RESPIRATORY DISEASES Flashcards

1
Q
  1. Bronchial breath sounds are normal near the bronchus. T/F?
A

True

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2
Q
  1. Bronchial breath sounds in one of the lungs could suggest pneumothorax. T/F?
A

False. There would be absent breath sounds.

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3
Q
  1. TB would be a reasonable likely diagnosis in a baby with wet cough for two weeks and mild fever. T/F?
A

False.

More likely causes are protracted bacterial bronchitis or pneumonia

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4
Q
  1. TB would be a reasonable likely diagnosis in an elderly Vietnamese man who migrated 20 years ago presenting with cough for 3 months. T/f?
A

True.

Vietnam has 10-30 times the incidence of TB compared to Australia.

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5
Q

An apical lung tumour can cause Ramsay-Hunt syndrome T/F

A

False.
Ramsay hunt syndrome - Ear shingles leading to facial nerve palsy that involves the forehead
Apical lung tumour -
- Can invade recurrent laryngeal nerve that supplies the larynx = hoarseness
- Can invade nerves supplying face = Horner’s syndrome
-> Can cause superior venal cava obstruction = Pemberton’s sign

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6
Q

Lung cancer can occur in non-smokers

A

T

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7
Q

Cardiac cause of chest pain can be excluded if pain is reproducible on palpation

A

True

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8
Q

Rib fractures require surgical treatment

A

False

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9
Q

Which of the following is suggestive of severe croup?

a. coughing that disrupts sleep
b. barking cough
c. stridor at rest
d. associated fever

A

stridor at rest

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10
Q

Cystic fibrosis can be complicated by

a. infertility
b. pleural effusion
c. lung cancer
d. Obesity

A

infertility

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11
Q

How can sarcoidosis and lung cancer be differentiated?

a. significant weight loss in sarcoidosis
b. painful red lumps on the shin (erythema nodosum ) usually occur in lung cancer
c. lung cancer would not cause brain symptoms such as headache
d. bilateral vs unilateral mediastinal lymph nodes on chest xray

A

d.bilateral vs unilateral mediastinal lymph nodes on chest xray

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12
Q

It is normal in a newborn to have:

a. an air leak around the heart ( pneumopericardium)
b. nasal flaring as they are obligate nose breathers
c. respiratory rate of 60
d. weak cry at 9 minutes of life

A

respiratory rate of 60

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13
Q

Which of the following statement is true about lung investigations:

a. chest xrays can pick up small lung cancers <1cm
b. bronchoscopy is indicated to determine the underlying cause of asthma
c. spirometry can diagnose pulmonary fibrosis
d. peak flow meters can help diagnose occupational asthma

A

d

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14
Q

A patient with pneumonia would need to go to hospital if:

a. their oxygen saturation is 95% in room air
b. they have known congestive cardiac failure
c. they are elderly
d. they have high fevers after one dose of antibiotic

A

b

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15
Q

Bronchitis is a

a. moderately serious condition requiring oral antibiotics
b. serious condition requiring urgent medical attention
c. minor condition in long term smokers
d. self-limiting condition requiring supportive treatment only

A

d

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16
Q

An 80y.o. lady lives alone had a 40 pack year history of smoking and chronic obstructive pulmonary disease. She walks around with a 4 wheel frame for dyspnea on exertion. She uses her COPD puffers regularly. She has a 2 week history of wet cough and trouble sleeping at night; her symptoms are not responding to antibiotics. What are the issues in this case? What are the next steps in treatment/management required?

A

Issues
- Frail elderly lady living alone with risk factors for lung cancer (age, significant smoking history) who has a persistent cough despite antibiotics
- Cancer needs to be excluded
¡Whether or not cancer present, quite unwell and unable to sleep at night - ability to manage by herself at home
- Difficulty sleeping - cardiac issue (cardiac risk factors – age, smoking)

Management

  • She needs medical assessment for degree of respiratory distress
  • She needs a chest xray to look for pneumonia, lung abscess, signs of cancer (unilateral lymph node, large mass)
  • CT chest if chest xray suggestive
  • Bronchoscopy to diagnose cancer
  • Oncology team and/or palliative care
  • Family need to be involved
  • advanced care directive
  • Aged care assessment – ability to manage independent living
17
Q

A 20y.o. female university student is studying for exams. She has a sore throat, fever and cough and wants antibiotics so she can improve quickly and get back to studying for exams. What are the red flags for antibiotics?

A
  • Sore throat and fever with no cough
  • One sided throat pain : quinsy/peritonsillar abscess
  • Tender cervical lymphadenopathy
  • Fever, vomiting
18
Q

What features of cough are concerning?

A

Persistent without identifiable cause

  • Inhaled foreign body in a child
  • Lung cancer
  • Post tussive vomiting (pertussis)
  • Associated weight loss
  • Haemoptysis
  • Large volume of sputum (bronchiectasis)
  • Failure to thrive in children (cystic fibrosis)