Respiratory

Question 1

What is haemoptysis

Answer 1

Coughing up blood

Question 2

What other symptoms should you ask about when patient presents with hemoptysis

Answer 2

Cough 
Sputum 
Wheeze 
Breathlessness 
Chest pain - Socrates

Question 3

Cough = when eg. What time of day, type eg chesty or dry, triggers eg. Animal hair, positional, wheeze

Answer 3

• when eg. What time of day,
• type eg chesty or dry,
• triggers eg. Animal hair,
• positional,
• wheeze

Question 4

What should you find out about haemoptysis

Answer 4

Volume - ask patient to describe in teaspoons 
Mixed with sputum/ clots/ streaks 
Nasal bleeding?
Frequency 
Other symptoms

Question 5

If a patient has a chronic respiratory disease, find out what their normal is

Answer 5

Do you have any existing lung conditions
Are you normally breathless
What does sputum normally look like

Question 6

If a chest pain is worse on inspiration, what diagnosis might this be indicative of

Answer 6

Pleuritic chest pain - inflammation of the pleura

Question 7

If inflammation of the pleura is near the diaphragm where can the pain radiate to

Answer 7

Shoulder or neck

Question 8

What are some causes of pleurisy

Answer 8

Pneumonia
Lung cancer
Pulmonary embolus

Question 9

If chest pain presents with fever as well, what are likely causes

Answer 9

Infective causes such as pneumonia, TB, or empyema

Question 10

Systematic Symptoms of malignancy and chronic infection

Answer 10

Weight loss
Malaise = fatigue, discomfort, uneasiness
Fevers

Question 11

What is haemotemosis

Answer 11

Vomiting up blood

Question 12

What must you specifically ask about in drug history if patient presents with haemoptysis, maleana, haemotemasis, or blood loss etc,

Answer 12

Anticoagulants
Antiplatlets
Are you on anything that thins the blood
Do you take aspirin over the counter

Question 13

What to ask about in drug history in respiratory history

Answer 13

Anticoagulants/ antiplatlets

Inhalers - technique, timing of use, frequency of use

Question 14

What to ask about in social history of respiratory history

Answer 14

Risk factors - DVT/ PE, eg, immobility, surgery
Occupational exposure - eg, asbestos, coal mining
Exposure through hobbies - eg, bird keeping
Smoking

Question 15

What kind of drug is salbutamol

Answer 15

B2 Adrenoreceptor agonist

Commonest short acting one

Question 16

Indications of salbutamol

Answer 16

Asthma
CPOD
Other airways conditions with reversible airway obstruction

Question 17

How does salbutamol work

Answer 17

Works on beta 2 receptors which allows muscles in the airways to relax, allowing the airway to open

Question 18

Side effects of salbutamol

Answer 18

Arrhythmias 
Tremor 
Palpitations
Hypokalemia 
Dizziness 
Headache

Question 19

How to work out smoking pack year history

Answer 19

The number of packs (of 20 cigarettes) a patient has smoked each day multiplied by the number of years they have smoked this for.

Question 20

Symptoms of pulmonary embolus

Answer 20

Haemoptysis (can but not always?)
Pleuritic chest pain
Hypoxia

Question 21

Common feature of bronchiectasis (abnormal widening of the bronchi or their branches)

Answer 21

Producing sputum regularly - during infective episodes, can change color to from clear to green or brown

Question 22

Symptoms of lung cancer

Answer 22

Cough 
Haemoptysis 
Phlegm 
Chest pain or discomfort 
SOB
Wheeze
Systemic symptoms eg weight loss

Question 23

Chest infection/ pneumonia symptoms

Answer 23

Cough
Haemoptysis 
Phlegm 
Temperature
Chest pain/ discomfort
SOB 
wheeze
Acute systemic symptoms

Question 24

Symptoms of pulmonary embolism

Answer 24

May or may not have cough
Haemoptysis
Temperature chest pain/ discomfort
SOB

Question 25

Main steps or respiratory exam

Answer 25

Look
Feel
Percuss
Auscultate