A 23-year-old patient who has had bronchiectasis since childhood ...

[fnuegbu]

A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following:
 
  A. Barrel-shaped chest
  B. Clubbing
  C. Pectus excavatum
  D. Prolonged capillary refill

Question 2

Which of the following is considered a red flag when diagnosing a patient with pneumonia?
 
  A. Fever of 102
  B. Infiltrates on chest x-ray
  C. Pleural effusion on chest x-ray
  D. Elevated white blood cell count

[missalyssa26]

Answer to Question 1

ANS: B
In bronchiectasis, there is usually a history of chronic, productive cough. Sputum is typically mucopurulent and produced in increased amounts. Other common findings include shortness of breath, wheezing, fatigue, and possibly hemoptysis. Physical examination reveals rhonchi and/or wheezing. In advanced disease, clubbing and cyanosis may be present.

Answer to Question 2

ANS: C
With pneumonia, the chest film typically reveals an area of infiltrate. It is a red flag if a pleural effusion is also visualized, in which case adequate follow-up to exclude development of an empyema is mandatory. This often involves prompt referral to a pulmonologist for possible thoracentesis. Cultures and Gram stains of sputum are usually not ordered for outpatients. The white blood cell count is often elevated.