RESPIRATORY BLOCK CASE 1 (basic) A 3 years old boy brought by his mother with a 3 days history of runny nose,

cough and 1 day history of noisy musical breathing and dyspnoea. 1. State the medical term of noisy musical breathing and its mechanism of production 2. List 3 the differential diagnosis and your provisional diagnosis 3. Explain briefly the pathogenesis of your provisional diagnosis 4. List 2 investigations that will help you to further confirmation of diagnosis

CASE 2 (normal) A B C

1. What is the instrument used to measure above findings 2. Explain briefly to the patient step of using the instrument in question 1 3. Assuming A is normal, state what type of ventilator defect in B and C 4. State 1 example of the disease that can cause reading in B and C CASE 3 (basic) A 42 years old HIV-positive man presents to A & E department with the history of haemoptysis. He states that he has lost 15 pounds over the last 2 months and had intermittent fever and cough. His CD4 count is <250. You send him for CXR and sample his sputum for acid fast bacilli, which was positive 1. State your provisional diagnosis 2. State the causative organisms

3. State 3 portal of entry of above organism to the host 4. List 2 findings on the CXR related to your provisional diagnosis 5. List 3 drug of choice in treating this condition

CASE 4 (hard) A 63 years old man presents to your office after noticing his left eye was droopy. Upon further questioning, he admits to some shortness of breath over the past 2 months, but attributes that to his 40 years old heavy smoking habit. Physical examination reveals ptosis and miosis of the left eye and extremely dry skin on the left face. 1. State your diagnosis 2. List the risk factor in this patient and 2 other risk factors 3. Explain the steps taken by the doctor to convey his diagnosis to this patient

CASE 5 (hard) A 25 years old man presents to HUSM with haemoptysis associated with chronic productive cough. He reports suffering from chronic sinusitis and have several bouts of severe pneumonia that have required hospitalization in the past. Pulmonary function reveals decrease FEV1/FVC ratio. When CT scan reveals dilated bronchioles with signet ring appearance, you decide to check for situs inversus, because this patient might have a rare genetic disorder 1. State your diagnosis 2. State 2 pathological findings associated with the above diagnosis 3. List 2 aetiologies associated with your diagnosis CASE 6 (normal) A 59-year-old man presents to your office complaining of productive cough and dyspnoea. He has smoked heavily and works in construction. A CT scan reveals interstitial lung fibrosis and calcified pleural plaques. You inform the patient that this condition may leads to certain cancer 1. State your diagnosis 2. Explain the pathogenesis of the disease stated above 3. What type of cancer will the above condition preceded to CASE 7 (basic)

A 13 years old man present to HUSM with MVA. He was in respiratory distress but alert. Upon examining the patient, you noted that there were reduce lung expansion on the left side, dull on percussion and increase vocal resonance on the left side. 1. Explain briefly the basic anatomy of the pleura 2. State the mechanism of a) Reduce lung expansion b) Dull on percussion on left lung c) Increase vocal resonance on the left side 3. State the management of the patient with MVA