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Medicine

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Respiratory

Question
4 out of 11
 

All of the following statements about Emphysema are true Except: (DNB Dec 2012)



A Breathlessness is the characteristic presenting symptom

B Diffusion rate of carbon monoxide is reduced

C Restrictive pattern on pulmonary function test is seen

D Long term bronchodilator therapy does not improve lung function

Ans. C

Restrictive pattern on pulmonary function test is seen

Pathophysiology

1). Airflow limitation

2). Hyperinflation

3). Cachexia – It causes weight loss a classical feature of emphysema due to Increase TNF α

4). Muscle dysfunction – Proximal limb girdle ms. are usually affected due to.

Protein loss, malnutrition, glucocorticoid use.

Clinical features Symptoms: Cough, sputum, dyspnea, and wheeze.

Chronic bronchitis patients are usually obese Q whereas weight lossQ is the feature of emphysema.

Signs :

1). Tachypnea; use of accessory muscles of respiration; hyperinflation

2). Decrease crico sternal distance (<3cm)

3). Reduced chest expansion

4). Resonant or hyperresonant percussion note

5). Wheeze; cyanosis; cor pulmonale.

6). Paradoxically inward movement of chest wall during inspiration (Hoover Sign) the result of alteration of the vector of diaphragmatic contraction on the rib cage as a result of chronic hyperinflation.

7). Patients with severe airflow obstruction may also exhibit use of accessory muscles of respiration, sitting in the characteristic "tripod" position to facilitate the actions of the sternocleidomastoid, scalene, and intercostal muscles.

Important clinical signs of emphysema:

1). Barrel shape chest

2). Reduced area of cardiac dullness

3). Liver dullness shifted more down ward.

Important Points about emphysema

1). Breathlessness (Dyspnea) is a characteristic presenting symptom

2). Obstructive pattern is seen on PFT

3). Diffusion of carbon monoxide is reduced (DLCO)

4). Long term bronchodilator therapy does not improve lung function

Respiratory Flashcard List

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