Answer

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BOF: 12

A 60-year-old male is admitted with a history of acute on chronic breathlessness. He has been a longstanding smoker. On examination, he is breathless at rest with pursed lip breathing, use of accessory muscles of respiration and a barrel shaped chest. He is not oedematous.
Which of the following physical signs will allow you to infer that on chest X-ray hyper inflated lung fields will be seen?

a) Determining respiratory movements

b) Vocal fremitus

c) Percussion

d) Auscultation of breath sounds

e) Vocal resonance

Answer:

c)

Absence or reduction of dullness over the praecordium (cardiac dullness) or reduction of dullness over the right lower chest (liver dullness) will allow you to infer that on chest X-ray the lung fields will be hyper inflated.

Revision Tip

Revise COPD KEYS to SUCCESS in Medicine page 188-191

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