Presenting signs/symptoms in respiratory disease Flashcards
List the differentials for someone presenting with dysponea
Haematological:
- Anaemia
Abdominal:
- Obesity, Ascites, Pregnancy
Altitude
Cardiac:
- Muscle disease ie LVF/Pulmonary oedema
- Valve disease (Regurgitation, stenosis)
- Electrical (Brady,Tachy-arrhythmia)
- Congenital (Septal defects)
Respiratory:
- Conducting airways (asthma, COPD, bronchiolitis)
- Alveoli (pneumonia, alveolitis, PE ,pneumothorax)
Psychological –functional dyspnoea (only after excluding all organic causes)
When someone presenting with dysponea, what is it important to assertain regarding it ?
Is it:
- Acute / Chronic onset
- At rest / On exertion
- Related to posture
- Diurnal variation
List the differentials for someone presenting with wheeze
Intrinsic obstruction in conducting airways (expiratory) Bronchioles:
- Asthma (episodic), COPD (constant), Bronchiolitis, Foreign body, Cancer
Intrinsic obstruction in Trachea (Stridor-inspir/expir):
- Angioedema, Cancer
Extrinsic mediastinal compression of trachea:
- Thyroid Goitre, Lymphoma,Thymoma, Cysts
List the differentials for someone presenting with a cough
Conducting airways (trachea, bronchioles):
- asthma, COPD (P), bronchiectesis(P), bronchiolitis, tracheitis ,foreign body
Alveoli:
- Pneumonia (P) , Alveolitis
Note - (P) = a productive cough
List the differentials for someone presenting with sputum productive
Upper (sinuses)/ Lower airway cause
Non infective sputum is clear/yellow:
- COPD
Infective sputum is purulent (Green):
- Pneumonia
- Bronchiectesis
Blood stained (Haemoptysis):
- Cancer
- Pulmonary infarction
- TB
- Bronchiectesis
Casts/ plugs:
- Allergic bronchopulmonary aspergillosis
List some of the differentials and types of chest pain
Pleuritic pain = acute worse on inspiration:
- Acute inflamm due to infection( pneumonia )/ infarction (PE) /Pneumothorax
- Chest wall pain – chronic due to malignant invasion of soft tissue or ribs
Deep pain:
- chronic usually due to malignant invasion/compression
Tight pain:
- radiating to arm /jaw –Angina
Burning pain:
- restrosternal – Oesoph reflux
What are the consitutional symptoms you should screen someone for and what differentials are they until proven otherwise ?
Constitutional symptoms:
- Weight loss/ poor appetite
- Night sweats
- Lethargy
If present differentials are:
- Cancer
- TB
- Lymphoma
Episodic non productive cough and wheeze with diurnal variation in young non smoker with history of atopy (eg hay hever or eczema)
What condition does this make you think of ?
Asthma
Chronic productive cough ,wheeze and dyspnoea in elderly smoker
What diagnosis does this make you think of?
COPD (if haemoptysis always suspect Ca)
Daily productive cough with lots of green sputum in non smoker with past history of pneumonia
What diagnosis does this make you think of ?
Bronchiectesis
Acute productive cough, pleuritic pain, dyspnoea and fever in any age
What diagnosis does this make you think of ?
Community acquired pneumonia
Acute pleuritic pain with dyspnoea with swollen leg (DVT) following recent hip replacement surgery
What diagnosis does this make you think of ?
PE
Acute onset of pleuritic pain with dyspnoea in young adult male
What diagnosis does this make you think of ?
Pneumonthorax
Cough, haemoptysis, weight loss and hoarseness in a middle aged or elderly smoker
What diagnosis does this make you think of ?
Bronchial cancer
Intractable chronic chest wall pain and weight loss in ship yard worker with asbestos exposure
What diagnosis does this make you think of ?
Mesothelioma
