A 10-year-old boy is brought to the Emergency Department after aspirating a peanut an hour earlier. He has a non-productive cough and shortness of breath. On arrival in the Emergency Department, he is tachypnoeic and has an oxygen saturation of 90% on room air. A chest X-ray demonstrates a complete whiteout of the right lung and the trachea is seen deviated to the right of the midline.
Which of the following processes is most likely causing the findings seen on the chest X-ray?
A 62-year-old female patient complains of breathlessness and weight loss over the past three months. She is a smoker who consumes 10 cigarettes per day. During the examination, you observe clubbing of the fingers and a few crackles in the chest. What is the probable diagnosis?
A 42-year-old man with advanced lung disease due to cystic fibrosis (CF) is being evaluated for a possible lung transplant. What respiratory pathogen commonly found in CF patients would make him ineligible for transplantation if present?
A nurse in the Emergency Department presents an electrocardiogram (ECG) to you. The elderly patient is feeling breathless and has long-standing limited mobility. The ECG shows a sinus tachycardia with an S-wave in lead I, Q-wave in lead III and T-wave inversion in lead III.
What is the most likely diagnosis?
A previously healthy 85-year-old woman is hospitalised and undergoes surgery to replace the broken hip that she sustained as a result of falling down stairs. Upon discharge to a nursing home 10 days later, she is unable to ambulate fully and, about a month later, she dies suddenly.
Which of the following is most likely to be the immediate cause of death found at post-mortem examination?
A 67-year-old woman has had bowel surgery two days ago. She is currently on postoperative day one, and you are called to see her as she has developed sudden-onset shortness of breath. She denies any coughing but complains of chest discomfort. The surgical scar appears clean. Upon examination, the patient is afebrile; vital signs are stable other than rapid and irregular heartbeat and upon auscultation, the chest sounds are clear. The patient does not have any other significant past medical history, aside from her breast cancer for which she had a mastectomy five years ago. She has no family history of any heart disease.
What is the patient’s most likely diagnosis?
A 25-year-old lady with a history of asthma is brought to the Emergency Department with an acute asthma attack. She has previously been admitted to the intensive therapy unit (ITU) with the same problem. Treatment is commenced with high-flow oxygen and regular nebulisers.
Which of the following is a feature of life-threatening asthma?
A 55-year-old female presents with worsening dyspnoea and the need to sit down frequently. She has had no other health issues. The patient works in an office.
During the physical examination, the patient is found to have clubbing and fine end-inspiratory crackles upon auscultation. A chest X-ray reveals diffuse reticulonodular shadows, particularly in the lower lobes.
What is the most suitable next step in managing this patient?
A 75-year-old man presents to the Emergency Department with complaints of difficulty breathing. Upon examination, you observe that his trachea is centralized and there is decreased chest expansion on the left side, accompanied by a dull percussion note and diminished breath sounds. What is the diagnosis?
A 68-year-old man with chronic obstructive pulmonary disease (COPD) visits his general practitioner (GP) complaining of increased wheezing, breathlessness, and a dry cough. He is able to speak in complete sentences.
During the examination, the following observations are made:
Temperature 37.2 °C
Respiratory rate 18 breaths per minute
Blood pressure 130/70 mmHg
Heart rate 90 bpm
Oxygen saturations 96% on room air
He has diffuse expiratory wheezing.
What is the most appropriate course of action for this patient?