Question 2 from the second paper of 2001 is a question about the differential diagnosis of wheeze. There can be a myriad answers.

UpToDate even has a page about this sort of thing.

Causes of widespread wheeze

  • Extrathoracic causes
    • Anaphylaxis
    • Vocal cord paralysis
    • Laryngeal stenosis
    • Goiter with thoracic inlet obstruction
    • Anxiety with hyperventilation
  • Intrathoracic central airway causes
    • Tracheal stenosis
    • Mediastinal tumours
    • Hyperdynamic airway collapse due to tracehomalacia
    • Mucus plugs
    • Thoracic aortic aneurysm
    • Foreign body inhalation
  • Intrathoracic lower airway causes
    • Bronchitis or bronchiolitis
    • COPD
    • Pulmonary oedema - "cardiac asthma"
    • Airway distortion due to mechanical causes, eg. bronchial mass, bronchiectasis, pneumothorax
    • Exposure to inhaled irritant or corrosive agent, and this includes the aspiration of gastric contents

Causes of unilateral wheeze

The differential diagnosis of a unilateral wheeze really comes down to how many different ways of obstructing a main bronchus you can think of.

  • ETT malposition
  • foreign body
  • blood clot
  • Sputum secretions
  • Tumour
    • Bronchogenic carcinoma
    • Thymus carcinoma
    • Retrosternal goitre
  • compression by lymph nodes
  • compression by aortic aneurysm
  • traumatic dissection
  • Bronchial stenosis post infection
  • Bronchiectasis
  • Bronchial compression by enlarged left side of heart