Resp Exam

Question 1

Flapping tremor?

Answer 1

CO2 retention - COPD

Question 2

Bruising?

Answer 2

Oral/inhaled steroid use

Question 3

Respiratory causes of clubbing?

Answer 3

Fibrotic lung disease
Cystic fibrosis
Bronchiectasis
Lung cancer

Question 4

Look for Horner’s syndrome: Causes?

Answer 4

Pancoast tumour
Trauma to the brachial plexus
Stroke
Syringomelia
Schwannoma
Traumatic injury

Damage to the carotid artery along the side of the neck
Damage to the jugular vein along the side of the neck
Tumor or infection near the base of the skull
Migraines
Cluster headaches, a disorder that results in cyclical patterns of severe headaches

Question 5

What does elevated JVP indicate?

Answer 5

Cor pulmonale

Question 6

Chest deformities?

Answer 6

Pectus excavatum - inwards
Pectus carinatum- outwards
Bruises
Scars
Cachetic?

Question 7

Thoractomy scar - which surgeries?

Answer 7

Lobectomy, pneumonectomy, lung transplant

Question 8

VATS car – small scars on back and side: for what procedure?

Answer 8

lung biopsy, treated effusion/empyema

Question 9

What is a heave?

Answer 9

Right ventricular hypertrophy (COPD, ILD, pulmonary hypertension

Question 10

Assess apex beat in resp exam

Answer 10

do it

Question 11

Stony dull percussion?

Answer 11

Pleural effusion

Question 12

Coarse crepitations/crackles?

Answer 12

Bronchiectasis
Pneumonia
Pulmonary oedema

Question 13

Quiet breaths?

Answer 13

Pleural effusion, hyperinflated lungs

Question 14

Fine-end inspiratory crackles?

Answer 14

Pulmonary fibrosis

Question 15

Increased vibration vocal fremitus?

Answer 15

Pneumonia
Lobar collapse

Question 16

Decreased vibration vocal fremitus?

Answer 16

Pneumothorax
Pleural effusion

Question 17

Acutely managing AF

Answer 17

A-E
If unstable, discuss with cardiology for cardioversion
If stable, consider beta blocker
Look for reversible causes e.g. infection

Question 18

2nd degree heart block, Mobitz type 2
How would you manage this patient?
What is this patient at risk of?

Answer 18

How would you manage this patient?
A-E
Refer to cardiology for consideration of pacing
At risk of complete heart block

Question 19

What medications does she need to be on after MI?

Answer 19

BADS
beta blocker, ACEi, dual antiplatelets, statin

Question 20

Investigations for sinus bradycardia?

Answer 20

A medication review, blood tests including thyroid function, repeat ECGs, chest x-ray, echocardiogram and 24-hour tape would be reasonable first-line investigations.

Question 21

Treatment of brugada?

Answer 21

ICD