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Module 9: Pulmonology

Total questions: 13

Worksheet time: 6mins

Name
Class
Date
1.

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?

a)

Emphysema

b)

Chronic Bronchitis

c)
Pneumonia
d)
Asthma
2.
  • 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?

a)
Pneumonia
b)
Asthma
c)
Chronic Obstructive Pulmonary Disease
d)
Bronchitis
3.

Which of the following factors can trigger asthma?

a)

Air pollution

b)

Exercise

c)
Exposure to allergens
d)

Cold air

4.

Each of the following occur in asthma EXCEPT

a)

Thickening of airway walls

b)

Elastin destruction

c)

Mucus plugs

d)

Bronchospasms

5.

What is the most common cause of acute bronchitis?

a)

Bacterial infections

b)

Smoking crack

c)
Viral infection
d)
Allergic reactions
6.

What is the most common cause of chronic bronchitis?

a)

Smoking crack

b)
Air pollution
c)
Allergies
d)

Smoking cigarettes

7.

Blue bloaters are blue because of ___ and bloat because of ___

a)

Cyanosis and Edema

b)

Hypercapnia and Edema

c)
Anemia and Obesity
d)

Emphysema and Edema

8.

Pink puffers are pink because of ___ and puff because of ___

a)

Hypercapnia, to compensate for respiratory acidosis

b)

Muscle wasting, pursed lip breathing

c)

Lack of oxygen, Hypercapnia

d)

Hypercapnia, pursed lip breathing

9.
  • 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?

a)

Pneumonia, purulent sputum positive for bacteria

b)

Asthma, bronchospasms

c)

Tuberculosis, caseus necrosis

d)

Bronchitis, viral infection

10.

What are some signs and symptoms of cor pulmonale? Which side of the heart is involved?

a)

Shortness of breath, swelling of the legs, and a JVD

Right sided heart failure

b)

Fever, cough, and weight loss

Left sided heart failure

c)

Headache, blurred vision, and dizziness

Right sided heart failure

d)

Nausea, vomiting, and abdominal pain

Left sided heart failure

11.

Alpha-1 Anti-Trypsin defect would result in what?

a)

Destruction of elastin in the alveoli

b)

Asthma

c)

Increased risk of pneumonia

d)

Increase risk of TB

12.

What condition involves destruction of alpha 1 anti-trypsin

a)
Emphysema
b)
Asthma
c)
Bronchitis
d)
Pneumonia
13.

A 12-year-old male patient presents to the pediatric clinic with a chronic cough, recurrent respiratory infections, and poor growth. He has a history of meconium ileus as a neonate and a family history of lung disease. Physical examination reveals digital clubbing and auscultation of the chest reveals coarse crackles. What is the most likely diagnosis for this patient, and what pathophysiological mechanisms underlie the observed clinical manifestations?

a)

Cystic fibrosis, due to a defect in the FGFR3 gene leading to abnormal chloride transport and thickened secretions

b)

Cystic fibrosis, due to a defect in the CFTR gene leading to abnormal Cl- transport and thickened secretions

c)

Bronchiectasis, due to chronic inflammation and destruction of the bronchial walls

d)

Cystic fibrosis, due to a defect in the CFTR gene leading to abnormal Na+ transport and thickened secretions