EMQs in Respiratory Medicine Flashcards
A 21 year old man has a productive cough, wheeze and steatorrhoea. On examination he is clubbed and cyanosed, and has bilateral coarse crackles. His blood glucose is measured at 11 mmol/L.
Most likely diagnosis:
Cystic Fibrosis
A 63 year old man presents to A&E with weight loss, cough, and haemoptysis and dyspnea. On examination he is anaemic, clubbed and apyrexial.
Most likely diagnosis:
Lung cancer - Broncogenic carcinoma
A 65 year old man presents with dyspnea, and a cough productive of pink frothy sputum. On examination, he is cold, clammy, and tachycardiac, and bibasal end-inspiratory crackles. His jugular venous pressure is elevated.
Most likely diagnosis:
Pulmonary Oedema
A 70 year old woman presents with fever, rigors, shortness of breath and right-sided pleuritic chest pain. On examination the right side of the chest shows reduced expansion, dull percussion and increased vocal resonance.
Most likely diagnosis:
Community Acquired Pneumonia
A 30 year old farmer presents with repeated episodes of fever, rigors, dry cough and shortness of breath with onset several hours after starting work. On examination he is pyrexial with fine end-expiratory crackles. His CXR shows mid-zone mottling.
Most likely diagnosis:
Extrinsic Allergic Alveolitis
An 80 year old man presents with bilateral cavitiating bronchopneumonia after an influenza infection.
Pneumonia Causative Agent:
Staphylococcus aureus
A 24 year old student presents with severe headache, fever, dry cough, and arthralgia. He has recently bought several parrots and was previously fit and healthy.
Pneumonia Causative Agent:
Chlamydia psittaci
A 40 year old man with HIV presents with fever, dry cough, weight loss and exertional dyspnoea.
Pneumonia Causative Agent:
Pneumocystis jiroveci
A 75 year old man presents with headache, dry cough, anaemia and a skin rash. Blood tests detect cold agglutinins.
Pneumonia Causative Agent:
Mycoplasma pneumonia
A 25 year old air-conditioning technician, who suffered from flu-like symptoms a week ago, has developed a dry cough. His chest X-ray shows multi lobar shaddowing. Blood tests show hypoatraemia and lymphopenia. Urinalysis reveals haematuria. He has an acute kidney injury with a urea of 14 mmol/L and creatinine of 145 umol/L.
Legionella pneumophila
A 65 year old smoker, who has exertional angina, presents with shortness of breath, gallop rhythm and production of pink frothy sputum.
Likely Cause:
Pulmonary Oedema
A 24 year old man initially complaining of a cough and intermittent haemoptysis presents a few weeks later with haematuria. Biopsy confirms a crescentic glomerulonephritis. Renal biopsy shows linear pattern deposition on immunofluorescence.
Goodpasture’s Syndrome
A 34 year old woman originally complaining of nasal obstruction develops cough, haemoptysis and pleurtic chest pain. Her CXR shows multiple nodular masses.
Wengener’s Granulomatosis
A 22 year old man presents with fever, nightweats, weight loss and cough productive of cupfuls of blood. Zhiel-Neelsen stain positive for acid-fast bacilli.
Tuberculosis TB
A 35 year old businessman returns from a trip abroad and collapses at the airport with haemoptysis and pleuritic chest pain. He has a sinus tachycardia and his ECG shows right axis deviation.
Pulmonary Embolus
