Respiratory Flashcards
What is haemoptysis
Coughing up blood
What other symptoms should you ask about when patient presents with hemoptysis
Cough Sputum Wheeze Breathlessness Chest pain - Socrates
Cough = when eg. What time of day, type eg chesty or dry, triggers eg. Animal hair, positional, wheeze
- when eg. What time of day,
- type eg chesty or dry,
- triggers eg. Animal hair,
- positional,
- wheeze
What should you find out about haemoptysis
Volume - ask patient to describe in teaspoons Mixed with sputum/ clots/ streaks Nasal bleeding? Frequency Other symptoms
If a patient has a chronic respiratory disease, find out what their normal is
Do you have any existing lung conditions
Are you normally breathless
What does sputum normally look like
If a chest pain is worse on inspiration, what diagnosis might this be indicative of
Pleuritic chest pain - inflammation of the pleura
If inflammation of the pleura is near the diaphragm where can the pain radiate to
Shoulder or neck
What are some causes of pleurisy
Pneumonia
Lung cancer
Pulmonary embolus
If chest pain presents with fever as well, what are likely causes
Infective causes such as pneumonia, TB, or empyema
Systematic Symptoms of malignancy and chronic infection
Weight loss
Malaise = fatigue, discomfort, uneasiness
Fevers
What is haemotemosis
Vomiting up blood
What must you specifically ask about in drug history if patient presents with haemoptysis, maleana, haemotemasis, or blood loss etc,
Anticoagulants
Antiplatlets
Are you on anything that thins the blood
Do you take aspirin over the counter
What to ask about in drug history in respiratory history
Anticoagulants/ antiplatlets
Inhalers - technique, timing of use, frequency of use
What to ask about in social history of respiratory history
Risk factors - DVT/ PE, eg, immobility, surgery
Occupational exposure - eg, asbestos, coal mining
Exposure through hobbies - eg, bird keeping
Smoking
What kind of drug is salbutamol
B2 Adrenoreceptor agonist
Commonest short acting one
Indications of salbutamol
Asthma
CPOD
Other airways conditions with reversible airway obstruction
How does salbutamol work
Works on beta 2 receptors which allows muscles in the airways to relax, allowing the airway to open
Side effects of salbutamol
Arrhythmias Tremor Palpitations Hypokalemia Dizziness Headache
How to work out smoking pack year history
The number of packs (of 20 cigarettes) a patient has smoked each day multiplied by the number of years they have smoked this for.
Symptoms of pulmonary embolus
Haemoptysis (can but not always?)
Pleuritic chest pain
Hypoxia
Common feature of bronchiectasis (abnormal widening of the bronchi or their branches)
Producing sputum regularly - during infective episodes, can change color to from clear to green or brown
Symptoms of lung cancer
Cough Haemoptysis Phlegm Chest pain or discomfort SOB Wheeze Systemic symptoms eg weight loss
Chest infection/ pneumonia symptoms
Cough Haemoptysis Phlegm Temperature Chest pain/ discomfort SOB wheeze Acute systemic symptoms
Symptoms of pulmonary embolism
May or may not have cough
Haemoptysis
Temperature chest pain/ discomfort
SOB
Main steps or respiratory exam
Look
Feel
Percuss
Auscultate
