Chest

Question 1

Causes of Pigeon chest (Pectus Carinatum)

Answer 1

1. Congenital
2. Chronic lung disease
3. Chronic heart failure

Question 2

Causes of Funnel Chest (Pectus Excavatum)

Answer 2

Congenital

Question 3

Causes of short sternum

Answer 3

1. Turners
2. Noonan’s
3. Edwards

Question 4

Causes of long narrow chest

Answer 4

Ellis van Creveld syndrome

Question 5

Causes of hypoplastic nipples

Answer 5

1. Polland Syndrome (unilateral)

2. Turner’s Syndrome

Question 6

Cause of widely spaced nipples

Answer 6

1. Turners
2. Noonan’s
3. Edwards

Question 7

Causes of hyperinflatted chest

Answer 7

1. Unilateral - FB obstruction; Lymph node due to TB; Congenital lobar emphysema
2. Bilateral - Asthma; CF; Acute Brochiolitis; Interstitial Pneumonitis

Question 8

Harrison’s Sulcus

Answer 8

1. Chronic lung disease (Asthma, BPD, CF, Kartageners etc)
2. Chronic heart disease
3. Soft chest wall - Osteogenesis Imperfecta; Rickets

Question 9

Steps in clinical examination of Chest abnormalities

Answer 9

1. Look for short statue, wasting, cyanosis, finger clubbing, eczema, adenoid face in asthma, erythema nodosum and BCG scar
2. Examine the chest
3. BP & PFR are important Inx in chest examination

Question 10

Causes of Gynaecomastia

Answer 10

1. Normal puberty
2. For male - Klinefelter’s syn
3. For female - Precocious puberty / Thelarche
4. Drugs - Digoxin, Cimetidine and Spironolactone
5. Liver cirrhosis
6. Endocrine - Hypothyroidism, DM
7. Hypothalamic lesion

Question 11

Surgical scars in chest wall

Answer 11

1. Sternotomy scar:
• Open heart surgery - Waterston shunt (Aorto-pulmonary)
• Shunt for TOF 
• Thymectomy in MG
• Mediastinal operation

2. Left Thoracotomy scar
• Ligation of PDA
• CoA repair
• PA banding
• Blalock-Taussig shunt 
• Repair of diaphragmatic hernia
• Oesophageal atresia, Hiatus hernia
• Lung surgery

3. Right Thoracotomy scar
   • BT shunt
   • PA banding
   • Lung surgery