Respiratory diagnosis cases on Saturn Dx help you practise the reasoning behind cough, breathlessness, wheeze and pleuritic chest pain. This free pulmonology diagnosis game offers 123 clinical cases. Read the presentation, name the diagnosis, and earn more points the fewer hints you need.
How our respiratory diagnosis cases work
Pick a difficulty (Easy, Medium or Hard) and start a case. You see the patient presentation first. Type your diagnosis, and if it is wrong the next hint unlocks: examination findings, then laboratory results, then imaging or other investigations. The fewer hints you need, the more points you earn, and at the end you read a short explanation of why the diagnosis fits.
Why practise respiratory diagnosis cases?
Lung disease is common in every clinic and ward, and many chest conditions look alike at first. A cough that lasts for weeks might be asthma, an infection, a tumour or heart failure. The pattern of symptoms, the smoking and exposure history, the chest examination and a chest X-ray usually narrow the list. These cases show you how to build that list step by step.
What you learn from each case
Every one of these respiratory diagnosis cases ends with the same three things: the correct diagnosis, a short explanation of the reasoning, and the full list of clues so you can see where your thinking went right or wrong. Over time you start to recognise typical patterns in respiratory medicine, you remember the key investigations for each condition, and you become faster at ruling out the dangerous causes first. Use the difficulty setting to begin with classic presentations and then move on to harder, more subtle cases.
Topics in the respiratory diagnosis game
This area of medicine covers presentations such as:
- asthma and COPD
- community-acquired and hospital-acquired pneumonia
- pulmonary embolism
- pneumothorax and pleural effusion
- interstitial lung disease
- lung cancer
- tuberculosis
- respiratory failure and acute respiratory distress
How to approach a respiratory case
Ask first how sick the patient is, using the breathing rate, the oxygen level and the ability to speak in full sentences. Then decide whether the problem lies in the airways, the lung tissue, the pleura or the blood vessels. Think about the onset: sudden breathlessness suggests different causes from months of slow decline. Check which hints fit your first idea and which do not.
- Write down two or three possible diagnoses before you type an answer.
- Use every hint to rule something in or out, not only to confirm your first idea.
- Read the explanation after each case, even when you were right.
Trusted resources to read next
After a case, deepen your understanding with American Lung Association for patient information on lung disease, and MedlinePlus lung diseases for plain-language summaries of breathing problems.
Keep studying with Saturn Medic
Test yourself with the Saturn Medic Question Bank, revise key facts with our medical flashcards, or return to the medical diagnosis game home page. You can also practise another system:
- Cardiovascular diagnosis cases
- Gastrointestinal diagnosis cases
- Endocrinology diagnosis cases
- Renal System diagnosis cases
- Hematology diagnosis cases
- Infectious System diagnosis cases
Respiratory diagnosis game FAQ
Are these respiratory diagnosis cases free?
Yes. Every respiratory case on Saturn Dx is free to play, and there is no limit on how many you can try. There are currently 123 respiratory cases.
How many hints do I get in a respiratory case?
Each case has between four and six clues. You start with the history, and every wrong answer unlocks the next hint, such as examination findings, laboratory results or imaging.
Are the respiratory cases real patients?
No. They are original teaching scenarios written to match standard textbook presentations. Our team reviews each case before it goes live, and no real patient records are used.
All 123 respiratory cases
- Respiratory case #104 - A tall, slim 22-year-old man who smokes has had sudden pain on one side of his chest for 3 hours.
- Respiratory case #105 - A 58-year-old woman developed sudden breathlessness this morning.
- Respiratory case #106 - A 29-year-old woman has had painful, swollen ankles and fatigue for 3 weeks.
- Respiratory case #131 - A 19-year-old woman has had a dry cough that wakes her at night for 2 months.
- Respiratory case #132 - A 63-year-old man has had a morning cough with sputum for several years and now gets breathless on stairs.
- Respiratory case #133 - A 34-year-old man has had 3 days of fever, shaking chills and a cough.
- Respiratory case #134 - A 66-year-old man with a 40-pack-year smoking history has had a persistent cough for 3 months.
- Respiratory case #135 - A 45-year-old woman has had a daily cough for many years since a severe chest infection in childhood.
- Respiratory case #136 - A 68-year-old man has had 18 months of slowly worsening breathlessness and a dry cough.
