21 Signs and Symptoms of Respiratory Disease

Question 1

Useful table: Disease, chest movement, percussion, breath sounds (on auscultation)

Answer 1

Question 2

Give an example of a non-respiratory condition that might cause breathlessness.(4)

Answer 2

• Anaemia
• Heart failure
• Obesity
• Diabetic ketoacidosis

Question 3

A patient presents with dyspnoea. How can we explore this symptom further? (4)

Answer 3

Question 4

A patient presents with chest pain, give some differential diagnosis for the following areas:

1. Pleura
2. Mediastinal structures
3. Chest wall

Answer 4

Question 5

How is cardiac pain likely to present? What cardiac condition does not present in this way?

Answer 5

Central, dull, poorly localised, heaviness, radiates to shoulder and jaw, won’t be worse breathing in

Pericarditis will present with sharp pain

Question 6

How does the cough reflex work?

Answer 6

Stimulation: mechano/chemo receptors in airway

Question 7

A patient presents with a cough, how can we explore this symptom further?

Answer 7

Question 8

If a patient is consistently producing large volumes of yellow/green sputum when they cough, what could this be suggestive of?

Answer 8

Bronchiectasis

Question 9

Give 3 non-respiratory causes of a cough.

Answer 9

Question 10

Differetiate between a wheeze and stridor.

Answer 10

• Wheeze
  
  • normally on expiration
  • may only be heard with stethoscope
  • narrowing of intrathoracic (small airways)
• Stridor
  
  • normally on inspiration
    
    • (both if really bad)
  • may be heard without stethoscope
  • obstruction of extrathoracic (large, upper airways)

Question 11

Why might involvement of the diaphragm and pleura in pathology cause referred pain to the shoulder?

Answer 11

C3-5 dermatome

Question 12

Why might someone with COPD be breathing with pursed lips?

Answer 12

Pursed lips- increase resistance to airflow on expiration

• Pressure in thoracic cavity doesnt drop as quickly*
• Prolong period for gas exchange*
• Open small airways longer*

Question 13

What might cause a shift in tracheal position?

Answer 13

Push: Pneumothorax, large pleural effusion

Pull: lung fibrosis

Question 14

What respiratory condition might cause dull percussion and whsat respiratory condition might cause stony-dull percussion?

Answer 14

Question 15

What might the following sounds on clinical examination of the respiratory system suggest?

• Fine crackles
• Coarse crackles
• Pleural rub (like someone walking through snow)

Answer 15

• Fine crackles
  
  • pulmonary fibrosis
• Coarse crackles
  
  • COPD, bronchiectasis
• Pleural rub (like someone walking through snow)
  
  • Inflammation of pleura