Macleod's III

Question 1

What is the cause of early inspiratory crackles/rales?

Answer 1

Early inspiratory crackles are usually due to small airway disease such as in bronchiolitis.

Question 2

What is the cause of mid inspiratory crackles?

Answer 2

Mid inspiratory crackles are due to pulmonary oedema

Question 3

What are the causes of late inspiratory crackles?

Answer 3

Pulmonary fibrosis (fine crackles)
Pulmonary oedema
Bronchial secretions in COPD, pneumonia, lung abscess, tubercular lung cavities (coarse crackles)

Question 4

What is the cause of biphasic rales?

Answer 4

Bronchiectasis (coarse crackles)

Question 5

What are the common causes of rales and rhonchi respectively?

Answer 5

Rales are usually due to fluid overload.

Rhonchi is commonly caused by inflammation of the airways.

Question 6

Wheeze is characteristic of which 2 conditions?

Answer 6

Asthma and COPD

Question 7

The pleural friction rub is best heard using the diaphragm or the bell?

Answer 7

Diaphragm, as the pleural friction rub is high-pitched.

Question 8

What is a tracheal tug indicative of?

Answer 8

A tracheal tug is a diagnostic sign for the aneurysm of the arch of the aorta. Patients with severe emphysema or COPD can also present with a tracheal tug.

Question 9

Describe a tracheal tug.

Answer 9

When the Adam’s apple moves down with every inspiration.

Question 10

Which statement is indicative that the pleural effusion is exudative?
A) Pleural fluid protein/serum fluid <0.5
B) Pleural fluid protein/serum fluid >0.5
C) Serum protein/pleural fluid protein <0.5
D) Serum protein/pleural fluid protein >0.5

Answer 10

Pleural fluid protein/serum protein >0.5 is indicative of exudative pleural effusion fluid.