- Respiratory case #137 - A 41-year-old farmer has episodes of fever, chills, cough and breathlessness.
- Respiratory case #138 - A 70-year-old retired man has had 2 months of breathlessness and a dull ache in the right chest.
- Respiratory case #139 - A 24-year-old man has had a chronic productive cough since adolescence and was thin as a child.
- Respiratory case #140 - A 32-year-old woman has had 8 months of increasing tiredness and breathlessness on exertion.
- Respiratory case #203 - A 34-year-old man who recently moved from a country where this infection is common has had a cough for 6 weeks.
- Respiratory case #204 - A 52-year-old woman has had chest tightness and breathlessness for several years. She has worked in a textile mill for 25 years.
- Respiratory case #205 - A 74-year-old man has been in hospital for 5 days after a hip fracture repair. He now has a fever and a productive cough.
- Respiratory case #206 - A 48-year-old man was treated for pneumonia 10 days ago. He still has fever and now has severe pain on the right side of his chest when he…
- Respiratory case #207 - A 54-year-old man has had a dry cough and slowly increasing breathlessness for 2 years. He has no wheeze.
- Respiratory case #208 - A 69-year-old retired man has had worsening breathlessness on exertion for 18 months. He has a dry cough but no wheeze.
- Respiratory case #209 - A 55-year-old man with a heavy alcohol intake was found unconscious after a drinking binge. Two weeks later he has fever and weight loss.
- Respiratory case #210 - A 46-year-old man developed severe breathlessness 2 days after emergency surgery for a perforated bowel with generalised sepsis.
- Respiratory case #211 - A 28-year-old woman with long-standing asthma has had worsening wheeze, fever and cough for 3 weeks.
- Respiratory case #212 - A 61-year-old man has had lethargy and weight loss for months. He had treatment for a lung infection 20 years ago.
- Respiratory case #213 - A 41-year-old man has had a dry cough, progressive breathlessness, night sweats and aching joints for 8 months.
- Respiratory case #214 - A 63-year-old retired coal miner has had a cough and increasing breathlessness for 2 years. Some of his sputum is jet black.
- Respiratory case #301 - A 52-year-old lorry driver has fallen asleep at the wheel twice in the last month. He wakes unrefreshed with a morning headache, however…
- Respiratory case #302 - A 34-year-old nurse had a mild cold for a week. She now has bouts of severe coughing that go on for weeks and leave her exhausted…
- Respiratory case #303 - A 19-year-old student has sudden bursts of sneezing every June, with a watery nose and itchy red eyes. Symptoms ease during rainy weeks.
- Respiratory case #304 - A 61-year-old man who has smoked 40 cigarettes a day for 40 years has had a cough, weight loss and increasing confusion for 6 weeks.
- Respiratory case #305 - A 66-year-old woman who smokes has had progressive breathlessness for 6 weeks, with a dull ache in the right chest and a 5 kg weight loss.
- Respiratory case #306 - A 24-year-old man has had a fever, night sweats and right-sided pain on breathing in for 3 weeks. He recently moved from a country where…
- Respiratory case #307 - A 19-year-old university student has had a dry cough, headache and low-grade fever for 8 days. Several friends in her hall of residence…
- Respiratory case #308 - A 58-year-old man who smokes has had swelling of his face and neck, morning headache and a feeling of fullness in the head for 2 weeks. It…
- Respiratory case #309 - A 67-year-old retired shipyard worker has a routine chest X-ray before a hernia operation. He worked with lagging and insulation 40 years…
- Respiratory case #310 - A 31-year-old baker has developed wheeze and a tight chest over the last year. He used to be well and has no history of childhood asthma.
- Respiratory case #311 - A 58-year-old man returned from a conference 5 days ago with a fever, headache and a dry cough. He has now become confused and breathless.
- Respiratory case #312 - A 54-year-old man with a history of heavy drinking has had 3 days of fever, rigors and cough with thick, dark red sputum. He is now…
- Respiratory case #313 - A 27-year-old man had influenza for 4 days and was beginning to recover. He then developed a high fever, a productive cough with…
- Respiratory case #314 - A 33-year-old woman has had 6 weeks of fever, night sweats, weight loss and a dry cough that is getting worse. She has recently arrived…
- Respiratory case #315 - A 55-year-old woman was treated with radical radiotherapy to a lung tumour 8 weeks ago. She now has a dry cough, mild fever and increasing…
- Respiratory case #316 - A 47-year-old woman had a mastectomy for breast cancer 3 years ago. She now has mild exertional breathlessness but no cough or haemoptysis.
