History Taking in resp Sept29 A3 Flashcards
6 symptoms that may point to respiratory problem
runny, blocked nose and sneezing Cough Chest pain Shortness of breath (dyspnea) Wheezing Swollen feet or ankles (peripheral edema)
medical term for runny nose
Rhinitis
Pathophysiology of rhinitis
Inflammatory response in airways (infectious or non-infectious)
Cough: physiological goal
Protective mechanism designed to clear airways
3 important things to ask for cough
Duration, timing, provoking and palliating factors
other stuff to ask about when cough and one important
SMOKING, sputum (presence or not, blood), occupational-toxic exposure, associated symptoms
1st and 2nd most exposed organs to environment
first: skin
second: lungs
when rhinitis, usually presence or absence of cough?
usually absence
in what individuals do we usually see chronic bronchitis
in smokers
asthma def
eosinophilic bronchitis (lung allergy)
When there’s an irritating agent causing the cough, what to think about?
asthma
spectrum of asthma
mild (just cough) to life threatening (might die, need chemotherapy)
T-F: asthma has genetic component
True
T-F: blood when coughing is always pathological
F. Can happen when cough very hard breaking some blood vessels
Other cause of cough not related to resp system itself
NM problem as in MS or deglutition problem, epiglottis doesn’t close to block food from going to airways so we cough food out
Def of acute cough vs chronic cough
3 weeks or less: acute cough
more than 3 weeks: chronic cough
why can have chest pain bc of cough
if fractured a rib when coughing very hard
hoarsness meaning
voix rauque, vocal cords affected
why caugh can cause urinary incontinence
increase in intraabdominal pressure, little squirts of urine everytime you cough
why caugh can cause dizzyness and fainting + name for that
cough syncope. Cough so hard venous return to blood is reduced
chest pain: where and what causes the pain? lungs?muscle?
Not in lungs (no nerve endings)
Infection or tumor invasion in pleura, intercostal muscles, chest wall
Chest pain: what symptom can eliminate pneumothorax diagnosis
Flu (pneumothorax becomes less likely)
Pleuritis def
Very very painful viral infection of the pleura
two other terms for pleuritis
devil’s grip
bornholm syndrome
how to confirm pleuritis diagnosis
chest X-ray
(Related to cough) Important thing to ask about in respiratory medicine
Smoking (no matter what you smoke) and environment and exposure
How to confirm a pneumothorax diagnosis
Chest X-ray
Chest pain pathophysiology
Inflammation, invasion or infection of pleura or chest wall, acute pulmonary artery dilation
Chest pain: important feature to ask about
Ask about the quality: Crushing, pressure, squeezing, Levine’s sign, mentionning discomfort in chest described as crushing without necessarily saying chest pain
Levine’s sign
sensation of crushing like a fist that closes in the chest
Mnemonic of things to ask about for chest pain
OPQRST
Onset, Provocation or palliation, quality and quantity, radiation (where feel it), severity, timing
dyspnea pathophysiology
anything that increases work of breathing (ventilation-perfusion mismatch, right to left shunt, diffusion defect (edema, etc.), increased respiratory drive (ex. acidosis)
Pathophysiology of wheezing
Narrowing of airways
Specific question to ask when wheezing
How it affects ADLs
Coughing blood medical term
Hemoptysis
cyanosis
bluish or purplish discolouration of the skin or mucous membranes due to the tissues near the skin surface having low oxygen saturation.
General stuff to ask about for resp system
Hemoptysis, swollen feet or ankles, snoring, cyanosis, voice change, recent chest X-ray
When asthmatic patient comes in with symptoms, what must be determined
If asthma is well controlled
3 things to ask asthmatic patient with symptoms of resp problem
1) do you have puffer and use it more than prescribed
2) Does it wake you up at night
3) Feeling when waking up in morning (tight chest = asthma less well controlled)
