Respiratory Assessment Quiz

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Questions and Answers

What type of breathing pattern is characterized by progressively deeper breathing followed by temporary apnea?

Asymmetrical chest expansion

Kussmaul's breathing

Paradoxical chest movement

Cheyne-Stokes breathing (correct)

What type of chest abnormality is associated with severe metabolic acidosis?

Pectus carinatum

Paradoxical chest movement

Asymmetrical chest

Overinflated chest (correct)

What is the purpose of using the ulnar side of the hand to assess tactile vocal fremitus?

To assess symmetrical or asymmetrical chest expansion

To evaluate increased or decreased vibrations over areas of the chest (correct)

To feel the apex beat of the heart

To determine if the trachea is central or deviated

What type of chest abnormality is indicated by a displaced apex beat of the heart?

Mediastinal displacement or distortion Signup and view all the answers

What is the significance of assessing the symmetry of chest expansion during physical examination?

It helps determine the presence of pleural effusion Signup and view all the answers

What is the purpose of palpating the trachea during the physical examination?

To determine if the trachea is central or deviated Signup and view all the answers

What is a common presenting symptom of pericardial tuberculosis?

Pericardial friction rub Signup and view all the answers

How is pericardial tuberculosis diagnosed?

By examining pericardial fluid Signup and view all the answers

Which of the following is NOT a clinical form of extrathoracic tuberculosis discussed in the text?

Lupus Erythematosus Signup and view all the answers

How do nodes affected by cervical lymph node tuberculosis usually feel upon physical examination?

Painless, firm, and movable Signup and view all the answers

What may happen to untreated cervical lymph node tuberculosis if it progresses?

It can lead to necrosis and caseation of the lymph node Signup and view all the answers

What is the most common route through which tubercle bacilli reach the central nervous system in TB meningitis?

Via the blood stream during lymphohematogenous spread Signup and view all the answers

What is the process called when the genome of two SARS-CoV-2 variants combine during viral replication to form a new variant?

Recombination Signup and view all the answers

What is the name given to the lineage that results from recombination of two SARS-CoV-2 variants?

Recombinant Variant Signup and view all the answers

What is the hierarchical naming system used for SARS-CoV-2 lineages called?

PANGO Lineage System Signup and view all the answers

What is the relationship between a 'lineage' and a 'sublineage' in the PANGO Lineage System?

Sublineages are evolutionary descendants of their parent lineages. Signup and view all the answers

What type of SARS-CoV-2 variant is BA.2.75?

Sublineage of BA.2 Signup and view all the answers

What is the recommended wait time before interpreting the tuberculin skin test (TST)?

48 to 72 hours Signup and view all the answers

What is the recommended course of action if a patient has a cough for more than 2 weeks with antibiotics?

Suspect and perform a TST Signup and view all the answers

What is the recommended diameter of induration for a positive TST in immunosuppressed children?

>5mm Signup and view all the answers

Which of the following is NOT mentioned as an appropriate clinical sample for bacteriological confirmation of tuberculosis?

Blood samples Signup and view all the answers

What is the recommended test for detecting both tuberculosis and resistance to rifampicin in less than 2 hours?

Xpert MTB/RIF Signup and view all the answers

What is the purpose of Interferon Gamma Release Assays (IGRAs) in the diagnosis of tuberculosis?

To measure the immune response to infection with M. tuberculosis Signup and view all the answers

What is the main function of the respiratory system?

Provides oxygen to the blood stream and removes carbon dioxide Signup and view all the answers

Which part of the respiratory system is responsible for gas exchange?

Alveoli Signup and view all the answers

What is the function of cilia in the upper respiratory tract?

Trap smoke, dust, and small particles Signup and view all the answers

Which zone of the respiratory system forms a path for conduction of inhaled gases?

Bronchioles to Lungs Signup and view all the answers

What is the role of the trachea in the lower respiratory tract?

Transports air to the lungs Signup and view all the answers

Which part of the respiratory system enables reflexive air movements like coughing and sneezing?

Larynx Signup and view all the answers

Study Notes

SARS-CoV-2 Variants

BA.2.75 is a sublineage of BA.2, a viral genome that may contain one or more mutations
Recombination is a process in which the genome of 2 SARS-CoV-2 variants combine during the viral replication process to form a new variant that is different from both parent lineages
This may occur when a person is infected with two variants at the same time
The lineage that results from recombination is called a recombinant

Pango Lineage System

The Pango lineage system is hierarchical, like a family tree
Lineages are evolutionary descendants of a "parent" lineage
A lineage may be described as a "sublineage" when it is being discussed in relation to its parent lineage
Lineages are named using an alphabetical prefix and numerical suffix

Tuberculosis (TB)

Diagnosis

PPD (purified protein derivative) test: a marker is injected, and the test is interpreted after 48-72 hours
Palpation: if the marker is erased, measure the induration
A TST (tuberculin skin test) should be regarded as positive:
- In children who are immunosuppressed: >5mm diameter of induration
- In all other children: >10mm diameter of induration
Bacteriological confirmation: whenever possible, using appropriate clinical samples (e.g. sputum, gastric aspirates)
HIV testing: should be offered to all patients, including children, with presumptive and diagnosed TB
Chest radiography: opacification in the lung, together with enlarged hilar or subcarinal lymph glands

Clinical Forms of TB

Extrapulmonary TB

Cervical lymph nodes (scrofula/TB adenitis): most common form of extrapulmonary TB in children
Symptoms: often absent, nodes are painless, firm, discrete, and movable, becoming adherent to each other and anchored to the surrounding tissues
Physical examination: to find lymph nodes, measure and take note of tenderness, firmness, and movability

TB Meningitis

Most common type of TB of the nervous system
The tubercle bacilli reach the CNS via the blood stream during its lymphohematogenous spread
3 stages of TB meningitis

Respiratory System

Anatomy

Functionally, the respiratory system can be separated into two zones:
- Conducting zone (nose to bronchioles): forms a path for conduction of inhaled gases
- Respiratory zone (alveolar duct to alveoli): gas exchange takes place
Anatomically, the respiratory system can be separated into upper and lower respiratory tract
Upper respiratory tract: lined with mucous membranes, parts include nostrils, nasal cavity, pharynx, epiglottis, and larynx
Lower respiratory tract: major passages and structures include the trachea, right and left bronchus, bronchioles, and lungs containing the alveoli

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Description

Test your knowledge on assessing respiratory conditions based on chest shape, nature of breathing, operation scars, palpation, and other abnormalities. Questions may cover overinflated chest in severe acute asthma, asymmetry in pneumothorax, Kussmaul's breathing, Cheyne-Stokes breathing, paradoxical chest movement, and trachea palpation techniques.