Exam case studies

Question 1

Bronchiectasis

Answer 1

Long term condition affecting the airways
Abnormal dilation of one or more bronchi.
Due to severe lower respiratory tract infection e.g. pneumonia
Or secondary manifestation of COPD.

Question 2

Respiratory tubercolosis

Answer 2

Contagious infection that destroys tissue

Fever, night sweats, chest wall pain, weight loss, haemoptysis, SOB.

Question 3

Oesophageal carcinoma

Answer 3

Cancer of the oesophagus.

Question 4

Oesophagogastrectomy

Respiratory implication

Answer 4

Removal of top part of stomach and bottom part of oesophagus

PPC’s- pneumonia.

Question 5

Emphysema

Answer 5

Part of COPD
Walls of air sacs in lungs are damaged
No secretions.

Question 6

Below knee amputation

Answer 6

Transtibial amputation

Question 7

Laparotomy

Answer 7

Incision in abdominal wall to access abdominal cavity

Question 8

Duodenal ulcer

Answer 8

Develops in part of small intestine

Question 9

CABG

Answer 9

Coronary artery bypass graft surgery

Treats blockage or narrowing of coronary artery to restore blood supply to heart muscle.

Question 10

alpha1- antitrypsin deficiency emphysema

Answer 10

Rare inherited condition
Can lead to COPD
Low levels of AATD means lungs aren’t as well protected and enzymes can damage the lungs
SOB, wheezing, reduced exercise tolerance
Can lead to liver problems

Question 11

Lung volume reduction surgery

Answer 11

Remove least functional parts of lung to improve airflow.

Question 12

Respiratory TB physio management

Answer 12

Sputum samples in negative pressure room

Exercise in isolation cubicle.

Question 13

Elective left hemi-colectomy

Answer 13

Removal of left side of bowel
Altered diet prior to surgery- may lead to dehydration or fatigue after surgery.
Laparotomy incision

Question 14

Oesophageal gastrectomy physio management

Answer 14

Malnourished pre op commonly
Can affect healing
Avoid head down, neck extension

Question 15

Risks of c section

Answer 15

Infection
Womb line infection
DVT

Question 16

Heart lung transplant

Answer 16

Suggests end stage disease, survival limited, quality of life is poor.
Performed by median sternotomy or clam shell incision.

Question 17

Diabetes and amputation

Answer 17

Diabetes can cause nerve damage and poor circulation
Can lead to foot ulcers which can worsen quickly
High risk of peripheral artery disease which reduces blood flow to legs and feet.

Question 18

Diabetics after surgery

Answer 18

Poor, slow healing

Delays recovery

Question 19

Lung volume reduction surgery for emphysema/AATD

Answer 19

Removing large airway space- less air is trapped so breathing is more efficient
AATD- significant improvement dyspnoea and lung function for 3.5 years (Tutic et al, 2004)

Question 20

Pre transplant rehab for heart and lung transplant patient

Answer 20

Optimize physical and functional performance
Exercise training, nutritional support, psychosocial support, education
Education- nutrition, keeping active, stress management, use of time to improve quality of life
Training 2-3 times a week

Question 21

Exercise training pre heart and lung transplant

Answer 21

2-3 times a week

Functional exercises, ROM, stretching, endurance

Question 22

Post op transplant care

Answer 22

Optimize ventilation
Clear secretions
Increase exercise tolerance
Achieving independence with ADLs