Classic Presentations - Respiratory Flashcards
Patient presents with frontal headache, facial pain, purulent rhinorrhoea and fever
Sinusitis
Patient presents with sneezing attacks, nasal blockage/discharge occurring >1hr on most days +/- itchy eyes and ears
Rhinitis - either allergic or non-allergic
Patient presents with sore throat +/- tonsillar lymph node enlargement but not inflammation of the tonsils
Pharyngitis
Child < 3 presents with hoarseness, a barking cough, stridor and progressive airway obstruction
Acute laryngotracheobronchitis
Child aged 2-7 presents with severe airflow obstruction/stridor, high fever, drooling and a severe sore throat
Acute epiglottitis
Patient presents with fever, chills and aches, severe headache and sore throat + dry cough
Influenza
Patient presents with an dry cough that has become productive and a wheeze, breathlessness and mild fever
Acute bronchitis
Patient presents with fever and rigors, breathlessness, pleuritic chest pain, a cough and a loss of apetite
Pneumonia
A patient with a 20 pack year smoking history reports a productive cough, wheeze, breathlessness and frequent chest infections
COPD
Young patient reports sporadic chest tightness, wheeze, dry cough and breathlessness that is worse at night
Asthma
Middle aged patient presents with loud snoring, headache and daytime sleepiness
Obstructive sleep apnoea
A patient with CF reports a productive cough +/- haemoptysis, halitosis, clubbing, coarse crackles and recurrent pneumonic episodes
Bronchiectasis
A patient with a history of aspiration presents with persisting pneumonia, foul sputum, malaise, weight loss and raised infection markers
Lung abscess
A child presents with:
- Recurrent infections - Sinusitis
- Nasal polyps
- Breathlessness
- Haemoptysis
- Steatorrhoea
- Meconium ileus (SI obstruction)
- Malabsorption
Cystic fibrosis
A patient recently returning from living abroad presents with a persistent cough +/- haemoptysis, weight loss, night sweats, fever, fatigue, hoarseness and pleuritic pain
TB
An Afro-Caribbean woman presents with tender red nodules on the anterior shins (erythema nodosum), fatigue, weight loss, uveitis and peripheral lymphadenopathy
Sarcoidosis
A middle-aged patient presents with severe rhinorrhoea and nasal mucosa ulcer, a cough, haemoptysis and pleuritic pain
Granulomatosis with polyangiitis (GPA)
[Wegener’s granulomatosis]
A 40 year old man presents initially with allergic rhinitis, late-onset asthma, breathlessness, cough and a wheeze. This progresses to a fever, sweats, fatigue, weight loss, joint and muscle pain, difficulty passing urine, cold peripheries etc
Eosinophilic granulomatosis with polyangiitis (EGPA)
[Churg-Strauss syndrome]
A young asian woman presents with joint pain, fatigue, a malar rash on the face, pleurisy +/- small bilateral effusions etc
SLE
A farmer/coal worker/bird owner/miller etc develops fever, malaise, cough, breathlessness, wheeze, coarse end-inspiratory crackles, weight loss and idiopathic pulmonary fibrosis features
Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis)
A recently retired builder presents with progressive breathlessness, cough, wheeze, fatigue, finger clubbing and bilateral basal end-inspiratory crackles
Asbestosis
A tall, thin man presents with sudden onset pleuritic pain, increasing breathlessness and tachycardia
Spontaneous pneumothorax
A patient with pneumonia/pulmonary oedema/PE/asthma/ARDS has a PaO2 of <8kPa (hypoxic) with normal or low PaCO2
Type 1 respiratory failure
A patient with COPD/asthma/pneumonia/sedative drugs in their system/CNS trauma etc has a PaO2 of <8kPa (hypoxic) and a PaCO2 of >6.0kPa (hypercapnic)
Type 2 respiratory failure
A very ill patient presents with breathlessness, tachypnoea, increasing hypoxaemia, central cyanosis and fine bilateral crackles
Acute Respiratory Distress Syndrome (acute lung injury)
A patient with advanced COPD ( or any other cause of pulmonary hypertension) experiences progressive breathlessness, ankle oedema, RV hypertrophy, elevated JVP, ascites, parasternal heave and tricuspid regurgitation (high pitched, holosystolic murmur -begins at the first heart sound and continue to the second heart sound)
Cor pulmonale
A patient presents with sudden breathlessness, tachypnoea and chest pain +/- haemoptysis, fever, pleural rub & raised JVP
Pulmonary embolism
A patient presents with breathlessness, orthopnoea, cough +/- haemoptysis, leg/abdominal swelling and pale skin
Pulmonary oedema/congestive heart failure
A patient presents with a 3 week history of cough +/-breathlessness, haemoptysis, chest pain, wheeze, hoarseness and dysphagia
Lung cancer - most commonly bronchial carcinoma
