Lecture 20-Signs and Symptoms of Resp DIsease

Question 1

What are the six cardinal symptoms of respiratory disease?

Answer 1

• breathlessness
• cough
• chest pain
• wheeze/stridor
• sputum
• haemoptysis

Question 2

What are common causes of breathlessness?

Answer 2

• asthma
• COPD
• idiopathic pulmonary fibrosis
• LV failure
• anaemia
• obesity

Question 3

What is the most likely cause of sudden onset breathlessness?

Answer 3

Pulmonary embolism or pneumothorax

Question 4

What are the acute causes of breathlessness?

Answer 4

• asthma
• PE
• pneumonia
• MI
• hyperventilation syndrome

Question 5

What are the gradual causes of breathlessness?

Answer 5

• lobar collapse

- pleural effusion

Question 6

What are the chronic causes of breathlessness?

Answer 6

• COPD
• idiopathic pulmonary fibrosis
• bronchiectasis

Question 7

What are the common causes of cough?

Answer 7

• asthma
• COPD
• cystic fibrosis
• lung cancer
• pneumothorax
• LV failure
• GORD
• ACE inhibitors

Question 8

What are the causes of chest pain?

Answer 8

• pericarditis
• oesophageal reflux
• chest wall: costochondritis, rib fracture
• pleuritic

Question 9

Define wheeze

Answer 9

Noisy musical sound produced by turbulent flow through narrow airways, mostly on expiration

Question 10

What are the causes of a wheeze?

Answer 10

Bronchial SM contraction, oedema, mucus production (asthma and COPD)

Question 11

What is a silent chest?

Answer 11

Absent wheeze in a severe asthma attack

Question 12

Define stridor

Answer 12

Coarse inspiratory wheeze

Question 13

What causes stridor?

Answer 13

Extrathoracic upper airway obstruction: epiglottitis, croup, aspirated foreign bodies, goitre

Question 14

Which conditions increase the production of sputum?

Answer 14

• smoking
• COPD
• acute viral/bacterial bronchitis
• pneumonia
• bronchiectasis
• acute asthma
• lung cancer

Question 15

Which conditions cause haemoptysis?

Answer 15

• infections: pneumonia, TB, bronchiectasis, bronchitis
• lung cancer
• PE
• anticoagulation

Question 16

What can cause central cyanosis?

Answer 16

• right to left shunt
• severe heart failure
• COPD
• pneumonia

Question 17

What are the primary inspiratory muscles?

Answer 17

External intercostals and diaphragm

Question 18

What are the accessory inspiratory muscles?

Answer 18

Lat dorsi, SCM, pec minor, serratus anterior

Question 19

What are the accessory expiratory muscles?

Answer 19

Internal intercostals, external oblique, rectus abdominus

Question 20

When are accessory inspiratory muscles used?

Answer 20

• advanced emphysema
• asthma attack
• stridor due to obstruction

Question 21

When are accessory expiratory muscles used?

Answer 21

• emphysema
• chronic bronchitis
• asthma

Question 22

Why is pursed-lip breathing helpful?

Answer 22

Increases intra-pulmonary pressure to keep airways open/prevents airways from fully collapsing so the next inspiration is easier

Question 23

Why do emphysema patients present with barrel chest?

Answer 23

Loss of elastin allows the chest wall to fully expand (lungs are hyper-inflated)

Question 24

Which conditions push the trachea away from the affected side?

Answer 24

• tension pneumothorax

- large pleural effusion

Question 25

Which conditions push the trachea towards the affected side?

Answer 25

• lung collapse

- pulmonary fibrosis

Question 26

What is lung consolidation?

Answer 26

Solidification of lung tissue due to filling of lungs with liquid and solid

Question 27

What is the commonest cause of lung consolidation?

Answer 27

Pneumonia

Question 28

Which conditions cause fine crackles to be heard?

Answer 28

• idiopathic pulmonary fibrosis

- consolidation

Question 29

Which conditions cause coarse crackles to be heard?

Answer 29

• COPD

- bronchiectasis

Question 30

Which conditions cause clubbing?

Answer 30

• lung cancer
• mesothelioma
• bronchiectasis
• empyema
• idiopathic pulmonary fibrosis

Question 31

True or false: pleural effusion presents with stony dull percussion

Answer 31

TRUE