Respirology - Labs and Investigations

Question 1

What condition should you always consider in the elderly with decreased mental capacity?

Answer 1

Pneumonia

Question 2

What condition produces Charcot-Leydon Crystals in the sputum?

Answer 2

Asthma

These crystals are derived from eosinophils

Question 3

Would atelectasis result in radiopacity or radiolucency?

Answer 3

Radiopacity

Question 4

If the cardiac silhouette on a lung X-Ray is greater than what size (in relation to the chest wall) is it considered Cardiac Hypertrophy?

Answer 4

1/2 the width of the chest wall

Question 5

Describe the spirometry features of Restrictive Lung Conditions

Answer 5

1. ) Decreased Total Lung Capacity
2. ) Decreased FVC, FEV1
3. ) FEV1:FVC ratio is increased (>80%)

Question 6

Describe the spirometry findings of COPD

Answer 6

1. ) Decreased FVC, FEV1, FEV1:FVC ratio

2. ) Increased Total Lung Capacity (air trapping)

Question 7

Before taking a sputum culture, how do you prepare the mouth?

Answer 7

Rinse the mouth with sterile water to try and remove normal oral flora. The sample then needs to be preceded by a deep productive cough

Question 8

What screening modality should be performed on all cases of chronic cough (>2 months)?

Answer 8

Chest Plain Film

Question 9

This fungal infection is diagnosed by serological testing (IgM precipitins)

Answer 9

Coccidiomycosis

Question 10

Name the condition:

This fungal infection most commonly presents as atypical pneumonia with patchy infiltrates on X Ray and with concomitant flu-like symptoms.

Answer 10

Histoplasmosis (carried by bat droppings)

Question 11

All patients with cryptococcal pneumonia should undergo what investigative study?

Answer 11

Lumbar Puncture to rule out a comorbid meningitis

Question 12

Would a pulmonary embolism show up radiopaque or radiolucent on X-Ray?

Answer 12

Radiolucent on XRay

Question 13

What is the term used to describe the alternation of tachypnea with apnea in patients with neurologic diseases or congestive heart failure?

Answer 13

Cheyne-Stokes Respiration

Question 14

Histiologically, what happens in chronic bronchitis?

Answer 14

Mucinous hypertrophy.The Reid Index (ratio of mucinous glands relative to the total thickness of the bronchial wall) is > 50%

The mucinous hypertrophy explains why people with chronic bronchitis have a very productive cough

Question 15

What should acute onset of dyspnea with a normal chest X Ray be considered until proven otherwise?

Answer 15

Pulmonary Embolism

Question 16

Percussion during a pneumothroax would reveal what type of sound?

Answer 16

Dullness

Question 17

Why isn’t mycoplasma pneumoniae visible on gram stain?

Answer 17

M. pneumoniae does not have a cell wall

Question 18

Name the condition:

X Ray shows apical lung lesions with calcification and fibrosis. This pathogen is diagnosed via sputum culture and biopsy- not serology

Answer 18

Histoplasmosis