RESPIRATORY

Question 1

Key indicators of malignant lung cancer

Answer 1

HAEMOPTYSIS
BREATHLESS - pleural effusion
CHEST PAIN

Hoarsness/ Dysphagia
Lymphadenopathy in neck

Bone fractures/ Brain seizures

HYPONA, HYPOK
HYPERCa

Question 2

Key indicators of Asthma

Answer 2

Persistent dry cough, worse @ night/ exertion
END EXPIRATORY WHEEZE
Dyspnae
Chest tightness

Question 3

Key indicators of Bronchiectasis
Dilation of bronchi, occurs in COPD
Inflammation leads to mucus plugs

What does imaging show?

Answer 3

CHRONIC PRODUCTIVE COUGH (green/yellow sputum)
HAEMOPTYSIS
CLUBBING
Wheezing + crackles (caused by obstruction/ collapsed airways)

SIGNET RING + thickened bronchial walls

Question 4

Key indicators of COPD

Bronchitis + Emphysema

Answer 4

CHRONIC COUGH with MORNING EXPECTORATION

Tachycardia + Tachypnoae

Barrel chest

Use of accessory resp muscles

Possible ankle oedema

Question 5

What is emphysema

What is bronchitis?

Answer 5

Emphysema - dilation + bursting of alveoli
Bronchitis - productive cough for at least 3 months

Both together = COPD

Question 6

What is end stage sign of chronic interstitial lung disease?

Answer 6

Honeycomb lung

Question 7

Key indicators of pulmonary fibrosis?

Answer 7

Exertional dyspnoea - progresses to breathless alla time

Non productive cough

Fatigue

Clubbing

Question 8

What is pneumonitis?

Key symptoms?

Answer 8

Pigeon farrier’s lung

Acute - flu, malaise, NO WHEEZE, fine crackles.

Chronic - Rales, cyanosis, weight loss, productive cough

Question 9

Key indicators of pneumonia

Answer 9

Productive cough (green/ yellow sputum)
PLEURITIC PAIN
DULL TO PERCUSS

Rapid onset

Decr breath sounds - bronchial breathing

Pain projects to abdomen + epigastric region

High fever malaise + chills

o Tachypnoae
o Tachycardia
o Hypotension

Question 10

Key indicators of pleural inflammation

Causes?

Answer 10

PLEURITIC PAIN
PLEURAL RUB

Viral secondary to bacterial infection
Usually Coxsackie B

Question 11

Key indicators of pleural fibrosis

Answer 11

Breathless

Dry –> productive cough

Fine end inspiratory crackles

Clubbing

Question 12

Key indicators of pleural effusion

How to confirm diagnosis?
how to treat?

Answer 12

Dry non productive cough
NO PLEURITIC PAIN
Dull to percuss
Decr breath sounds

Confirm with imaging
Treat by removing fluid
If persistent - pleurodeisis

Question 13

What’s the difference between a pneumothorax + a tension pneumothorax?

Answer 13

Pneumothorax - caused by trauma/ disease, air in-between pleural membranes. Created negative pressure, causing lungs to collapse.

Pneumothorax can lead to a TENSION PNEUMOTHORAX - raised pressures in chest start to affect cardioresp functioning

Question 14

Symptoms of a pneumothorax?

Answer 14

sudden-onset dyspnea

ipsilateral chest pain

Decr breath sounds,

hyperresonant percussion on the affected side.

Question 15

Symptoms of a tension pneumothorax?

Answer 15

In addition to pneumothorax symptoms, a tension pneumothorax also presents with:

P-THORAX:
Pleuritic pain
Tracheal deviation + tachycardia
Hyperresonance
Onset sudden
Reduced breath sounds (and dyspnea)
Absent fremitus
X-rays show collapse.

AND Cyanosis + hypotension

Question 16

How to treat a pneumothorax?

Answer 16

decompress using a needle inserted into intercostal space 2-5th mid-axillary line.

Chest drain

Can self-resolve

Question 17

What is Fremitus?
When is it raised?
When is it lowered?

Answer 17

Vibration you feel when you palpate the posterior chest wall with the ulnar aspects of both hands while the patient says 99

Fremitus incr when there’s CONSOLIDATION

Fremitus dear when there’s EFFUSION or PNEUMOTHORAX .

Question 18

Signs of Pleuritic cancer?

Answer 18

Small tumours can cause pleural effusion bc makes capillaries leaky. Take sample of fluid to i.d. any malignant cells.

Non-specific - weight loss, breathless, clubbing

Question 19

Causes of Clubbing

Answer 19

CLUBBING

Cystic Fibrosis
Lung Abscess/ cancer
UC
Bronchiectasis
Benign mesothelioma
Infective endocarditis
idiopathic Pulmonary fibrosis
Neurogenic tumours
G