Respiratory Medicine Revision Points

Question 1

Hyperexpanded Chest

Answer 1

COPD, Chronic Asthma

Question 2

Postural flapping tremor

Answer 2

Acute CO2 retention

Question 3

Stony dull percussion

Answer 3

Pleural effusion

Question 4

Fine crepitations

Answer 4

Pulmonary oedema, Pulmonary fibrosis.

Question 5

Pleuritic Chest Pain

Answer 5

Pulmonary embolism, pneumonia, pneumothorax

Question 6

Stridor

Answer 6

Upper airway obstruction, i.e. foreign body or Croup.

Question 7

Clubbing: 8

Answer 7

Bronchial Carcinoma (lung cancer)
Bronchiectasis
Lung abscess
Empyema 
Cystic fibrosis 
Idiopathic pulmonary fibrosis 
Mesothelioma (lung cancer)
TB

Question 8

Kerley B lines

Answer 8

heart failure

Question 9

Bat wing shaddowing

Answer 9

heart failure

Question 10

tramline shadowing

Answer 10

bronchiectasis

Question 11

Miliary shadowing

Answer 11

Miliary TB

Question 12

Wedge-shaped infarct

Answer 12

Pulmonary embolus

Question 13

Ground glass appearance

Answer 13

Fibrosis

Question 14

Honeycomb appearance

Answer 14

Fibrosis - late

Question 15

Pleural mass with lobulated margin

Answer 15

Mesothelioma (lung cancer)

Question 16

Early onset emphysema plus liver disease

Answer 16

Alpha 1 Antitrypsin deficiency

Question 17

Fever, cough, shortness of breath hours after exposure to antigen (usually farmer after hay exposure)
Positive serum precipitins.

Answer 17

Extrinsic allergic alveolitis.

Question 18

Aysmptomatic with bilateral hilar lymphadenopathy, progressive dyspnoea, dry cough.
Erythema nodosum, increased serum ACE or hypercalcaemia.

Answer 18

Sarcoidosis.

Question 19

History of recurrent chest infections
Failure to thrive
Steatorrhoea/Pancreatic insufficency
Positive sweat test (sodium chloride > 60 mmol/L)

Answer 19

Cystic Fibrosis

Question 20

Progressive dyspnoea
Cyanosis
Gross finger clubbing 
Fine end-inspiratory crackles 
Chest X Ray: ground glass -> honeycomb lung.

Answer 20

Idiopathic pulmonary fibrosis.

Question 21

Non-specific:
fever, nightsweats, anorexia, haemoptysis.
Ziehl-Neelsen staining shows acid-fast bacilli AFBs.

Answer 21

TB

Question 22

Swinging fever, copious foul-smelling sputum

Usually patient has persistent, worsening pneumonia.

Answer 22

Lung Abscess.

Question 23

Positive cold agglutinins

Answer 23

Mycoplasma infection

Question 24

Occupation involving water systems

Answer 24

Legionella infection

Question 25

Cavitiating lungs

Answer 25

Staphylococcal/klebsiella infection

Question 26

Contact with birds

Answer 26

Chlamydia psittaci infection

Question 27

HIV+, bilateral hilar shadowing

Answer 27

Pneumocystis jiroveci pneumonia.

Question 28

Peripheral neuropathy, hepatitis

Answer 28

Isoniazid

Question 29

Orange-coloured tears, urine, deranged liver function tests, hepatisis

Answer 29

Rifampicin

Question 30

Retrobulbar neuritis (pain, loss of vision)

Answer 30

Ethambutol

Question 31

Gout

Answer 31

Pyrazinamide

Question 32

Tremor, tachycardia

Answer 32

Salbutamol

Question 33

Candidiasis mouth/pharynx

Answer 33

Inhaled high-dose corticosteroids.