Resp history and symptoms

Question 1

What are the 6 respiratory symptoms you must always ask about?

Answer 1

Cough
Sputum
Haemoptysis
Dyspnoea
Wheeze
Chest Pain

Question 2

Outline the MRC dyspnoea scale

Answer 2

1) Only breathless on strenuous exercise
2) Short of breath when walking up hill, or walking fast on the flat
3) Slower than contemporaries on the flat due to breathlessness
4) Stops after ~100m/a few minutes to catch breath
5) Too breathless to leave house. Breathless during ADLs

Question 3

Give 10 DDx for breathlessness

Answer 3

Resp - PE, COPD, lung cancer, infection, pneumothorax
Cardio - HF, IHD, arrythmias
Neuro - MND
Anxiety
Lack of fitness/deconditioning

Question 4

Give 8 DDx for wheeze

Answer 4

Asthma
COPD
PE
Infection
Vasculitis
Anaphylaxis
Pulmonary oedema
Foreign body

Question 5

Give 15 DDx for chest pain

Answer 5

Resp - PE, pneumonia, pleurisy, pneumothorax
Cardiac - angina, ACS, pericarditis, aortic dissection
GI - GORD, oesophagitis, oesophageal spasm
MSK - costochondritis, rib #, muscle strain
Neuro - shingles

Question 6

Give 5 DDx for cough with sputum

Answer 6

Viral URTI
Post-nasal drip
Pneumonia
COPD
CF

Question 7

Give 5 DDx for haemoptysis

Answer 7

Infection - TB, pneumonia
Lung cancer
Vasculitis
Warfarin