Cough Flashcards
What sputum does pneumococcal pneumonia present with?
Rusty
History of cough specific points
-Productive or non - colour, viscosity, volume
-Worse at particular times of day
- Frequency
- Haemoptysis
- Chest pain
- Fever
- Night sweats, weight loss
- Exacerbating/relieving factors
How does lung fibrosis?
long term cough, recurrent chest infection,
on exam likely to have fine end inspiratory crackles, unlikely to find wheeze
Haemoptysis differentials
- PE
- Pulmonary haemorrhage
- Lung cancer
- TB
- Goodpastures
- Granulomatosis with polyangitis
What could crackles signal?
- CAP/HAP
- Pulmonary oedema
- COPD
- Interstitial lung disease
- ARDS
If exam is normal what could be causing cough?
PE
Reflux
Psychogenic
Drugs
What is haemoptysis
expectoration of blood origin in tracheobronchial tree/pulmonary parenchyma eg lower pulm tract
Psuedo origins of haemoptysis
- Oesophagus
- Nose - pharynx and larynx
- Mouth
- Vomit - eg eat beetroot and vomit small amount into mouth
What is a massive haemoptysis?
100-1000ml or haemodynamically unstable
Red flags with haemoptysis
- aPPETITE
- Weight loss
- Fatigue
- Fever
What do pneumectomy, COPD, lung diseases have a high risk of?
Decompensation - fail to compensate due to overload of disease
Complications of haemoptysis
Anaemia
Haemodynamic compromise
Causes of a bleeding that arent originating in the lungs
- Gums, epistaxis
- No cough
- Ulceration
- Gingivitis
- Tetangiectasis
- Pharyngitis
- Nasopharyngoscopy to investigate
What causes purpura and petechiae?
Free bleeding under the skin - bleeding diathesis
When to refer 2 week urgent for CXR in haemoptysis
Under 40 and 2 of or over 40 and 1 of
- Cough
- Fatigue
- SOB
- Weight loss
- Appetitie loss
- Chest pain
