41 topics with brief reviews: definitions, key facts, and classroom questions.
This section is dedicated to the basics of clinical diagnostics of respiratory system diseases. It provides a detailed breakdown of the physician's journey from assessing basic complaints (cough, dyspnea, hemoptysis) and taking a medical history to physical examination. You will study the techniques of inspection, palpation, topographic and comparative percussion, as well as the nuances of lung auscultation—from basic to adventitious breath sounds.
The next module covers the laboratory and instrumental diagnostic framework (pulmonary function testing, diagnostic imaging, endoscopy) and the basics of clinical thinking. Pathologies are grouped by key syndromes: pulmonary consolidation, fluid or air accumulation in the pleural cavity, presence of a pulmonary cavity, bronchial obstruction, and respiratory failure.
In practical classes, instructors most frequently demand flawless proficiency in percussion and auscultation, an understanding of the mechanism of rale formation, and the ability to differentiate major nosologies: pneumonia, COPD, bronchial asthma, and pleurisy. A solid grasp of these topics is your core foundation for managing patients in an internal medicine clinic.
Why do we need auscultation when modern X-ray machines exist?
Some conditions, such as dry pleurisy or bronchobstructive syndrome, may not be visualized radiologically. In these cases, the leading role belongs to physical examination.
Why are chronic lung diseases often diagnosed late?
In chronic courses during early stages or in the remission phase, symptoms are often absent or minimally expressed. Without targeted examination, a patient may not seek medical help for a long time.
Why can a productive cough revert to a dry cough in acute laryngitis?
This is the phenomenon of "regression." It is associated not with the accumulation of secretions, but with hypersensitivity (a lowered excitation threshold) of cough receptors. In this phase, antitussives suppressing the reflex are indicated rather than expectorants.
Which diseases are characterized by the production of more than 1 liter of sputum per day?
This volume is typical for large bronchiectasis, lung abscess, tuberculous cavities, rupture of pleural empyema, and pulmonary edema.
How to quickly distinguish true pulmonary hemorrhage from gastric bleeding?
When the source is pulmonary, blood is expelled with a cough; it is bright red, frothy, and has an alkaline reaction. In gastric hemorrhage, blood is expelled with vomiting and is often dark in color (due to reaction with hydrochloric acid) with an acidic reaction.
How to differentiate pathological dyspnea from physiological fatigue (due to sports)?
The key criterion of pathology is decreased exercise tolerance. Dyspnea begins to occur during exertion (or daily activities) that the patient previously tolerated easily.
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