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WorksheetsModule 9: Pulmonology
Total questions: 12
Worksheet time: 6mins
Mr. Smith is a 65-year-old retired mechanic who presents to our clinic with a chief complaint of progressive shortness of breath, chronic cough, and increased sputum production over the past five years. He reports that these symptoms have gradually worsened and are now interfering with his daily activities, including walking, climbing stairs, and even performing routine household chores. Mr. Smith also mentions a recent exacerbation of his symptoms, which he describes as a sudden worsening of dyspnea, increased cough, and sputum that required him to seek emergency care two weeks ago.
Physical Examination:
General appearance: Appears fatigued, accessory muscle use during breathing.
Vital signs: BP 140/85 mmHg, HR 88 bpm, RR 22/min, SpO2 92% on room air.
Chest examination: Hyperinflation, prolonged expiratory phase, wheezing on auscultation.
Decreased breath sounds and crackles at lung bases.
Clubbing, cyanosis, and edema seen on physical exam.
What is your diagnosis?
Emphysema
Chronic Bronchitis
Mr. Smith presented to the emergency department with a 5-day history of fever, cough, and shortness of breath. His symptoms have progressively worsened, and he has noted productive cough with yellow-green sputum. Clinical Examination: Vital signs: Elevated temperature (101.5°F), tachycardia, tachypnea, and decreased oxygen saturation (SpO2 90% on room air). Pulmonary auscultation: Diminished breath sounds and crackles on the right lower lobe.
Other systems were unremarkable. What is your diagnosis?
Which of the following factors can trigger asthma?
Air pollution
Exercise
Cold air
Each of the following occur in asthma EXCEPT
Thickening of airway walls
Elastin destruction
Mucus plugs
Bronchospasms
What is the most common cause of acute bronchitis?
Bacterial infections
Smoking crack
What is the most common cause of chronic bronchitis?
Smoking crack
Smoking cigarettes
Blue bloaters are blue because of ___ and bloat because of ___
Cyanosis and Edema
Hypercapnia and Edema
Emphysema and Edema
Pink puffers are pink because of ___ and puff because of ___
Hypercapnia, to compensate for respiratory acidosis
Muscle wasting, pursed lip breathing
Lack of oxygen, Hypercapnia
Hypercapnia, pursed lip breathing
Ms. Martinez presented to our clinic with a persistent cough, unintentional weight loss, and night sweats for the past three months.
Medical History:
No known chronic medical conditions.
No history of TB exposure or vaccination.
No recent travel to high TB-endemic areas.
Clinical Examination:
Vital signs: Within normal limits.
Pulmonary auscultation: Crackles and decreased breath sounds in the upper right lung field. What is your diagnosis? And what would be seen in the lung?
Pneumonia, purulent sputum positive for bacteria
Asthma, bronchospasms
Tuberculosis, caseus necrosis
Bronchitis, viral infection
What are some signs and symptoms of cor pulmonale? Which side of the heart is involved?
Shortness of breath, swelling of the legs, and a JVD
Right sided heart failure
Fever, cough, and weight loss
Left sided heart failure
Headache, blurred vision, and dizziness
Right sided heart failure
Nausea, vomiting, and abdominal pain
Left sided heart failure
Alpha-1 Anti-Trypsin defect would result in what?
Destruction of elastin in the alveoli
Asthma
Increased risk of pneumonia
Increase risk of TB
What condition involves destruction of alpha 1 anti-trypsin
