EMQs in Clinical Medicine.pdf - Peshawar Medical College

48 Respiratory medicine
REVISION BOXES
Respiratory medicine
Findings of respiratory examination are common in extended matching questions
(EMQs) and can be confusing. Box 1 summarizes some findings that are highly
suggestive of particular diagnoses that are likely to be found in the options.
Box 1 On respiratory examination
Findings
Diagnosis
• Hyperexpanded chest COPD
Chronic asthma
• Postural flapping tremor Acute CO 2 retention
• Stony dull percussion Pleural effusion
• Fine crepitations Pulmonary oedema
Pulmonary fibrosis
• Pleuritic chest pain Pulmonary embolism, pneumonia, pneumothorax
• Stridor
Upper airway obstruction, e.g. foreign body, croup
Be aware that clubbing can be associated with several respiratory conditions and
this non-specific sign may be mentioned in EMQs (Box 2).
Box 2 The clubbed respiratory patient
• Bronchial carcinoma
• Bronchiectasis
• Lung abscess
• Empyema
• Cystic fibrosis
• Cryptogenic fibrosing alveolitis
• Mesothelioma
• TB
• NOT asthma, COPD
Being aware of distinctive chest radiograph changes is very useful when tackling
EMQs. Box 3 summarizes some pathologies that should spring to mind when you
see particular phrases in EMQs.