EMQs in Clinical Medicine.pdf - Peshawar Medical College

30 Respiratory medicine
13 Haemoptysis
A
B
C
D
E
F
tuberculosis (TB)
haemothorax
bronchogenic carcinoma
polyarteritis nodosa
Wegener’s granulomatosis
bronchiectasis
G
H
I
J
K
L
Goodpasture’s syndrome
haemophilia
pulmonary oedema
pneumonia
pulmonary embolus
Churg–Strauss syndrome
For each clinical scenario below, give the most likely cause for the clinical
findings. Each option may be used only once.
1 A 65-year-old smoker presents with shortness of breath, gallop rhythm and
production of pink frothy sputum.
2 A 24-year-old man initially complaining of cough and intermittent haemoptysis
presents a few weeks later with haematuria. Biopsy confirms a crescentic
glomerulonephritis. Renal biopsy shows linear pattern deposition on
immunofluorescence.
3 A 34-year-old woman originally complaining of nasal obstruction develops
cough, haemoptysis and pleuritic chest pain. Her chest radiograph shows
multiple nodular masses.
4 A 22-year-old man presents with fever, nightsweats, weight loss and cough productive
of cupfuls of blood. Ziehl–Neelsen stain is positive for acid-fast bacilli.
5 A 35-year-old businessman returns from a trip abroad and collapses at the
airport with haemoptysis and pleuritic chest pain. He has a sinus tachycardia
and his ECG shows right axis deviation.
Answers: see page 39.