DPD: Amir Sam Resp. cases

Question 1

List 3 causes of sudden onset shortness of breath (seconds)

Answer 1

Pneumothorax- rupture of bullae

PE

FB

Question 2

List 3 causes of shortness of breath occurring within minutes

Answer 2

Inflammation/ obstruction of airways

Chest infection (pus)

Acute heart failure (fluid)

Question 3

List 5 causes of shortness of breath persisting for days/ weeks

Answer 3

Interstitial lung disease

Malignancy

Large pleural effusion

Neuromuscular

Anaemia

Question 4

What treatment is required for primary pneumothoraces <2cm and >2cm?

Answer 4

< 2cm: Discharge, repeat CXR

> 2cm: Aspiration, if unsuccessful chest drain

Question 5

What treatment is required for secondary pneumothoraces <2cm and >2cm?

Answer 5

< 2cm: Aspiration

> 2cm: chest drain

Question 6

What signs may be seen on ECG due to a PE?

Answer 6

Signs of strain on the right side of the heart

RBBB

Right axis deviation

S1Q3T3

Question 7

What is the significance of either lead I or II being negative? What else should you look at?

Answer 7

Axis deviation

Overall +ve avL= LEFT axis deviation

Overall -ve avL= Right axis deviation

Question 8

What is the likely diagnosis in a: 50y F with chronic SOB, sputum, no clubbing + FEV1/FVC ratio < 70% ? What features may be seen on CXR?

Answer 8

COPD

Lung hyperinflation

Flattened diaphragm

Question 9

What is the likely diagnosis in a patient with: Cough sputum wt loss Night sweats fluffy airspace shadowing on CXR

Answer 9

Pulmonary TB

Question 10

What is the likely diagnosis in a: 70y M SOB Keeps pigeons CXR: bilateral reticular nodular shadowing

Answer 10

Extrinsic allergic alveolitis

Question 11

What features are seen on this CXR? What is the likely diagnosis?

Answer 11

hyperexpanded + flattened diaphragm

COPD

Question 12

What features are seen on this CXR? What is the likely diagnosis?

Answer 12

Lung markings absent on left

Pneumothorax

Question 13

What features are seen on this CXR? What is the likely diagnosis?

Answer 13

Airspace fluffy shadowing

Pneumonia

Question 14

What features are seen on this CXR? What is the likely diagnosis?

Answer 14

Bilateral airway shadowing

Pulmonary oedema

Question 15

What features are seen on this CXR? What is the likely diagnosis?

Answer 15

Reticular nodular pattern

Pulmonary fibrosis

Question 16

What features are seen on this CXR? What is the likely diagnosis?

Answer 16

Homogenoeus left pleural effusion

Question 17

What features are seen on this CXR? What is the likely diagnosis?

Answer 17

Right lung collapse

Question 18

What features are seen on this CXR? What is the likely diagnosis?

Answer 18

Left cavitating lesion with air-fluid level visible

Infection (TB)

Inflammation (RA)

Malignancy (squamous cell carcinoma)

Question 19

What features are seen on this CXR? What is the likely diagnosis?

Answer 19

Globular outline of the heart

Enlarged heart

Pericardial effusion

Question 20

What features are seen on this CXR? What is the likely diagnosis?

Answer 20

Bilateral hilar lymphadenopathy

Infection (TB)

Inflammation (sarcoid)

Malignancy (lymphoma)

Question 21

What features are seen on this CXR? What is the likely cause?

Answer 21

Pleural plaques

Asbestos exposure

Question 22

What are the different causes of shadowing based on distribution?

Answer 22

Alveolar/ interstitial shadowing: fluid (heart failure) or pus (pneumonia)

–reticulonodular shadowing (fibrosis)

–homogeneous shadowing (pleural effusion)

Question 23

What is suggested by a reticulo-nodular pattern of opacities?

Answer 23

Pulmonary fibrosis

Question 24

What is suggested by homogeneous shadowing?

Answer 24

Pleural effusion

Question 25

List 3 infectious causes of a cavitating lung lesion with an air fluid level

Answer 25

Staphylococcus aureus

Klebsiella pneumoniae

TB

Question 26

List 3 non-infectious causes of a cavitating lung lesion with an air fluid level

Answer 26

Squamous cell carcinoma

Rheumatoid arthritis

Granulomatosis with Polyangiitis