- Respiratory case #317 - A 60-year-old man who smokes has had 3 months of severe aching pain in his right shoulder and inner arm, which keeps him awake at night.
- Respiratory case #318 - A 63-year-old woman with a history of breast cancer has had rapidly worsening breathlessness over 3 weeks. She has little cough and no…
- Respiratory case #319 - A 58-year-old man with long-standing joint pains has had right-sided pleuritic pain and breathlessness for 4 weeks. He has had no fever.
- Respiratory case #320 - A 62-year-old retired coal miner with rheumatoid arthritis has noticed no new symptoms, but a chest X-ray done for a work medical shows an…
- Respiratory case #321 - A 41-year-old woman has had nasal polyps and late-onset asthma that is difficult to control for 3 years. She now has fever, weight loss and…
- Respiratory case #322 - A 28-year-old man who lives in a rural village in South Asia has had 3 months of nocturnal cough, wheeze, low-grade fever and weight loss…
- Respiratory case #323 - A 52-year-old non-smoker has had 5 weeks of fever, dry cough, malaise and weight loss. A course of amoxicillin and a later course of a…
- Respiratory case #485 - A 68-year-old man with alcohol dependence is found vomiting after a drinking binge and drifting in and out of consciousness. Five days…
- Respiratory case #486 - A 24-year-old nurse has had a blocked and runny nose, sneezing and a scratchy throat for 2 days. She feels mildly tired.
- Respiratory case #487 - A 35-year-old teacher has had nasal blockage for 8 days with thick discharge, pressure over her cheeks and forehead, and reduced sense of…
- Respiratory case #488 - A 52-year-old man was eating steak at a restaurant when he suddenly stopped talking, clutched his throat and could not breathe.
- Respiratory case #489 - A 47-year-old primary school teacher who smokes has had hoarseness and a tickling cough for 4 months, worse by the end of the school day.
- Respiratory case #490 - A 16-year-old boy is embarrassed by the shape of his chest, which has looked 'sunken' since early childhood. His father and an uncle have a…
- Respiratory case #491 - A 74-year-old man with past myocardial infarction has had increasing breathlessness on lying flat and swollen ankles for 3 weeks.
- Respiratory case #492 - A 31-year-old woman is traced as a close contact of her brother, who has smear-positive pulmonary tuberculosis. She has no cough, fever…
- Respiratory case #493 - A 26-year-old woman has episodes of feeling she 'cannot get a deep enough breath', with tingling around the mouth and in her fingers. They…
- Respiratory case #494 - A 45-year-old woman has a constantly blocked and watery nose that gets worse in cold dry air, with strong perfumes and in smoky rooms. She…
- Respiratory case #495 - A 33-year-old trekker flew to 3800 m and walked up to 4500 m on the second day. On the third night she developed a dry cough…
- Respiratory case #496 - A 28-year-old woman born in a high-incidence country has had a painless swelling on the left side of her neck for 2 months. She has no…
- Respiratory case #497 - A 69-year-old woman who rarely goes outdoors had a prolonged coughing fit during a chest infection and then felt a sharp stabbing pain in…
- Respiratory case #498 - A 55-year-old man was treated for 4 days at home for a left-sided chest infection but now has a persistent fever and worsening left-sided…
- Respiratory case #499 - A 70-year-old man with severe COPD is brought by ambulance with worsening breathlessness and a chest infection. He was given high-flow…
- Respiratory case #500 - A 66-year-old man with 40 years of heavy smoking and chronic cough has noticed swollen ankles and abdominal fullness over 2 months. His…
- Respiratory case #501 - A 54-year-old woman with a severe spinal curvature since adolescence has morning headaches, tiredness and daytime sleepiness. Her…
- Respiratory case #502 - A 38-year-old man was ventilated for 3 weeks after a road accident. Two months after discharge he has progressive noisy breathing on…
- Respiratory case #503 - A 41-year-old cleaner was exposed to a large chlorine gas leak when two cleaning products were mixed in a small room. Since then she has…
- Respiratory case #504 - A 68-year-old man with atrial fibrillation and ventricular arrhythmias, on long-term amiodarone, has had a dry cough and slowly worsening…
- Respiratory case #505 - A 63-year-old man who smoked 30 cigarettes daily for 40 years has developed aching pain over both shins and wrists for 2 months, with…
- Respiratory case #506 - A 44-year-old man is on day 12 of chemotherapy for acute leukaemia. He has had fever for 5 days despite broad-spectrum antibiotics and now…
- Respiratory case #507 - A 62-year-old woman with long-standing bronchiectasis from childhood whooping cough has had increased cough, low-grade fever, weight loss…
