Thorax And Lungs

Question 1

Progressive dyspnea with acute pulmonary edema, aggrevated when lying down, patient also shows othropnea, paroxysmal nocturnal dypnea, cough is dry and progress to pink frothy sputum(edema) / Frank hemoptysis and has a history of heart disease

Answer 1

• left sided HF /mitral stenosis

Question 2

progressive dyspnea with chronic productive cough maybe blood streaked/bloody, aggrevated by recurrent respiratory infections and has history of smoking (or inhaled irritants from job) relived by expectoration

Answer 2

• chronic bronchitis

Question 3

Slowly progressive dyspnea with slight cough and scant mucoid sputum patient has an alpha1 anti trypsin deficiency (or history of smoking)

Answer 3

• COPD

Question 4

Acute episodes of dyspnea separated by symptom free periods aggrevated by certain allergens/irritants, patient has wheezing and cough and tightness in the chest

Answer 4

-asthma

Question 5

Progressive dyspnea patient is weak and fatigued and less cough rest relive symptoms sometimes triggered by certain substances

Answer 5

• diffuse interstial lung disease

Question 6

Acute dypnea with pleuritic pain, cough, sputum is blood streaked, diffusely pink or rusty, along with fever and chills

Answer 6

• pneumonia

Question 7

Previously healthy patient with sudden onset of dyspnea and pleuritic pain and cough

Answer 7

• Spontaneous pneumothorax

Question 8

A postoperative patient (postpartum/bed rest/HF/ fractures/hypercoagulability) has a sudden onset of dyspnea and tachypnea, pleuritic pain,Dry cough w/ hemoptysis, syncope, unilateral leg swelling (no symptom’s/ retrosternal oppressive pain)

Answer 8

• acute pulmonary embolism

Question 9

Dyspnea is episodic and recurrent occurs in an upsetting situation patient feels light-headed, numbness, palpitations and chest pain diaphoresis

Answer 9

• anxiety with hyperventilation

Question 10

Dry cough may become productive with hoarseness

Answer 10

• laryngitis

Question 11

Drying hacking cough may become productive with acute febrile illness, malaise, headache

Answer 11

• mycoplasma and viral pneumonia

Question 12

Chronic cough mucoid sputum and discharge seen in posterior pharynx associated with allergic rhinitis

Answer 12

• postnasal drip

Question 13

Chronic cough, sputum purulent and foul smelling, maybe blood streaked with recurrent bronchopulmonary infections

Answer 13

• bronchiectasis

Question 14

Sputum purulent and foul smelling and maybe bloody with dysphagia/ impaired consciousness

Answer 14

• lung abscess

Question 15

Dry cough with mucoid sputum maybe blood streaked, early no symptom’s, later anorexia, weight loss, fever, night sweats

Answer 15

• TB

Question 16

same as TB but with history of tobacco use

Answer 16

Neoplasia

Question 17

Normal finding of air filled lungs

-

Answer 17

vesicular breath sounds, no bronchophony, egophony, nor whispered pectoriloquy, normal tactile fremitus

Question 18

Lung Findings of patient with COPD

-

Answer 18

hyperinflated
hyperresonant,
↓breath sounds, transmitted voice, and tactile fremitus.
Early inspiratory crackle

Question 19

Lung findings of patient with lobar pneumonia

-

Answer 19

1. consolidated lungs,
2. dull,
3. bronchial/bronchovesicular breath sounds, 4.↑transmitted sounds and fremitus
4. Biphasic crackles

Question 20

Lung finding of patient with pleural effusion

Answer 20

• lungs are dull,
• fluid is movable,
• ↓ breath sounds(or absent),
• ↓ transmitted voices and fremitus

Question 21

Fine crackle occurs in:

Answer 21

mid-late inspiratory→ pul. Fibrosis (Velcro rales), intertial fibrosis, intertial pneumonitis

Question 22

Early inspiration or biphasic ( last throughout exp) do not change with body position

Answer 22

• coarse crackles→ COPDA, asthma, bronchiectasis

Question 23

Stirdor occurs:

-

Answer 23

Tracheal stenosis, anaphylaxis, foreign object, epiglottitis

Question 24

Pleural rub

Answer 24

nonmusical biphasic, discontinuous low frequency grating

Question 25

Sound heard in pneumomediastinum

Answer 25

• mediastinal crunch (hamman sign)→ precordial crackle syn with heart beat not resp