Cough

Question 1

Define acute, persistent, chronic cough time span

Answer 1

acute is less than 3 weeks
Persistent is 3-8 weeks
Chronic is greater than 8 weeks

Question 2

If a patient has acute cough syndomes, what is it most likely? And what is it accompanied by

Answer 2

Usually viral respiratory infections. Usually accompanied by fever, nasal congestion, and sore throat to help confirm diagnosis
Could also be asthma, allergic rhinitis, and HF

Question 3

If someone with acute cough has dypsnea and phlegm with it, what could it be?

Answer 3

It’s more serious. Should include oxygenation assessment. Could be COPD. Also check cough-variant asthma if prominent nocturnal coughing.

Question 4

What should be considered if cough greater than three weeks?

Answer 4

Pertussis infection if persistent or severe cough lasting more than 3 weeks.

Question 5

If its not pertussis, what could it be if ACE inhibitor therapy, acute respiratory tract infection and chest radiography abnormalities are absent?

Answer 5

Postnasal drip, asthma, GERD, or some contribution of the three.
Especially with a history of nasal or sinus congestion, wheezing, or heartburn
Can also be Bronchiectasis, eosinophic bronchitis, tuberculosis

Question 6

When can a patient have pneumonia?

Answer 6

When acute cough accompanied by vital sign abnormalities (tachycardia, tachypnea, fever).

Question 7

What should be considered if patient has rapid onset of severe dyspnea in absence of other clinical features?

Answer 7

Pneumothorax, pulmonary embolism. Myocardial infarction.

Question 8

What should be considered first if dyspnea is accompanied with cough and fever?

Answer 8

Pulmonary infections is primary concern.

Myocarditis, pericarditis, and septic emboli can be present in this manner.

Question 9

What could it be if patient has dyspnea accompanied with wheezing

Answer 9

Most likely acute bronchitis. Check for new-onset asthma

Question 10

What could it be if patient reports prominent dyspnea with mild or no accompanying features?

Answer 10

Consider noncardiopulmonary causes of impaired oxygen delivery (anemia, methnomglobinemia, cyanide ingestion, carbon monoxide), metabolic acidosis, neuromuscular disorders, panic disorders, and chronic pulmonary embolism

Question 11

What is hemoptysis?

Answer 11

Coughing up blood

Question 12

What can the causes of hemoptysis be?

Answer 12

Blood may arise from airways in COPD, bronchiectasis, and brochiogenic carcinoma; from pulmonary vasculature mitral stenosis, pulmonary embolism, pulmonary arterial hypertension, and arteriovenous malformationsl or from pulmonary parenchyma in pneumonia

Question 13

What are the most common causes of hemoptysis?

Answer 13

Due to infection (acute or chronic bronchitis, pneuomonia, or tuberculosis). 
20% of cases due to lung cancer among elderly
Less commonly (<10% pulmonary venous hypertension (mitral stenosis, pulmonary embolism)

Question 14

Myocardial Ischemia symptoms

Answer 14

“pressure, tightness, squeezing” in heart area rather than sparp or spasmodic. Usually subsides with 5-20mins

Question 15

Myocardial infarction

Answer 15

Prolonged chest pain episodes might represent myocardial infarction, although 1/3 do not report any chest paint.

Question 16

What else could chest pain be?

Answer 16

25% of cases are panic disorders
ACS, pericarditis, hypertrophy of either ventricle or aortic stenosis. 75% cases of pulmonary embolism also have chest pain

Question 17

What is ACS?

Answer 17

Acute coronary syndrome (set of signs) due to decreased blood flow in the coronary arteries such as part of the heart muscle is unable to function properly or dies.

Question 18

What are palpitations

Answer 18

Defined as an unpleasant awareness of the forceful, rapid, or irregular beating of the heart.

Question 19

What is the most common diagnosis of palpitations? What could it be that is dangerous?

Answer 19

Usually benign and are a result of panic disorders, stress or anxiety; however, occasionally the symptom of life threatening arrhythmia.

Question 20

What is it if the palpitations start and stop abruptly?

Answer 20

Suggest supraventricular or ventricular tachycardias

Question 21

What are palpitations associated with chest pain?

Answer 21

Ischemic heart disease

Question 22

What are palpitations associated with lightheadedness, presyncope or syncope

Answer 22

Suggest hypotension and may signify lifethreatening cardia arrhythmia

Question 23

What is the most common cause of acute or chronic lower extremity edema?

Answer 23

chronic venous insufficiency affecting 2% of the population. Deep Vein Thrombosis also common

Question 24

What are the most common causes of involuntary weight loss?

Answer 24

Most common cause is 30% cancer, 15% gastrointestinal disorder, and 15% dementia or depression.
could be hyperthyroidism

Question 25

What are most common causes of fatigue?

Answer 25

Overexertion, poor physical conditioning, sleep disturbance, obesity, undernutrition, and emotional problems Drugs, alcohol, medications
Chronic fatigue syndrome include an occult retrovirus or an immune dysregulation mechanism.

Question 26

Diseases that could cause fatigue

Answer 26

Hypothyroidism, HF, endocarditis, hepatitis, COPD, sleep apnea, anemia, autoimmune disorders, irritable bowel syndrome, ad cancer

Question 27

Most common cause for dysuria for woman?

Answer 27

cystitis will be diagnosed 50-60% of cases for woman sexually active.

Question 28

What is the common cause for young men and older men?

Answer 28

for younger men, urethritis is main cause. For the older men, it is prostatitis.