Resp Exam Flashcards
An otherwise healthy 11 year old boy has a developmental defect involving a depression of the sternum. The term for this abnormality is
a. Pectus carinatum
b. Pectus excavatum
c. Harrison’s sulcus
d. Kyphoscoliosis
b. Pectus excavatum
A 60 yr old patient with biventricular cardiac failure complains that she is now unable to do her routine housework, such as taking down washing from the line, without feeling short of breath. How would you categorize this patient’s dyspnoea according to the New York Heart Association classification?
a. Class I
b. Class II
c. Class III
d. Class IV
c. Class III
I No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath).
III Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.
A patient presents with a history of dyspnoea whilst performing minimal household chores. Using the NYHA grading system, in which class would you place this patient?
a. Class 1
b. Class 2
c. Class 3
d. Class 4
c. Class 3
On inspection of a patient’s chest you observe Pectus Carinatum. Which one of the following statements best describes this deformity?
a. A linear depression of the lower ribs just above the costal margins
b. An outward bowing of the sternum and costal cartilage
c. Depression of the lower end of the sternum
d. Exaggerated forward curvature of the spine
b. An outward bowing of the sternum and costal cartilage
Which one of the following statements refers to vesicular breath sounds?
a. They have a hollow blowing quality
b. They are audible throughout expiration
c. They are longer and louder in inspiration than expiration
d. There is a gap between inspiratory and expiratory sound
They are longer and louder in inspiration than expiration
A patient presents with a localised prominence of the sternum and costal cartilage. The term used to describe this abnormality is
a. Harrison’s sulcus
b. Scoliosis
c. Pectus excavatum
d. Pectus carinatum
d. Pectus carinatum
On observation of a patient’s breathing pattern you notice rapid, deep respiration. The term used to describe this pattern of breathing is
a. Paradoxical breathing
b. Cheyne- stokes breathing
c. Kussmaul’s breathing
d. Ataxic breathing
c. Kussmaul’s breathing
(Cheyne–Stokes respiration is an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea.)
(Ataxic respiration is an abnormal pattern of breathing characterized by complete irregularity of breathing, with irregular pauses and increasing periods of apnea.)
(Paradoxical breathing is the term for a sign of respiratory distress associated with damage to the structures involved in breathing. Instead of moving out when taking a breath, the chest wall or the abdominal wall moves in. Often, the chest wall and the abdominal wall move in opposite directions with each breath.)
In which one of the following conditions are you UNLIKELY to find pulsus paradoxus?
a. Constrictive pericarditis
b. Pericardial effusion
c. Severe asthma
d. Infective endocarditis
d. Infective endocarditis
(Pulsus paradoxus, also paradoxic pulse or paradoxical pulse, is an abnormally large decrease in stroke volume, systolic blood pressure and pulse wave amplitude during inspiration)
Normally, the systolic blood pressure decreases by less than 10 mmHg during inspiration.
A patient presents with Cheyne- Stokes breathing. Which of the following diagnoses is associated with this breathing pattern?
a. Enlarged tonsils
b. Left ventricular failure
c. Metabolic acidosis
d. Diaphragmatic paralysis
b. Left ventricular failure
On examination a patient is found to have tracheal deviation towards the side of the lung lesion. Which one of the following pathologies could cause this sign?
a. Upper mediastinal mass
b. Upper lung collapse
c. Tension pneumothorax
d. Subcutaneous emphysema
b. Upper lung collapse
In which of the following conditions is the patient most UNLIKELY to complain of haemoptysis?
a. Systemic lupus erythematosus
b. Bronchial carcinoma
c. Cystic Fibrosis
d. Tracheitis
d. Tracheitis
A. Sleep apnoea B. Apneustic breathing (post-inspirational pause) C. Kussmauls breathing D. Hyperventilation E. Paradoxical breathing F. Cheyne Stokes breathing G. Ataxic breathing (irregular rate and depth) H. Hypoventilation
For each of the following patients, select the most appropriate breathing pattern the patient will present with
a. A 22 year old Type 1 diabetic is admitted with diabetic keto-acidosis
b. An unconscious man is admitted following a motor vehicle accident, in which he sustained a severe head injury
c. A patient is admitted to the Trauma Unit with multiple fractures of the left chest resulting in unequal chest rise
d. A patient is admitted to casualty after taking an overdose of morphine
C
F
E
H
A patient complains of a dry irritating cough. Which of the following is the most likely cause?
a. Obstructive pulmonary disease
b. Vocal chord paralysis
c. Lung abscess
d. ACE inhibitor drugs
d. ACE inhibitor drugs
The mechanism of ACE inhibitor-induced cough remains unresolved, but likely involves the protussive mediators bradykinin and substance P, agents that are degraded by ACE and therefore accumulate in the upper respiratory tract or lung when the enzyme is inhibited.
A patient is examined and it is noted that his respiratory depth waxes and wanes over a period of a minute from hyperpnoea to periods of apnoea. Which one of the following conditions is unlikely to be a cause of this pattern of breathing?
a. Enlarged tonsils
b. Terminal disease
c. High altitude
d. Brain damage
a. Enlarged tonsils
In which one of the following conditions would you expect to find pulsus paradoxsus?
a. Severe asthma
b. Pulmonary odema
c. Pneumothorax
d. Lobar pneumonia
a. Severe asthma
On auscultation of the patient’s chest you hear bronchial breathing. Which one of the following conditions is most likely to produce this sign?
a. Localized pulmonary fibrosis
b. Pleural effusion
c. Lung consolidation
d. Pneumothorax
c. Lung consolidation
A patient presents with dysphonia. Which one of the following conditions is likely to cause this symptom?
a. Inhaled corticosteroids
b. Foreign body inhalation
c. Epiglottitis
d. Anaphylaxis
a. Inhaled corticosteroids
Dysphonia refers to having an abnormal voice. It is also known as hoarseness.
