EMQs in Clinical Medicine.pdf - Peshawar Medical College

2 Respiratory medicine
QUESTIONS
11 Shortness of breath
A
B
C
D
E
F
G
pleural effusion
pulmonary oedema
right-sided rib fracture
pneumothorax
bronchogenic carcinoma
pneumonia
fibrosing alveolitis
H
I
J
K
L
extrinsic allergic alveolitis
anaemia
pulmonary embolus
acute respiratory distress
syndrome
cystic fibrosis
For each clinical scenario below, give the most likely cause for the clinical
findings. Each option may be used only once.
1 A 21-year-old man has a productive cough, wheeze and steatorrhoea. On examination
he is clubbed and cyanosed, and has bilateral coarse crackles.
2 A 63-year-old man presents to A&E with weight loss, cough, haemoptysis and
shortness of breath. On examination he is anaemic, clubbed and apyrexial.
3 A 65-year-old man presents with shortness of breath and cough productive of
pink frothy sputum. On examination he is cyanosed and tachycardic, and has
bibasal end-inspiratory crackles. His jugular venous pressure (JVP) is elevated.
4 A 70-year-old woman presents with fever, rigors, shortness of breath and
right-sided pleuritic chest pain. On examination the right side of the chest
shows reduced expansion, dull percussion and increased tactile vocal fremitus.
5 A 30-year-old farmer presents with repeated episodes of fever, rigors, dry cough
and shortness of breath with onset several hours after starting work. On examination
he is pyrexial with coarse end-expiratory crackles. His chest radiograph
shows mid-zone mottling.
Answers: see page 37.