Pathology: Obstructive Diseases

Question 1

Appearance of the Chest:

• Barrel chest
• increased A-P diameter

Answer 1

Emphysema
Bronchitis
Bronchiectasis
Asthma

Question 2

Chest Percussion: Hyperresonant/tympanic note

Answer 2

Emphysema
Bronchitis
Bronchiectasis
Asthma
Pneumothorax

Question 3

Chest X-ray:

• hyperlucent
• depressed or flattened diaphragm
• long & narrow heart
• increased retro-sternal air space

Answer 3

Emphysema
Bronchitis
Asthma

Question 4

Decreased flow rates (FEV1, FEF25-75%, FEV1/FVC)

Answer 4

Emphysema
Bronchitis
Bronchiectasis
Asthma
Cystic Fibrosis

Question 5

Cough: Productive purulent sputum

Answer 5

Bronchitis

Bronchiectasis

Question 6

Past Medical History: Smoking

Answer 6

Emphysema

Bronchitis

Question 7

Past Medical History: Recurrent pulmonary infections

Answer 7

Bronchiectasis

Question 8

Cough: Hemoptysis

Answer 8

Bronchiectasis

Hemothorax

Question 9

Cough: Foul smelling sputum

Answer 9

Bronchiectasis

Question 10

Past Medical History: Daytime sleepiness, insomnia, loud snoring, hypothyroidism

Answer 10

Sleep Apnea

Question 11

Pulmonary Function: Decreased volumes

Answer 11

Sleep Apnea

Question 12

Special Test: Polysomography

Answer 12

Sleep Apnea

Question 13

If both nasal flow and respiratory effort decrease then desaturation is caused by __________.

Answer 13

Central Apnea

Question 14

If nasal flow decreases with an increase in respiratory effort then desaturation is caused by _________.

Answer 14

Obstructive Apnea

Question 15

Shortness of Breath: Pursed-lip breathing

Answer 15

Emphysema
Bronchitis
Bronchiectasis
Asthma

Question 16

Pulmonary Function: Pre and post bronchodilator improvement

*at least 12% and 200mL increase in FEV1

Answer 16

Asthma

Question 17

Cough: Increase in

• eosinophils
• Charcot-Leyden crystals
• IgE levels

Answer 17

Asthma

Question 18

Special Diagnostic Tests: CT/bronchogram indicating “Tree in winter” pattern

Answer 18

Bronchiectasis