Respiratory

Question 1

Signs of hyperinflation

Answer 1

1. Reduced cricosternal distance
2. Increased A-P diameter
3. Intercostal in-drawing (Hoover’s Sign)
4. Apex beat not palpable
5. Hyper-resonant percussion tone

Question 2

Bibasal crepitations Ddx

Answer 2

1. Pulmonary Oedema
2. Interstitial lung disease
3. Bronchiectasis
4. Cystic fibrosis

Question 3

Pleural effusion - transudate

Answer 3

(Protein < 30g/L)

1. CHF
2. Volume overload
3. Hypoalbuminaemia
4. Meig’s syndrome

Question 4

Pleural effusion - exudate

Answer 4

(Protein > 30g/L)

1. Infection (pneumonia, TB)
2. Infarction (PE)
3. Inflammation (RA, SLE)
4. Malignancy (Bronchogenic, Mesothelioma)

Question 5

Raised hemidiaphragm (causes)

Answer 5

Examination findings are identical to effusion
Phrenic nerve palsy
Ddx
1. Thoracic surgery
2. Trauma
3. Malignancy

Question 6

Pneumonectomy indications

Answer 6

1. Bronchogenic carcinoma
2. Bronchiectasis
3. Trauma
4. Old Rx for TB

Question 7

Indications for lobectomy/pneumonectomy

Answer 7

1. Cancer
2. TB - prior to antibiotics if elderly pt
3. Lung abscess
4. Emphysema
5. Fungal infections

Question 8

Pneumonectomy/lobectomy - procedure risks

Answer 8

1. Infection
2. Tension pneumothorax
3. Bleeding
4. Bronchopleural fistula
5. Empyema

Question 9

Causes of interstitial lung disease?

Answer 9

1. Inhaled allergen
   - bird fancier’s lung
   - farmers lung
2. Inhaled irritant
   - asbestos
   - coal workers pneumoconiosis
3. Associated with systemic disease
   - SLE
   - RA
   - Sarcoidosis
   - Systemic sclerosis
4. Drug related
   - methotrexate
   - amiodarone