By : M.

S
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Chest

Enumerate: 1. Causes of pneumothorax. 2. Causes of pneumonia. 3. Pleuro-pulmonary presentations of bronchial carcinoma. 4. Causes of cor-pulmonale. 5. Anti-tuberculous drugs. 6. Causes of mediastinal syndrome. 7. Causes of acute respiratory failure. 8. Causes of chronic respiratory failure. 9. Causes of haemoptysis. 10. Causes of acute chest pain.

Differentiate between: 1. Closed, open & tension pneumothorax. 2. Lobar-pneumonia & broncho-pneumonia. 3. Lung abscess & bronchiectasis. 4. Transudate & exudate. 5. Pink puffer & blue bloater. 6. Hypoxic cor-pulmonale & bilharzial cor-pulmonale.

By : M.S
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7. Extrinsic asthma & inrinsic asthma. 8. Bronchial asthma & cardiac asthma.

Give a short account on: 1. Diagnosis of spontaneous pneumothorax. 2. Diagnosis of lobar pneumonia. 3. Diagnosis of broncho-pneumonia. 4. Complications of pneumonia. 5. Non-resolving pneumonia. 6. Treatment of pneumonia. 7. Clinical manifestations of bronchogenic carcinoma. 8. Extra-pulmonary manifestations of bronchial carcinoma. 9. Investigations to diagnose bronchial carcinoma. 10. Aetiology of COPD. 11. Clinical picture & complications of COPD. 12. Investigations for COPD. 13. Treatment of COPD. 14. Aetiology of bronchial asthma. 15. Diagnosis of bronchial asthma. 16. The plan of therapy for bronchial asthma. 17. The drugs used in treatment of bronchial asthma. 18. Status asthmaticus. 19. Diagnosis of acute respiratory failure. 20. Diagnosis of chronic respiratory failure. 21. Treatment of acute respiratory failure.

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22. Treatment of chronic respiratory failure. 23. Anti-tuberculous drugs. 24. Diagnosis of mediastinal syndrome.

What are the reasons (causes) for each of the following? 1. Bronchial breathing. 2. Crepetations. 3. Rhonchi. 4. Aegophony. 5. Despigns sign. 6. Shifting dullness. 7. Rusty sputum. 8. Chest pain in pneumonia. 9. Indux crepetations. 10. Redux crepetations. 11. Non-resolving pneumonia. 12. Jaundice in pneumonia. 13. Anaemia in pneumonia. 14. Pneumonia with GERD. 15. Abscess in right lower lobe of the lung. 16. Foeted sputum in lung abscess. 17. Grey sputum. 18. Green sputum. 19. Anchovy sauce sputum. 20. Milky effusion.

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21. Haemorrhagic effusion. 22. Oedema of lower limbs in bronchiectasis. 23. Clubbing of the fingers in respiratory diseases. 24. Bronchoscopy for lung abscess. 25. Estimating sweat Na in suppurative syndrome. 26. Wasting of muscles of the hand in bronchial carcinoma. 27. Neurological manifestations in bronchial carcinoma. 28. Unequal pupil in bronchial carcinoma. 29. Carcinoid syndrome. 30. Cushings syndrome with bronchial carcinoma. 31. Cyanosis in COPD. 32. Pulmonary hypertension in COPD. 33. Oedema of LL in COPD. 34. Congested neck veins in COPD. 35. Chest pain in COPD. 36. Disturbed mentality in COPD. 37. Puffy eye lids in COPD. 38. Palpable liver in COPD. 39. Flapping tremors. 40. Respiratory failure in morbid obesity. 41. Respiratory failure in scleroderma. 42. Bilharzial cor-pulmonale. 42. Elevated haemoglobin with COPD. 43. Increased serum bicarbonate in COPD. 44. Silent chest in acute severe asthma. 45. False negative tuberculin test. 46. Positive tuberculin test.

