Lecture 20-Signs and Symptoms of Resp DIsease Flashcards
What are the six cardinal symptoms of respiratory disease?
- breathlessness
- cough
- chest pain
- wheeze/stridor
- sputum
- haemoptysis
What are common causes of breathlessness?
- asthma
- COPD
- idiopathic pulmonary fibrosis
- LV failure
- anaemia
- obesity
What is the most likely cause of sudden onset breathlessness?
Pulmonary embolism or pneumothorax
What are the acute causes of breathlessness?
- asthma
- PE
- pneumonia
- MI
- hyperventilation syndrome
What are the gradual causes of breathlessness?
- lobar collapse
- pleural effusion
What are the chronic causes of breathlessness?
- COPD
- idiopathic pulmonary fibrosis
- bronchiectasis
What are the common causes of cough?
- asthma
- COPD
- cystic fibrosis
- lung cancer
- pneumothorax
- LV failure
- GORD
- ACE inhibitors
What are the causes of chest pain?
- pericarditis
- oesophageal reflux
- chest wall: costochondritis, rib fracture
- pleuritic
Define wheeze
Noisy musical sound produced by turbulent flow through narrow airways, mostly on expiration
What are the causes of a wheeze?
Bronchial SM contraction, oedema, mucus production (asthma and COPD)
What is a silent chest?
Absent wheeze in a severe asthma attack
Define stridor
Coarse inspiratory wheeze
What causes stridor?
Extrathoracic upper airway obstruction: epiglottitis, croup, aspirated foreign bodies, goitre
Which conditions increase the production of sputum?
- smoking
- COPD
- acute viral/bacterial bronchitis
- pneumonia
- bronchiectasis
- acute asthma
- lung cancer
Which conditions cause haemoptysis?
- infections: pneumonia, TB, bronchiectasis, bronchitis
- lung cancer
- PE
- anticoagulation
What can cause central cyanosis?
- right to left shunt
- severe heart failure
- COPD
- pneumonia
What are the primary inspiratory muscles?
External intercostals and diaphragm
What are the accessory inspiratory muscles?
Lat dorsi, SCM, pec minor, serratus anterior
What are the accessory expiratory muscles?
Internal intercostals, external oblique, rectus abdominus
When are accessory inspiratory muscles used?
- advanced emphysema
- asthma attack
- stridor due to obstruction
When are accessory expiratory muscles used?
- emphysema
- chronic bronchitis
- asthma
Why is pursed-lip breathing helpful?
Increases intra-pulmonary pressure to keep airways open/prevents airways from fully collapsing so the next inspiration is easier
Why do emphysema patients present with barrel chest?
Loss of elastin allows the chest wall to fully expand (lungs are hyper-inflated)
Which conditions push the trachea away from the affected side?
- tension pneumothorax
- large pleural effusion
Which conditions push the trachea towards the affected side?
- lung collapse
- pulmonary fibrosis
What is lung consolidation?
Solidification of lung tissue due to filling of lungs with liquid and solid
What is the commonest cause of lung consolidation?
Pneumonia
Which conditions cause fine crackles to be heard?
- idiopathic pulmonary fibrosis
- consolidation
Which conditions cause coarse crackles to be heard?
- COPD
- bronchiectasis
Which conditions cause clubbing?
- lung cancer
- mesothelioma
- bronchiectasis
- empyema
- idiopathic pulmonary fibrosis
True or false: pleural effusion presents with stony dull percussion
TRUE
