Advanced Respiratory Exam

Question 1

Asymmetrically decreased breath sounds

Answer 1

focal bulla; lung cancer preventing flow distally

Question 2

Symmetrically decreased breath sounds

Answer 2

– emphysema; someone heavy with thick chest wall

Question 3

Bilateral High pitched Wheezes

Answer 3

asthma or COPD exacerbation

Question 4

Focal Wheeze that persists

Answer 4

focal airway obstruction (tumor, aspirated foreign body)

Question 5

Rhonchi

Answer 5

lots of mucus in airways (bronchitis, pneumonia, COPD, asthma)

Question 6

Crackles

Answer 6

something in small airways & in/around alveoli (edema fluid, pus, fibrosis)

Question 7

Pleural Rub

Answer 7

pleuritic from any cause without much pleural fluid keeping pleural surfaces apart

Question 8

Egophony

Answer 8

consolidative pneumonia; compressed lung at top of large effusion

Question 9

Localized pain without tenderness

Answer 9

– pleural irritation, airway inflammation if substernal

Question 10

Localized pain with tenderness

Answer 10

injury to that part of chest wall (eg fracture)

Question 11

Asymmetrically decreased fremitus

Answer 11

increased diaphragm; anything that keeps pleural surface away from chest wall (effusion, pneumothorax); anything that blocks airflow to that part of lung (endobronchial lesion)

Question 12

Bronchial breath sounds

Answer 12

a pneumonia with consolidation in that area; top of pleural effusion