Macleod's Flashcards
Define acute and chronic cough
Acute cough lasts <3/52
Chronic cough lasts >8/52
Severe asthma or chronic obstructive pulmonary disease (COPD) causes what type of cough?
A prolonged wheezy cough and often a paroxysmal dry cough after a viral infection that lasts several months.
What does a feeble non-explosive bovine cough with hoarseness suggest?
A lung cancer which invades the left recurrent laryngeal nerve, causing left vocal cord paralysis.
What does nocturnal cough disrupting sleep indicative of?
It is a feature of asthma.
What does coughing during and after swallowing liquids suggestive of?
Coughing during and after swallowing liquids suggests neuromuscular disease of the oropharynx.
What is the reason for cough syncope?
Raised intrathoracic pressure impairs venous return to the heart and reduce cardiac output.
What do these types of stridor indicate:
A) Inspiratory stridor
B) Biphasic stridor
C) Stridor on expiration
A) Inspiratory stridor indicates narrowing at the vocal cords
B) Biphasic stridor suggests tracheal obstruction
C) Stridor on expiration suggests tracheobronchial obstruction
What is the colour of the sputum coughed up by patients with COPD?
Clear or “mucoid” sputum
What condition produces pink frothy sputum?
Pulmonary oedema
What condition produces rusty red sputum? Give the reason
early pneumococcal pneumonia, as pneumonic inflammation causes lysis of red blood cell
What colour sputum is produced by asthmatic patients?
Yellow sputum (eosinophils) or white mucoid sputum
Why are sputum green?
From dead neutrophils as lysed neutrophils produces a green-pigmented enzyme, verdoperoxidase
What is the colour of the sputum for bronchiectasis?
Green purulent sputum
What does bronchorrhea means? What is a common cause of bronchorrhea?
Bronchorrhea is the production of large volumes (>100ml) of watery sputum per day.
The common cause is chronic bronchitis. It can also indicate alveolar cell cancer.
Blood-streaked clear sputum or clots in sputum for more than a week is indicative of?
Lung cancer
What are the potential causes of coughing up large amounts of pure blood?
Lung cancer, tuberculosis or bronchiectasis
Single episodes of haemoptysis associated with pleuritic chest pain and breathlessness is indicative of?
Pulmonary Thromboembolism and infarction
What are the differential diagnosis for breathlessness presenting for months to years?
COPD, Pulmonary fibrosis and pulmonary tuberculosis
What are the differential diagnosis for breathlessness presenting for weeks to months?
Anaemia, Pleural effusion, Respiratory neuromuscular disorders
What are the differential diagnosis for breathlessness presenting for minutes?
Pulmonary thromboembolism, Asthma, pneumothorax, inhaled foreign body, acute left ventricular failure
What are the differential diagnosis for breathlessness presenting for hours to days?
Pneumonia, asthma, exacerbation of COPD
What does platypnoea means?
What are the potential causes?
Breathlessness on sitting up.
Right to left shunting through a patent foramen ovale, atrial septal defect, or large intrapulmonary shunt
What does trepopnoea means?
Breathlessness when lying on one side.
Which side does patient prefer to lie down on if they have trepopnoea caused by unilateral lung disease?
Patient will prefer the healthy lung down
Which side does patient prefer to lie down on if they have trepopnoea caused by dilated cardiomyopathy?
Patient prefers right side down
What are the causes of Paroxysmal Nocturnal Dyspnoea?
Asthma and left ventricular failure
