Diseases with impaired respiratory muscle function

Answer 35

Poliomyelitis GBS MYasthenia gravis

Question 36

Herring breuer reflex

Answer 36

Due to J receptors at the alveolo capillary junction

Question 37

Orthopnea DEFN

Answer 37

Dyspnea in supine / dorsal recumbent position Due to pulmonary congestion in recumbency, diaphragm elevation , increased venous return

Question 38

Causes of orthopnea

Answer 38

RESP- COPD , ASTHMA , BL DIAPHRAGM PALSY NON RESP - Constrictive pericarditis , gerd , gross ascites , obesity

Question 39

DDx of PND

Answer 39

Night mares Panic attacks Nocturnal hypoglycemia OSA

Question 40

Trepopnea DEFN

Answer 40

Aggravation of dyspnea when lying on one side and relieved by lying on opposite side

Question 41

Causes of trepopnea

Answer 41

Unilateral lung disease CHF Lung tumore

Question 42

Platypnea

Answer 42

Dyspnea on sitting or standing and relieved by supine position

Question 43

Platypnea causes

Answer 43

Venous to arterial shunting Asd , pneumonectomy Hepatopulmonary syndrome Pulmonary embolism COPD ARDS STRAIGHT BACK SYNDROME Pericardial effusion Constrictive pericarditis