Random 1
GERD
Which of the following is NOT a risk factor for asthma?
a) atopy & eczema at 4 years old; b) recurrent chest infections at 2 years old; c) genetic/family history; d) early allergen exposure
d)
A hallmark sign of this COPD subtype is chronic productive cough
COPD (chronic bronchitis - "blue bloaters")
This condition presents with an irreversible dilation of bronchioles as a result of complications from COPD, asthma or CF. Like COPD, it has a longstanding productive cough but the sputum is very foul smelling
Bronchiectasis
What are the 3 red flag syndromes of metastasizing lung cancer?
1) Horner's: constricted pupil (myosis), lack of sweat (anhidrosis), sunken eyes (enophthalmos
2) Pancoast: shoulder pain radiating down ulnar nerve
3) SVC: elevated JVP, vision loss, arm swelling
What is the most common cause of chronic cough?
Upper Airway Cough Syndrome (aka postnasal drip)
Is wheezing alone a predictor for asthma?
No
Are inspiratory crackles more likely in chronic bronchitis or emphysema?
Chronic bronchitis - emphysema has a quiet chest
This is a common complication of bacterial pneumonia, ruptured lung abscesses or penetrating chest wounds. Like COPD, it has a productive cough but the sputum is foul smelling. Clinical findings also include friction rub and chest pain.
Empyema
What type is most aggressive with the worst prognosis? Associated with smokers, and is 20-25% of all lung cancers. Starts at hilum.
Small Cell Carcinoma
UACS has no gold standard of diagnosis, but may present with all of the following except:
a) cough worse at night; b) nasal congestion; c) rhinorrhea; d) cobblestone appearance of nasopharynx; e) sore throat; f) hoarseness; g) wheezing; h) ear/sinus pain
How does asthma present as a pattern?
Symptoms worsen at night or with triggers. Symptoms include wheezing, dyspnea, chest tightness, cough.
What clinical findings are present in both chronic bronchitis and emphysema?
Hyperresonance on percussion, barrel chest (increased AP diameter), wheezing on expiration
If you have an infant patient that presents with meconium ileus (first stool is thick/hard to pass) and failure to thrive. You suspect they're suffering from the most common lethal genetic disease.
Cystic Fibrosis
This type has primary malignant lung tutor, 10-15% of all lung cancers, associated with smoking but not always.
Large cell carcinoma
a) dry hacking cough; b) nocturnal dyspnea; c) rhinorrhea; d) sputum tinged with blood
a, b, d
What 2 exams help rule in asthma?
Spirometry & Methacholine challenge
T/F: chronic bronchitis has cyanosis, peripheral edema and dyspnea on exertion while emphysema has pursed lips, huffing and puffing, and weight loss
True
This condition affects the lungs, skin, joints. Presents with dry non-productive cough, wheezing, dyspnea on exertion, weight loss, splenomegaly.
Sarcoiditis
This type is a primary malignant tumour of pulmonary bronchi, originates in hilum, grows rapidly with early metastasis and better prognosis. 25-40% of all lung cancers.
Squamous cell carcinoma
What are the 2 subtypes of COPD?
Chronic bronchitis (blue bloaters)
Emphysema (pink puffers)
What would be found on a physical exam?
Nothing unless exacerbation
What is the gold standard test for COPD? What is the finding?
Spirometry; reduced FEV1; increased TLC means lung hyperinflation; increased RV means can't blow all the air out
Wegener's Granulomatosis and Goodpasture syndrome both present with hemoptysis, hematuria, fever, malaise. Which one will have inspiratory crackles?
Goodpasture syndrome
This type has mucin secreting cancer cells, 25-40% of all cancers, main cause of lung cancer in non-smokers, good prognosis.
Adenocarcinoma
This type is highly aggressive malignant pleural tutor, 1-3% of all lung cancers, unrelated to smoking, poor prognosis.
Mesothelioma
This type has a low grade primary malignant tumour of neuroendocrine cells in bronchi, originates at hilum. 1-3% of lung cancers and is unrelated to smoking. Mostly seen in those exposed to asbestos - very poor prognosis.
Bronchial carcinoid tumor