M101 Respiratory History Taking Flashcards
What are the symptoms of respiratory disease?
Breathlessness (dyspnoea) Cough Sputum Haemoptysis (coughing blood) Wheeze Pain
What does the onset of breathlessness indicate?
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
What causes coughing?
stimulation of irritant receptors in the airways
How often is a cause for coughing up blood found?
60% of the time
What are the most common causes for coughing up blood?
bronchitis pulmonary embolism lung cancer tuberculosis bronchiectasis
What are examples of conditions that cause pleuritic pain?
pneumonia / pleurisy
peripheral pulmonary embolism (infarction)
pneumothorax
What are examples of conditions that cause mediastinal pain?
tumour
cardiac pain
large pulmonary embolism
What is an example of a condition that can cause chest wall pain?
rib fracture
What is mediastinal pain caused by?
disease of central mediastinal structures
What is weight loss a major symptom of?
lung cancer
TB
What are two major symptoms of pneumonia?
fever
What is a symptom of TB?
night sweats
What are the potential symptoms for respiratory disease that can be seen from the end of the bed?
emotional distress using oxygen? noisy breathing pursed-lips breathing in COPD the use of accessory muscles of respiration cyanosis anaemia ssigns of CO2 retention
What are the signs of CO2 retention?
warm peripheries
bounding pulse
flapping tremor
What are the potential signs for respiratory disease from outside of the chest?
raised jugular venous pressure (JVP)
peripheral oedema
lymph node enlargement
finger clubbing
When does the jugular venous pressure become raised?
right heart failure (cor pulmonale)
SVC obstruction
What is peripheral oedema caused by?
right heart failure
What might lymph node enlargement be caused by?
carcinoma
TB
sarcoidosis
What is cor pulmonale caused by?
pulmonary hypertension
What conditions can cause clubbing of the fingers?
lung cancer lung fibrosis chronic infections in the lungs causing pus cyanotic congenital heart disease bacterial endocarditis liver cirrhosis IBS
How does percussion compare over the normal lung, over the heart and over the liver?
normal lung - resonant
heart & liver - dull
What does percussion involve?
comparing the degree of resonance over the same sites on each side of the chest
When are breath sounds decreased?
if there is fluid
if there is a collapsed lung
When are breath sounds increased?
if there is consolidated lung between a bronchus and the chest wall
