resp Flashcards
what should be included in general resp hx?
1) hx of cough
2) hx of SOB
3) hx of chest pain
4) hx of wheeze
5) fever, night sweat
6) weight loss
7) current/past hx of TB, asthma, DVT/PE, pneumonia, chronic bronchitis or emphysema
8) Fhx of resp disease - eg TB, astham, CF
9) detailed occupational hx
10) home circumstances incl pet
11) past and current meds incl steriods and inhaler
how would costochondritis present?
localized chest pain near costochondritis without any pleuritic chest pain
why do we ask about fever and night sweat in general resp hx?
any infection can lead to that but in resp - we need to thnk about TB
what should be included in cough hx?
1) how long?
2) if chronic cough, any changes in the cough?
3) is the cough productive or dry
4) how much sputum
5) what is the consistency, colour, odor of the sputum
6) haematemsis?
7) any particular time of the day is the cough worse? does the cough keep the pt awake at night?
8) cough made worse by anything?
9) any associated symptoms eg SOB, chest pain
10) fever, night sweat?
11) if pt feels systemically unwell?
12) weight loss?
13) suffer from indigestion or acid regrurg?
14) recent travel abroad?
15) hx of asthma, COPD or TB?
16) any current meds? - incl steriod and inhaler and ACEi
17) occupation
18) smoking?
19) hx of childhood resp disease
2) any vaccination against TB?
what 1 specific meds can lead to coughing?
ACEi
what does purulent/yellow/green sputum mean?
pneumonia
bronchiectasis
what does dark/foul sputum mean?
lung abscess
what does yellow sputum mean?
asthma
what can haematemesis mean?
TB bronchiectasis pulmonary infection tumour bleeding disorder
what should be included in SOB hx?
1) describe the sensation of SOB
2) how long ago did they first noticed SOB?
3) any chest pain
4) any activities that pt unable to do due to SOB + how far can they walk?
5) if SOB is constant or comes and go?
6) level of exertion that gets pt SOB incing or decing?
7) anything that makes the SOB better or worse?
8) does lying flat make pt more SOB and how many pillows do they use at night?
9) ever wake up during the night due to SOB
10) noticed any ankle/leg swelling
11) any associated symptoms eg wheeze and cough or systemic illness
12) hx of asthma, COPD or cardiac disease
13) smokes?
14) inahler use?
15) ever get tingling in fingers/feel light-headed when SOB?
what can sudden onset SOB mean?
PE, tension pneumothorax, asthma attack , inhaled foreign object
what can SOB that came for few hours mean?
asthma
pneumonia
pulmonary oedema
alveolitis
what can SOB that came for few days mean?
asthma
pleural effusion
pulmonary oedema
what can SOB that came for few months mean?
COPD
tumour
fibrosis
aneamia
what does SOB that comes and go mean
asthma = intermittent
