Final Exam

Question 1

PNEUMOTHORAX:
Causes:

Answer 1

1- Spontaneous
2- Emphysema (rupture of emphysematous bulla)
3- Trauma & During mechanical ventilation.

Question 2

An excessive accumulation of fluid in the pleural
space.

Answer 2

PLEURAL EFFUSTION

Question 3

Abnormal dilatation of the bronchi.

Answer 3

BRONCHIECTASIS

Question 4

Localized suppuration in the lung resulting in cavity formation with a fluid level that is not due to tuberculosis.( long history of predictive cough , foited odour , purulent sputum > 200 cc / day )

Answer 4

LUNG ABSCESS

Question 5

Complications of COPD

Answer 5

Complications of COPD
1 - Respiratory failure
2- Right sided heart failure
3- Polycythemia
4- Rupture of emphysematous bulla

Question 6

Distension of air spaces distal to terminal bronchioles due to
disruption of alveolar walls.

Answer 6

PULMONARY EMPHYSEMA

Question 7

COPD classification

Answer 7

COPD is classified according to
Mild
60-79% predicted
Moderate
40-59% predicted
Severe
< 40% predicted

Question 8

Treatment of bronchial asthma

Answer 8

1 - DURING ATTACKS (mild or moderate attacks):
Rapid-acting inhaled bronchodilator: Salbutamol

Question 9

Finger clubbing
Causes and Tvpes:

Answer 9

1- Pale (toxic)
Causes: Bronchogenic carcinoma,, suppurative lung syndromes,
infective endocarditis
2- Blue (hypoxic)
Causes: Congenital cyanotic heart disease COPD or interstitial pulmonary fibrosis

Question 10

Reflux box

Answer 10

Cough receptors: (pharynx, larynx, trachea & main bronchi)
The afferents: (vagus).
Cough center ( medulla).
Efferents (phrenic N & intercostals nerves.
Expiratory muscles

Question 11

A drop of systolic BP of 20 mmHg or more on standing from a sitting or lying position

Answer 11

Postural orthostatic hypotension

Question 12

Elevation of the legs up while the patient laying on the ground increases venous return and restores blood pressure , if not IV atropin .

Answer 12

Treatment of Neurocardiogenic vasovagal syncope

Question 13

Transient loss of consciousness due to transient cerebral ischemia.

Answer 13

SYNCOPE

Question 14

Right ventricular failure

Answer 14

Cyanosis
Peripheral edema
Ascites
Pericardial effusion
Systemic venous hypertension

Question 15

Normal blood pressure
Prehypertension
Hypertension:
Stage 1
Stage 2

Answer 15

Normal blood pressure: systolic <120 mmIg and diastolic <80
Prehypertension: systolic 120-139 or diastolic 80-89.
Hypertension:
Stage 1: systolic 140-159 or diastolic 90-99
Stage 2: systolic 160 or diastolic 100

Question 16

It is an infective inflammation of cardiac valves & endocardium
It may be : Acute fulminate or more common sub-acute in nature .
It can occur on native or prosthetic valve

Answer 16

INFECTIVE ENDOCARDITIS

Question 17

modified Jones criteria

Answer 17

modified Jones criteria : Two major manifestations or one major and two minor manifestations indicate a high probability of acute rheumatic fever

Question 18

Minor diagnostic criteria of rheumatic fever

Answer 18

Fever
Arthralgia
Prolonged P-R interval on ECG
elevated WBC count
Elevated ESR & C-reactive protein
Elevated ASO tire >200
Prior history of RF

Question 19

Major diagnostic criteria of rheumatic fever

Answer 19

Carditis
Polyarthritis
Chorea
Subcutaneous nodules
Erythema
marginatum

Question 20

Etiology of rheumatic fever

Answer 20

group A beta hemolytic streptococcal pharyngitis.

Question 21

A non-suppurative acute inflammatory complication of group A
streptococcal infection.

Answer 21

RHEUMATIC FEVER

Question 22

•Site : Retrosternal, often radiating down the ulnar aspect of the left arm
and into the neck, to the left shoulder, jaw, or teeth.
Pain is intense, severe.
- Unremitting for 30 to 60 minutes.
- Not relieved by rest or sublingual nitrates.

Answer 22

Myocardial infarction

Question 23

Site : Retrosternal, heaviness, tightness, radiates to left shoulder, inner site of left arm, clbow and little finger.
Relieved rapidly by rest or sublingual nitroglycerine short-acting nitrates.
Duration less than 15 minutes, never seconds or hours.

Answer 23

Angina

Question 24

Difference between hemoptysis and
HEMOPTSIS

Answer 24

HEMATEMSIS
Vomiting of blood
Dark red, Coffee ground[acid hematin]
Mixed with food particles
Acidic.
Followed by melena

HEMOPTSIS
Cough of blood
Bright red due to oxyhemoglobin
Frothy mixed with air
Alkaline
No melena

Question 25

Severe form of cardiac asthma, with severe dyspnea, orthopnea, chest wheezes and cough with frothy blood tinged sputum, associated with intense pericordial oppression and cyanosis. , Bubbling of the chest, with extreme anxiety.

Answer 25

4-ACUTE PULMONARY EDEMA:

Question 26

Dyspnea on lying down, relieved by sitting (patient use more pillows)

Answer 26

3- ORTHOPNEA:

Question 27

Severe attacks of despnya und cough I-2 hs stier sleep (relieved by getting
up). Pathognoronic of lung congestion secondary to left side licant failure

Answer 27

PAROXYSMAL NOCTURNAL DYSFNEA

Question 28

Subjective respiratory distress (increase work of breathing).

Answer 28

1- DISPNRA

Question 29

Left ventricular failure

Answer 29

Left ventricular heart failure

Dyspnea
Orthopnea
Paroxysmal nocturnal dyspnea
Hemoptysis
Cheyne stokes respiration
Nocturia
Acute pulmonary edema

Question 30

A deep expiratory effort against a closed glottis which open suddenly

Answer 30

Cough

Question 31

Allergic disease of anyways characterised by repeated reversible episodes of airway obstruction

Answer 31

Bronchial asthma