resp DDx

Question 1

Covid 19

Answer 1

URTI in which viral replication leads to loss of both type 1 and type 2 pneumocytes( line alveoli)

fever, rigors, cough/productive-non productive

Question 2

Influenza

Answer 2

URTI affecting respiratory epithelial lining, and progressing to the lower tract as it worsens until it reaches alveolar and becomes systemic

fever, Pharyngitis, headache

Question 3

Lung Cancer

Answer 3

malignant epithelial tumours within the respiratory tract

cachexia, cough, dullness on percussion, pleuritic chest pain

Question 4

Tonsillitis

Answer 4

bacteria or virus infection of tonsils

Pharyngitis, fever, enlarged lymph nodes

Question 5

Bronchiolitis

Answer 5

infection of smaller airways

fever, SOB, atelectasis, more prone in children

Question 6

asthma

Answer 6

bronchial airways narrow/ inflame causing increase mucus bronchi spasms-via extrinsic/intrinsic triggers

(intrinsic more in adults with nil Hx)

wheeze, decrease SpO2, cyanosis, reduce speech

Question 7

bronchiectasis

Answer 7

irreversible dilation of airways, via inflammation of bronchial walls, creating excess mucus crushing cilia creating difficulty moving mucus

coarse crackles, wheezes, muscle inflammation due to poor gas exchange

Question 8

emphysema

Answer 8

abnormal permanent enlargement of air spaces distal to bronchioles with alveolar wall damage

barrel chest, persistent cough, cachexia

Question 9

COPD

Answer 9

combination of emphysema and chronic bronchitis

dyspnoea, purulence, cough

Question 10

pneumonia

Answer 10

pathogen infecting bronchioles or alveoli causing inflammatory response
3 types- CAP, HAP, aspiration pneumonia

cough-purulent, fever, dyspnoea, crepitus on auscultation

Question 11

idiopathic pulmonary fibrosis

Answer 11

unknown cause of lung scarring, via damage to epithelial lining, causing increase in collagen and decrease elasticity and gas exchange

dry cough, dyspnoea, finger clubbing, decrease chest wall movement

Question 12

cystic fibrosis

Answer 12

affects lung and pancreas. due to inability to pump chloride ion outside of cell causing thick mucus body wide causing damage to pancreas and then pulmonary damage

new born- bowel obstructions

early child-pancreatitis, malnutrition

bronchiectasis-due to pulmonary remodelling

Question 13

Pleuritis

Answer 13

inflammation of the pleura (membranes surrounding lung to allow expand/contract on chest wall, pleuritis infection of inner lining), normally from viral cause

dyspnoea, plural effusion, pleuritic chest pain, back/shoulder pain worsening on respiratory use

Question 14

pneumothorax

Answer 14

air between the lung and chest wall, equalising pressure in cavity, removing lung ability to recoil, and collapse
closed due to puncture or rupture of lung
open-puncture to chest wall
tension-increase in pressure plural cavity

dyspnoea, tachycardia, stabbing chest pain, decrease breath sounds, hyper resonance on percussion

Question 15

Acute pulmonary oedema

Answer 15

caused by increase in lung permeability with changes to hydrostatic and oncotic pressure, leading to movement of fluid normally in relation to heart failure

dyspnoea worsen on lying, pink frothy sputum, coarse/fine crackles, oedema