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ESA 3- Resp System > 11. Signs and symptoms of resp disease > Flashcards

11. Signs and symptoms of resp disease Flashcards

1
Q

Name the 6 cardinal signs of resp disease.

A
  1. Dyspnoea (breathlessness)
  2. Cough
  3. Chest pain
  4. Wheeze/stridor
  5. Sputum
  6. Haemoptysis
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2
Q

Name common non-resp causes of dyspnoea

A
  • myocardial dysfunction, esp LV failure
  • anaemia
  • obesity
  • deconditionig
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3
Q

Name 2 causes of instantaneous onset dyspnoea

A
  1. Pulmonary embolism

2. Pneumothorax

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4
Q

Name 5 causes of acute onset dyspnoea (mins-hrs)

A
  1. Asthma
  2. PE
  3. Pneumonia
  4. LVF/MI
  5. Hyperventilation syndrome
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5
Q

Name 2 causes of gradual onset dyspnoea (days)

A
  1. Lobar collapse (e.g. Lung cancer)

2. Pleural effusion

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6
Q

Name 3 causes of chronic onset (mths-yrs) dyspnoea.

A
  1. COPD
  2. Idiopathic pulmonary fibrosis
  3. Bronchiectasis (e.g. Secondary to CF)
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7
Q

What is the pathophysiology of bronchiectasis

A

Persistent chronic inflammation… loss of elastin in bronchi… dilation of bronchi (restrictive resp disease)

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8
Q

Why is cough a common symptom of resp disease

A

Is a reflex arc stimulated by mechano-/chemo-Rs in the respiratory epithelium (or oesophagus or diaphragm)

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9
Q

Name possible causes of pleuritic chest pain

A
  • PE
  • pneumothorax
  • viral/bacterial pleurisy
  • pericarditis
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10
Q

Describe the quality, relieving factors and aggravating factors of pleuritic chest pain

A
  • sharp and well localised
  • aggravated by chest wall mov. Eg inspiration, coughing
  • relieved by sitting forward
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11
Q

What is a wheeze and what is the underlying pathophysiology? Consequently, what are the associated conditions?

A

High pitched musical sound produced by turbulent flow through narrowed small airways (bronchial SM contraction, oedema and mucus production) - mostly expiratory.

  • asthma
  • COPD
  • bronchiolitis
  • sometimes heard in LVF (fluid in airways)
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12
Q

Name 2 possible causes of nocturnal wheeze

A
  • asthma: worse at night as PNS tone is increased causing bronchoconstriction
  • LVF: worse at night due to increased venous return to heart and lungs (relieved by sitting up)
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13
Q

What is stridor and how is it caused

A

A coarse inspiratory wheeze.
Caused by extrathoracic upper airways obstruction:
- epiglottis
- croup
- diptheria
- aspirated foreign bodies
- extrinsic compression, e.g. Large goitre

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14
Q

Why is wheeze heard on exhalation and stridor heard on inspiration?

A
  • wheeze involves intrathoracic small airway narrowing so is worsened by the increased intrapulmonary pressure on expiration
  • stridor involves extrathoracic airway narrowing so is worsens by the negative pressure in the lumen on inspiration
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15
Q

Suggest causes of increased sputum production

A

Infection:

  • bronchitis
  • pneumonia
  • lung abscess

Allergy/irritation:

  • smoking/smoke pollution
  • acute asthma
  • COPD
  • lung cancer
  • LVF (pink-tinged frothy sputum)
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16
Q

Suggest causes of haemoptysis

A
  • mostly infection: pneumonia, TB…
  • lung cancer
  • PE
  • anticoagulation
  • LVF
17
Q

When might accessory muscles of resp be used - inspiratory vs expiratory

A

Accessory inspiratory muscles (SCM, scalenes, pec minor, serratus ant) - when adequate pulmonary ventilation cannot be achieved by normal inspiratory efforts (gross overdistention of lungs):

  • advanced emphysema
  • severe asthma

Accessory muscles of expiration (internal ICs, abdominals)- when elastic recoil of lungs insufficient to empty alveoli or expiratory airway obstruction

  • some Ps with emphysema
  • some chronic bronchitis
  • asthma
18
Q

Why is barrel chest a sign of emphysema

A

Loss of elastin in lungs allows chest wall to expand

19
Q

Where is it normal to here resonance and dullness on percussion

A
  • resonance: above clavicle, between ribs

- dullness: over viscera (heart, liver) and bones/muscles (e.g. Scapula)

20
Q

What are fine or coarse crackles as sign of

A
  • fine crackles (snapping open of airways or fluid in airways): fibrosis, consolidation and LVF
  • coarse crackles (viscid secretions, may reduce after coughing): COPD, bronchiectasis

ESA 3- Resp System (17 decks)

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