what signs may the patient have on examination

Question 1

bronchial carcinoma

Answer 1

Cachexia

Finger Clubbing

Hypertrophic pulmonary osteoarthropathy:

• clubbing
• periostitis (layer surrounding bone)
• large joint arthropathy

Anaemia

Horner’s syndrome (if tumour is apical)

Question 2

pneumonia

Answer 2

decreased breath sounds
dull on percussion
crackles

Tachypnoea
tachycardia

Use of accessory resp muscles

Question 3

Asthma

Answer 3

-Bilateral widespread “polyphonic” wheeze

Question 4

COPD

Answer 4

Abnormal breath sounds- wheezing, decreased breath sounds

normal percussion (resonant)

Expanded chest

Question 5

Pulmonary Embolism

Answer 5

Hypoxia

Tachycardia

Raised respiratory rate

Low grade fever

Haemodynamic instability causing hypotension

Question 6

Pneumothorax

Answer 6

Cyanosis, hypotension, tachycardia

contralateral tracheal deviation (in tension)

hyperresonant on percussion

reduced breath sounds

reduced chest expansion

Question 7

Pleural Effusion

Answer 7

Stony dull percussion

Reduced breath sounds on auscultation

reduced tactile vocal fremitus, reduced vocal resonance

reduced exercise tolerance