Hoarseness of voice occurs in which condition?

AIIMS Raipur NO- 2019 (shift 3rd)

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Raipur NO- 2019 (shift 3rd)

Explanation

Hoarseness is the most common and earliest symptom of laryngeal cancer, especially for glottic tumors that arise on the true vocal cords.
The presence of a tumor on the vocal cords directly interferes with their ability to vibrate and close properly, leading to a change in voice quality.
Persistent hoarseness lasting more than two weeks is a key warning sign that warrants immediate medical evaluation to rule out malignancy.

Option A: This option is incorrect because Larynx cancer is a primary and direct cause of hoarseness, making it a valid condition listed in the options.
Option C: The primary symptoms of pulmonary TB are related to the lungs (e.g., chronic cough, fever, night sweats). Hoarseness only occurs if the infection spreads to the larynx (laryngeal tuberculosis), which is a secondary complication, not a primary feature.
Option D: Bronchitis is inflammation of the bronchial tubes. While the associated severe and persistent coughing can irritate the vocal cords and cause temporary hoarseness, it is a secondary effect, not a primary symptom of the condition itself.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differential diagnosis of hoarseness of voice as background academic context rather than a clinical decision trigger.
Nurses must educate patients that any hoarseness lasting over two weeks is a red flag and requires prompt ENT consultation to rule out laryngeal cancer.
Post-laryngectomy, the nurse's priority is managing the patient's airway (e.g., tracheostomy care) and establishing a method of non-verbal communication.
What if? If a patient with bronchitis reports hoarseness, the nurse should first assess the severity and duration of the cough. The initial intervention would focus on cough suppressants and soothing measures, rather than an immediate cancer workup, unless the hoarseness persists after the bronchitis resolves.

How to Approach the Question

First, identify the key symptom presented in the question: 'hoarseness of voice'.
Next, evaluate each option by considering its primary anatomical location and pathophysiology.
Larynx cancer directly affects the vocal cords within the larynx, making hoarseness a direct and early symptom.
Pulmonary TB primarily affects the lungs. Hoarseness is a secondary complication if the infection spreads to the larynx.
Bronchitis affects the bronchi. Hoarseness is a secondary effect of irritation from severe coughing.
Conclude that the condition where hoarseness is a hallmark and primary symptom is the most accurate answer.

Concept Tested & Keywords

QWqjlm1ub0NU2RL96B2ibd

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 744-746

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 3 (515-969) p. 1-3

E6 Medicine Davidson Principles Practice 24e p. 644-646