RespDiseasePresentations

Question 1

Laryngitis

Answer 1

• Acute inflammation
• dry cough; may become productive of variable amounts of sputum
• acute fairly minor with hoarseness. Often associated with viral rhinosinusitis

Question 2

Acute Bronchitis

Answer 2

• Acute inflammation
• cough, may be dry or productive
• acute, often viral
• illness generally without fever or dyspnea
• at times with burning retrosternal discomfort

Question 3

Mycoplasma and viral pneumonias

Answer 3

• Acute inflammation
• dry hacking cough; may become productive of mucoid sputum
• acute febrile illness, often with malaise, headache, and possibly dyspnea

Question 4

Bacterial pneumonias

Answer 4

• acute inflammation
• sputum is mucoid or purulent (pus)
• sputum may be blood streaked, diffusely pinkish, or rusty
• chills, often high fever, dyspnea, and chest pain
• commonly from strep pneumonia, Haemophilus influenza, moraxella catarrhalis, Klebsiella in alcoholism, esp if underlying smoking, chronic bronchitis and COPD, CV disease, diabetes

Question 5

Postnasal Drip

Answer 5

• chronic inflammation
• chronic cough; sputum mucoid to mucopurulent
• postnasal discharge may be seen in posterior pharynx
• associated with allergic rhinitis, with ot w/o sinusitis

Question 6

Chronic Bronchitis

Answer 6

• chronic inflammation
• chronic cough
• sputum mucoid to purulent may be blood streaked or even bloody
• often with recurrent wheezing and dyspnea, and prolonged history of tobacco use
• possible scattered coarse crackles in dependent portions
• possible wheezing

Question 7

Bronchietasis

Answer 7

• chronic inflammation
• chronic cough
• sputum purulent often copious and foul-smelling; may be blood streaked or bloody
• recurrent bronchopulmonary infections common
• sinusitis may coexist

Question 8

Pulmonary TB

Answer 8

• chronic inflammation
• cough, dry or with mucoid or purulent sputum; may be bloody or blood streaked
• early, no sympts
• later, anorexia, weight loss, fatigue, fever, and night sweats

Question 9

Lung abscess

Answer 9

• chronic inflammation
• sputum purulent and foul-smelling, may be bloody
• usually from aspiration pneumonia with fever and infection from oral anaerobes and poor dental hygiene
• often with dysphagia or episode of impaired consciousness

Question 10

Asthma

Answer 10

• chronic inflammation
• cough, at times with thick mucoid sputum, esp near end of an attack
• episodic wheezing and dyspnea, but cough may occur alone
• often history of allergies
• percussion: resonant to diffuse hyperresonant
• breath sounds often obscured wheezes
• wheezes possibly crackles
• dec tactile fremitus

Question 11

Gastroesophageal reflux

Answer 11

• chronic inflammation
• chronic cough, esp at night or early in the morning
• wheezing, esp at night (often mistaken for asthma)
• early morning hoarseness, and repeated attempts to clear the throat
• often with heartburn and regurg

Question 12

Lung cancer

Answer 12

-neoplasm
-cough, dry to productive
sputum may be blood-streaked or bloody
-commonly with dyspnea, weight loss, and history of tobacco abuse

Question 13

Left Ventricular Failure or mitral stenosis

Answer 13

• CV disease
• often dry, esp on exertion or at night
• may progress to the pink frothy sputum or pul edema or to frank hemoptysis
• dyspnea, orthopnea, paroxysmal nocturnal dyspnea
• normal breath sounds
• late inspiratory crackles in dependent portions
• possible wheezing

Question 14

Pulmonary embolism

Answer 14

• CV disease
• dry cough, at times with hemoptysis
• tachypnea
• chest or pleuritic pain, dyspnea, fever, syncope, anxiety, factors tht predispose to deep venous thrombosis

Question 15

Irritating particles, chemicals, or gases

Answer 15

• variable
• may be a latent period from exposure to symptoms
• exposure to irritants
• eyes, nose, and throat may be affected

Question 16

Pleural Effusion

Answer 16

• Percussion: dull to flat
• trachea: shifted toward unaffected side if large effusion
• breath sounds: dec to absent, but bronchial sounds near top of effusion
• possible pleural rub
• Tactile fremitus: dec to absent, may inc near top of effusion

Question 17

Pneumothorax

Answer 17

• percussion: hyperressonant over pleural air
• trachea: shifted toward unaffected side of tension
• breath sounds: dec to absent over pleural air
• adventitious sounds: none possible pleural rub
• tactile fremitus: dec to absent over pleural air

Question 18

COPD

Answer 18

• percussion: diffusely hyperresonant
• breath sounds: dec to absent, with delayed expiration
• tactile fremitus: dec
• possible crackles, wheezing, rhonchi assoc with chronic bronchitis

Question 19

Lobar Pneumonia (consolidation)

Answer 19

• dull over the airless area
• breath sounds bronchial over the involved area
• late inspiratory crackles over the involved area
• tactile fremitus: inc over the involved area with egophony, bronchophony and whispered pectoriloquy

Question 20

Partial Lobar obstruction (atelectasis)

Answer 20

• percussion: dull over airless area
• trachea may be shifted toward involved side
• breath sounds are usually absent when bronchial plug persists exceptions include right upper lobe atelectasis, where adj tracheal sounds may be transmitted
• tactile fremitus: usually absent but right upper lobe may be increased

Question 21

Croup

Answer 21

• bark-like or brassy cough
• may be assoc with hoarseness
• inspiratory stridor and resp distress
• laryngeotracheitis is most common form
• usually have URT infection with some combo of rhinorrhea, phrayngitis, mild cough, and low-grade fever for 1-3 days b4 signs and sympts of upper airway obstruction

Question 22

Epiglottis

Answer 22

• high fever
• sore throat
• dyspnea
• rapidly progressing and resp obstruction
• resp distress- tripod position
• drooling
• breathing labored and w/in hours can become toxic
• stridor will be heard right before airway is comletely obstructed