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 EMQ 9

 

   

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EMQ: 9

Respiratory Conditions

a)      Left sided pleural effusion

b)      Right sided pleural effusion

c)      Left sided pneumothorax

d)      Right sided pneumothorax

e)      Right apical collapse

f)        Right apical consolidation

g)      Fibrosing alveolitis

h)     Bronchiectasis

i)        Pulmonary embolus

j)        Chronic bronchitis

1) A 56-year-old male presenting with cough and fever. On examination he is febrile, no clubbing, trachea midline, respiratory movements decreased at right apex, vocal fremitus increased at the right apex, percussion note dull at the right apex.

Bronchial breathing at the right apex with fine inspiratory crepitations localised to the right apex. Vocal resonance increased at the right apex.

2) A 63-year-old male presents with dyspnoea. On examination he is afebrile, the trachea is deviated to the left, respiratory movements are decreased at the right base, vocal fremitus is decreased at the right base. Percussion note is stony dull at the right base, breath sounds are diminished at the right base, vocal resonance is decreased at the right base and there is aegophony at the upper limit of the area of dullness.

3) A 62-year-old female with progressive breathlessness. On examination she has clubbing and there are fine late inspiratory crepitations at both lung bases

4) A 26-year-old male presents with sudden onset chest pain and breathlessness. On examination his trachea is deviated to the right, respiratory movements are decreased on the left hand side. Percussion note is hyper-resonant on the left hand side. Breath sounds are decreased on the left hand side.

5) A 40-year-old male with a chronic productive cough and recurrent respiratory infections. He gives a history of whooping cough in childhood.

On examination he is clubbed, there are coarse crepitations at both bases of the lings. The crepitations change when the patient is asked to cough.

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