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47. Parasthesia with INH. 48. Dark urine with rifampicin. 49. Vertigo with streptomycin. 50. Hoarsness of voice in mediastinal syndrome. 51. Bovine cough. 52. Brassy cough. 53. Dyspnea in LVF. 54. Dyspnea in Renal failure. 55. Dyspnea in diabetes mellitus. 56. Myasthenia. 57. Dyspnea in pleurisy. 58. Dyspnea in liver cirrhosis. 59. Pain in pulmonary infarction. 60. Pain in massive pulmonary embolism.

Cases : Case 1: Mr. Magdy Salah, a 32 year-old man, was transferred to the emergency room in severe dyspnea. He gave the history of recurrent attacks of dyspnea for the last 10 years, which used to improve by using inhaler. The patient was given bronchodilators by inhalation in the emergency room, but his condition did not improve. By examination there was diminished mobility and absent air entry over

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the right side of the chest. X-ray for Mr. Magdy showed right side hypertranslucency. 1. Enumerate the complications of the original disorder 2. What is the diagnosis of the recent condition? 3. Enumerate other causes for this condition. Case 2: A 30 year-old male presents with a rapid rise in temperature. Within a few hours chest pain & cough with production of rusty sputum occurs. The patient appears ill with rapid shallow respiration and chest x-ray shows a lobar opacity. With no treatment, the patient continues to run a temperature up to 39.5 for a week, at which time there is a dramatic improvement in the clinical picture. 1. What is the most probable diagnosis of this case? 2. What is the most probable cause of this condition? 3. What are the signs that could be found during the week of illness? 4. What are the rest of investigations that could be done? 5. How would you treat this patient earlier? 6. What complications could happen for this patient? Case 3: A 30 year-old male presents with a history of recurrent pneumonias & a chronic cough productive of foul-smelling purulent sputum, occasionally blood-tinged, which is worse in the morning and on lying down. The patient appeared chronically ill with clubbing of the fingers. Crepetations are heard at the lung bases.

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1. What is the most probable diagnosis of this case? 2. Enumerate other possible causes. 3. How to confirm your diagnosis? 4. How to treat this patient?

Case 4: 47 years old male, smokes 30 cigarettes per day during the last 30 years, is complaining of cough of 15 years duration with expectoration of sputum which is white grayish most of the time. His BP is 140/60 and he has blue tongue, warm hands & clubbing of the fingers. 1. What is the most probable diagnosis of this case? 2. What chest signs can be found in such a case? 3. What are the investigations you need to do in this case? 4. What is the role of smoking in the aetiology of this case? 5. How to treat this case? 6. Enumerate the possible complications of this disorder. During the last 4 months the patients condition deteriorated markedly. He became severely dyspnoeic, sputum became yellow, together with rise of temperature & weight loss. The trachea is shifted to the right and there is right infra-clavicular dullness together with bronchial breathing. 1. What is the most probable diagnosis of this deterioration? 2. What investigations you need to do at this stage?

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The patient deteriorated markedly, became severely cyanosed, confused, together with flappy tremors and was transferred to the ICU. 1. What is the diagnosis now? 2. How to investigate? 3. How to treat? Case 5: A 45 year- old man had a routine X-ray chest which showed a solitary rounded density about 2 cm in diameter in the center of the right upper lung field. He had been a heavy smoker but had no symptoms. How to investigate this case? Case 6: A 15 year-old boy from a low socioeconomic neighborhood presents with a three-month history of weight loss, night sweats, cough and haemoptysis. Physical examination reveals crepetations in the upper 1/3 of the right lung that persist after coughing. His father had similar symptoms two years earlier. 1. What is the suspected diagnosis? 2. How to confirm diagnosis? 3. How to treat the case after confirming diagnosis? 4. What are the adverse effects of the used drugs? Case 7: A 21-year old woman complaining of chronic cough and

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expectoration of a large amount of sputum for the last .6 years. Recently she noticed painless, bilateral ankle swelling togethre with puffiness of the eyelids. Physical examination revealed clubbing of the fingers and urine was found to contain 5 gm proteins/litre.