History Taking in resp Sept29 A3

Question 1

6 symptoms that may point to respiratory problem

Answer 1

runny, blocked nose and sneezing
Cough
Chest pain
Shortness of breath (dyspnea)
Wheezing
Swollen feet or ankles (peripheral edema)

Question 2

medical term for runny nose

Answer 2

Rhinitis

Question 3

Pathophysiology of rhinitis

Answer 3

Inflammatory response in airways (infectious or non-infectious)

Question 4

Cough: physiological goal

Answer 4

Protective mechanism designed to clear airways

Question 5

3 important things to ask for cough

Answer 5

Duration, timing, provoking and palliating factors

Question 6

other stuff to ask about when cough and one important

Answer 6

SMOKING, sputum (presence or not, blood), occupational-toxic exposure, associated symptoms

Question 7

1st and 2nd most exposed organs to environment

Answer 7

first: skin
second: lungs

Question 8

when rhinitis, usually presence or absence of cough?

Answer 8

usually absence

Question 9

in what individuals do we usually see chronic bronchitis

Answer 9

in smokers

Question 10

asthma def

Answer 10

eosinophilic bronchitis (lung allergy)

Question 11

When there’s an irritating agent causing the cough, what to think about?

Answer 11

asthma

Question 12

spectrum of asthma

Answer 12

mild (just cough) to life threatening (might die, need chemotherapy)

Question 13

T-F: asthma has genetic component

Answer 13

True

Question 14

T-F: blood when coughing is always pathological

Answer 14

F. Can happen when cough very hard breaking some blood vessels

Question 15

Other cause of cough not related to resp system itself

Answer 15

NM problem as in MS or deglutition problem, epiglottis doesn’t close to block food from going to airways so we cough food out

Question 16

Def of acute cough vs chronic cough

Answer 16

3 weeks or less: acute cough

more than 3 weeks: chronic cough

Question 17

why can have chest pain bc of cough

Answer 17

if fractured a rib when coughing very hard

Question 18

hoarsness meaning

Answer 18

voix rauque, vocal cords affected

Question 19

why caugh can cause urinary incontinence

Answer 19

increase in intraabdominal pressure, little squirts of urine everytime you cough

Question 20

why caugh can cause dizzyness and fainting + name for that

Answer 20

cough syncope. Cough so hard venous return to blood is reduced

Question 21

chest pain: where and what causes the pain? lungs?muscle?

Answer 21

Not in lungs (no nerve endings)

Infection or tumor invasion in pleura, intercostal muscles, chest wall

Question 22

Chest pain: what symptom can eliminate pneumothorax diagnosis

Answer 22

Flu (pneumothorax becomes less likely)

Question 23

Pleuritis def

Answer 23

Very very painful viral infection of the pleura

Question 24

two other terms for pleuritis

Answer 24

devil’s grip

bornholm syndrome

Question 25

how to confirm pleuritis diagnosis

Answer 25

chest X-ray

Question 26

(Related to cough) Important thing to ask about in respiratory medicine

Answer 26

Smoking (no matter what you smoke) and environment and exposure

Question 27

How to confirm a pneumothorax diagnosis

Answer 27

Chest X-ray

Question 28

Chest pain pathophysiology

Answer 28

Inflammation, invasion or infection of pleura or chest wall, acute pulmonary artery dilation

Question 29

Chest pain: important feature to ask about

Answer 29

Ask about the quality: Crushing, pressure, squeezing, Levine’s sign, mentionning discomfort in chest described as crushing without necessarily saying chest pain

Question 30

Levine’s sign

Answer 30

sensation of crushing like a fist that closes in the chest

Question 31

Mnemonic of things to ask about for chest pain

Answer 31

OPQRST

Onset, Provocation or palliation, quality and quantity, radiation (where feel it), severity, timing

Question 32

dyspnea pathophysiology

Answer 32

anything that increases work of breathing (ventilation-perfusion mismatch, right to left shunt, diffusion defect (edema, etc.), increased respiratory drive (ex. acidosis)

Question 33

Pathophysiology of wheezing

Answer 33

Narrowing of airways

Question 34

Specific question to ask when wheezing

Answer 34

How it affects ADLs

Question 35

Coughing blood medical term

Answer 35

Hemoptysis

Question 36

cyanosis

Answer 36

bluish or purplish discolouration of the skin or mucous membranes due to the tissues near the skin surface having low oxygen saturation.

Question 37

General stuff to ask about for resp system

Answer 37

Hemoptysis, swollen feet or ankles, snoring, cyanosis, voice change, recent chest X-ray

Question 38

When asthmatic patient comes in with symptoms, what must be determined

Answer 38

If asthma is well controlled

Question 39

3 things to ask asthmatic patient with symptoms of resp problem

Answer 39

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)