Cough, Hemoptysis, SOB (UKM) Flashcards
Define acute cough
Cough that lasts for < 3 weeks
Define subacute cough
Cough between 3 - 8 weeks
Define chronic cough
> 8 weeks
Give some differentials for acute cough
- URTI
- Pneumonia
- Acute bronchitis
- AECOPD
- AEBA
- Pulmonary embolism
State (2) differentials for subacute cough
- Post-infectious cough
- Pneumonia
State some differentials for chronic cough
- Post-nasal drip
- Asthma
- COPD
- GERD
- Chronic bronchitis
- Bronchiectasis
- Bronchogenic CA
- TB
- Heart failure
- Interstitial lung disease
- ACEI induced
State 3 types of cough receptors
- Rapidly adapting: Responds to lung inflation, bronchospasm and lung collapse
- Slowly adapting stretch receptor: Responds to mechanical forces
- C-fibres: Nociceptor that responds to chemical stimuli
These receptors join to form the AFFERENT PATHYWAY via the VAGUS NERVE
State what the efferent arc consists
- Diaphragm: via PHRENIC NERVE
- Abdominal muscles: via SPINAL MOTOR NERVES
- Larynx: via LARYNGEAL BRANCH OF VAGUS NERVE
Define hemoptysis
Expectoration of blood from the tracheobronchial tree or pulmonary parenchyma
Define life-threatening hemoptysis
- Implies expectoration of >150mL of blood in 24 hours period
- Bleeding at a rate of >100mL/hour
- Which potentially causes airway obstruction, impaired gaseous exchange and hemodyanamic instability
How to differentiate hemoptysis from
1. UBGIT
2. Upper respiratory tract bleeding
UBGIT
- Coffee ground color vomitus, not foamy
- Nausea and vomiting are common
Upper respiratory tract bleeding
- Most commonly due to EPISTAXIS
- Often no coughing
Give some differentials of hemoptysis based on the following structures
1. Tracheobronchial tree
2. Parenchyma
3. Vascular
4. Systemic cause
Tracheobronchial tree
- Inflammation (Bronchitis, Bronchiectasis)
- Neoplasm (Bronchogenic CA)
- Other (Foreign body inhalation, traumatic injury)
Parenchyma
- Infection (Pneumonia, TB)
- Autoimmune (SLE, diffuse alveolar hemorrhage)
- Neoplasm (Lung malignancy)
- Other (Traumatic injury, cocaine inhalation)
Vascular
- Pulmonary embolism
- Left ventricular failure
- Mitral stenosis
- Pulmonary hypertension
Systemic cause
- Inherited
- Acquired (Anticoagulant therapy)
Define dyspnea
Subjective experience of breathing discomfort
Define orthopnea
Dyspnea that develops in recumbent position
Define PND
Sudden awakening after a few hours of sleep with dyspnea and sensation of suffocation