- Respiratory case #508 - A 50-year-old woman with 8 years of Raynaud phenomenon and tight skin on her fingers has had a dry cough and progressive breathlessness for…
- Respiratory case #509 - A 58-year-old man with seropositive rheumatoid arthritis for 12 years has no chest symptoms. A chest film done before joint surgery shows…
- Respiratory case #510 - A 22-year-old man who recently started smoking has had 3 days of fever, dry cough, pleuritic chest pain and rapidly increasing…
- Respiratory case #511 - A 47-year-old woman has had 3 months of malaise, fever, weight loss, breathlessness and an unproductive cough. Antibiotics have not helped.
- Respiratory case #512 - A 38-year-old man has had months of nasal crusting and blood-stained discharge, then a cough with small haemoptyses and pleuritic chest…
- Respiratory case #513 - A 68-year-old retired shipyard pipe-laggers' mate has had slowly worsening breathlessness on exertion for 2 years and a dull ache in the…
- Respiratory case #514 - A 55-year-old insulation worker with 25 years of exposure to asbestos dust has had a week of right-sided pleuritic chest pain with a mild…
- Respiratory case #515 - A 59-year-old man with chronic back pain taking high-dose opioid analgesia, and who drinks alcohol most evenings, has morning headaches and…
- Respiratory case #516 - A 54-year-old woman was treated with anticoagulation for a large pulmonary embolism 8 months ago. Despite this she remains breathless on…
- Respiratory case #517 - A 66-year-old smoker has mild breathlessness on exertion that is worse lying flat. He has a history of a cough and weight loss.
- Respiratory case #518 - A 28-year-old man has had a wet cough, recurrent chest infections and blocked, runny nose since childhood. He has also had persistent ear…
- Respiratory case #519 - A 27-year-old woman with a photosensitive facial rash and painful joints has had repeated bouts of sharp chest pain on breathing in over…
- Respiratory case #520 - A 40-year-old woman develops swelling of the lips and tongue within minutes of eating a prawn dish. She then notices her voice becoming…
- Respiratory case #521 - A 45-year-old woman, a non-smoker, has had 8 months of dry cough and progressive breathlessness. She also has stiff, puffy fingers that are…
- Respiratory case #522 - A 41-year-old non-smoking man has a chest X-ray for an insurance medical. He has no cough, haemoptysis or weight loss and no family history…
- Respiratory case #523 - A 57-year-old man treated for tuberculosis 10 years ago has had cough, intermittent haemoptysis, weight loss and fatigue for 9 months, with…
- Respiratory case #524 - A 29-year-old man who injects heroin has had 10 days of fever, rigors, cough and pleuritic chest pain. He has track marks on both arms.
- Respiratory case #525 - A 36-year-old man was treated 14 months ago for pulmonary tuberculosis but stopped medication after 3 months when he felt better. He now…
- Respiratory case #526 - A 49-year-old woman who has never smoked has had a persistent dry cough and dull right-sided chest ache for 4 months, with a 4 kg weight…
- Respiratory case #527 - A 31-year-old woman with a 6-year history of systemic lupus erythematosus has developed breathlessness on exertion and when lying flat over…
- Respiratory case #528 - A 33-year-old man who has been sandblasting stone surfaces with poor protection for 5 months has developed severe breathlessness and weight…
- Respiratory case #529 - A 19-year-old student had a severe sore throat and a painful swollen neck for a week. He then developed high fevers with rigors, cough…
- Respiratory case #530 - A 52-year-old man with poor dental hygiene and untreated tooth abscesses has had 4 months of productive cough, low-grade fever and weight…
- Respiratory case #531 - A 66-year-old man with known oesophageal cancer spreading in the mediastinum now coughs violently each time he drinks water or swallows…
- Respiratory case #532 - A 38-year-old man who has worked for 4 years in a factory mixing artificial butter flavouring has had progressive dry cough and…
- Respiratory case #533 - A 64-year-old obese man with mild COPD (FEV1 72% predicted) has morning headaches, ankle swelling and severe daytime sleepiness. His wife…
- Respiratory case #534 - A 31-year-old man is found collapsed in a stairwell with a needle beside him. He is brought round with naloxone but within an hour becomes…
- Respiratory case #805 - A tall, thin 22-year-old smoker develops sudden right-sided chest pain and breathlessness while resting. Over the next hour the…
- Respiratory case #806 - A 28-year-old woman has felt tired for three weeks with low-grade fever and painful ankles. She has no cough.
