Rosh Internal Medicine Boost Practice Exam

What finding is typically present in a patient with a history of bronchitis and ongoing respiratory symptoms?

1. Diastolic murmur

2. Barrel chest

3. Scaphoid abdomen

4. Wheezing

The correct answer is: Barrel chest

In the context of a patient with a history of bronchitis and ongoing respiratory symptoms, the presence of a barrel chest is significant. Barrel chest is characterized by a rounded, prominent chest that occurs as a result of prolonged lung hyperinflation, which is commonly seen in chronic respiratory conditions like bronchitis or emphysema. This chronic lung disease leads to changes in lung structure and mechanics, causing the chest wall to appear more cylindrical rather than the typical elliptical shape. While wheezing is also a potential symptom of bronchitis, it is primarily an indication of airway obstruction rather than a physical characteristic of the chest. Other options, such as a diastolic murmur or a scaphoid abdomen, are unrelated to the respiratory implications of bronchitis and do not connect to the typical physical findings observed in patients with chronic respiratory issues. Thus, barrel chest is an important and relevant finding in this clinical scenario.