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M101 > M101 Respiratory History Taking > Flashcards

M101 Respiratory History Taking Flashcards

1
Q

What are the symptoms of respiratory disease?

A 
Breathlessness (dyspnoea)
Cough
Sputum
Haemoptysis (coughing blood)
Wheeze
Pain
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2
Q

What does the onset of breathlessness indicate?

A

Sudden pulmonary embolism, pneumothorax
Over hours asthma, pneumonia, LVF
Over days pneumonia, LVF
Over weeks pleural effusion, anaemia
Over months tumours, lung fibrosis, muscle weakness
Over years COPD, lung fibrosis, muscle weakness

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3
Q

What causes coughing?

A

stimulation of irritant receptors in the airways

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4
Q

How often is a cause for coughing up blood found?

A

60% of the time

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5
Q

What are the most common causes for coughing up blood?

A 
bronchitis
pulmonary embolism
lung cancer
tuberculosis 
bronchiectasis
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6
Q

What are examples of conditions that cause pleuritic pain?

A

pneumonia / pleurisy
peripheral pulmonary embolism (infarction)
pneumothorax

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7
Q

What are examples of conditions that cause mediastinal pain?

A

tumour
cardiac pain
large pulmonary embolism

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8
Q

What is an example of a condition that can cause chest wall pain?

A

rib fracture

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9
Q

What is mediastinal pain caused by?

A

disease of central mediastinal structures

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10
Q

What is weight loss a major symptom of?

A

lung cancer

TB

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11
Q

What are two major symptoms of pneumonia?

A

fever

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12
Q

What is a symptom of TB?

A

night sweats

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13
Q

What are the potential symptoms for respiratory disease that can be seen from the end of the bed?

A 
emotional distress
using oxygen? 
noisy breathing
pursed-lips breathing in COPD
the use of accessory muscles of respiration
cyanosis
anaemia 
ssigns of CO2 retention
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14
Q

What are the signs of CO2 retention?

A

warm peripheries
bounding pulse
flapping tremor

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15
Q

What are the potential signs for respiratory disease from outside of the chest?

A

raised jugular venous pressure (JVP)
peripheral oedema
lymph node enlargement
finger clubbing

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16
Q

When does the jugular venous pressure become raised?

A

right heart failure (cor pulmonale)

SVC obstruction

17
Q

What is peripheral oedema caused by?

A

right heart failure

18
Q

What might lymph node enlargement be caused by?

A

carcinoma
TB
sarcoidosis

19
Q

What is cor pulmonale caused by?

A

pulmonary hypertension

20
Q

What conditions can cause clubbing of the fingers?

A 
lung cancer
lung fibrosis
chronic infections in the lungs causing pus
cyanotic congenital heart disease
bacterial endocarditis
liver cirrhosis 
IBS
21
Q

How does percussion compare over the normal lung, over the heart and over the liver?

A

normal lung - resonant

heart & liver - dull

22
Q

What does percussion involve?

A

comparing the degree of resonance over the same sites on each side of the chest

23
Q

When are breath sounds decreased?

A

if there is fluid

if there is a collapsed lung

24
Q

When are breath sounds increased?

A

if there is consolidated lung between a bronchus and the chest wall

25
Q

What are the causes of dullness to percussion?

A

Lung consolidation
Lung collapse
Lung fibrosis
Pleural effusion

26
Q

How are breath sounds generated?

A

when turbulent air in the larynx is transmitted through the airways and lung tissue to the chest wall

27
Q

What are wheezes caused by?

A

by air passing through narrowed airways, usually expiratory

28
Q

What are crackles caused by?

A

popping open of blocked small airways, usually inspiratory

29
Q

What are pleural rubs caused by?

A

friction of inflamed pleural surfaces, may be inspiratory and expiratory

30
Q

What is reduced vocal resonance caused by?

A

pleural fluid

lung collapse

31
Q

What two words can you ask the patient to say to check for vocal sounds?

A

ninety nine

one, one, one

M101 (8 decks)

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