- Respiratory case #807 - A 34-year-old trekker flew to 3500 m and went straight on a hike. That night she has a pounding headache, nausea, poor appetite and cannot…
- Respiratory case #808 - A 16-year-old boy is pulled from a lake by friends after being under water for a couple of minutes. He coughed and vomited after rescue and…
- Respiratory case #809 - A 2-year-old boy was eating peanuts when he suddenly choked and coughed violently, then recovered. For the past week he has had a…
- Respiratory case #810 - A 45-year-old woman has had a blocked nose and loss of smell for years, and developed wheeze and breathlessness in her forties.
- Respiratory case #811 - A 58-year-old man has had a dry irritating cough for two months with no breathlessness, fever or sputum. He is a lifelong non-smoker.
- Respiratory case #812 - A fit 46-year-old man develops sudden breathlessness and a cough 10 minutes into the swim leg of a triathlon in cold water. He coughs up…
- Respiratory case #813 - A 52-year-old man with severe obesity has become increasingly breathless and sleepy during the day. His wife says he snores loudly and he…
- Respiratory case #814 - A 15-year-old girl becomes breathless, wheezy and tight in the chest a few minutes after she stops running in cold weather, but she is fine…
- Respiratory case #815 - A 48-year-old man who has smoked 30 cigarettes a day for 25 years has had increasing breathlessness and a dry cough for a year. He has no…
- Respiratory case #816 - A 33-year-old woman has had breathlessness on exertion and a small amount of coughed-up blood for a year. Two months ago she had a sudden…
- Respiratory case #817 - A 27-year-old man completed several cycles of chemotherapy for testicular cancer. Over the past three weeks he has developed a dry cough…
- Respiratory case #818 - A 66-year-old woman has had a low-grade fever, dry cough and breathlessness for a week. She started a long-term antibiotic for recurrent…
- Respiratory case #819 - A 24-year-old man who smokes has coughed up blood on two occasions and feels breathless. A few days later he passes dark, smoky urine.
- Respiratory case #820 - A 31-year-old woman completed three scuba dives over two days and surfaced quickly after the last. Four hours later she has deep aching…
- Respiratory case #821 - A 38-year-old experienced diver panics at 10 m and holds his breath while making an emergency ascent. Within minutes of surfacing he…
- Respiratory case #822 - A 24-year-old competitive breath-hold swimmer takes a series of rapid deep breaths before swimming the length of a 4 m deep pool…
- Respiratory case #823 - A 40-year-old climber has had a severe headache, nausea and vomiting for two days at 4500 m but chose to continue ascending.
- Respiratory case #824 - A 35-year-old man who works in construction in the south-western United States has had fever, cough, pleuritic chest pain and aching joints…
- Respiratory case #825 - A previously well 42-year-old woman had a flu-like illness with sore throat and fever, then over four days developed severe breathlessness…
- Respiratory case #826 - A 38-year-old man has had slowly worsening breathlessness and a dry cough for six months. He has no fever and has not lost weight.
- Respiratory case #827 - A 44-year-old pet-shop worker has a week of high fever, severe headache, muscle aches and a dry cough. He has been cleaning cages of newly…
- Respiratory case #828 - A 47-year-old man who smokes has had gradually worsening exertional breathlessness over several months with little cough.
- Respiratory case #829 - A 60-year-old woman had radiotherapy to the right chest for breast cancer eight months ago, without lung symptoms. After a new course of…