Respiratory Examination
COPD
Differences between and causes obstructive and restrictive airways disease
What do you think spirometry/lung function tests would show? (mixed as
COPD and fat)
What is the key question to ask this patient? – are they a smoker
(current or former)? Advice on giving up
How do you examine for central cyanosis?
What concentration of Hb needs to be desaturated before cyanosis is clinically
apparent?
Chest dullness
Differential Diagnosis
What are the causes of a pleural effusion?
What would you think if you heard bowel sounds at R base?
Differential Diagnosis of a raised right hemi-diaphragm
Bronchiectasis
Causes
Genetics of CF
Pulmonary fibrosis
Causes, most likely cause in the gentleman?
If I told you this man had worked for many years in construction, can
you think of any explanation for the signs you have elicited?
Differential Diagnosisof bilateral fibrosis
Differential Diagnosis of focal fibrosis
What treatment is this man receiving? (Presumed steroids due to central
obesity and thinning of skin – seemed to be correct answer)
Indications for lobectomy
normal examination
Discussion of causes of breathlessness with normal examination. Discussed
physiological causes/anxiety, PE and asthma between attacks.
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