Respiratory History

Question 1

Main respiratory disease types

Answer 1

Inflammatory
Neoplastic
Infective
Vascular

Question 2

Main respiratory structures for disease categorisation

Answer 2

Breathing tubes (obstructive)
Parenchyma (restrictive)
Chest wall (restrictive)
Pulmonary circulation
Pleura

Question 3

Questions to ask about the occupation

Answer 3

Were you ever exposed to industrial dusts or irritants?

Were you ever exposed to cigarette fumes?

Question 4

History of child health

Answer 4

Premature?
Whooping cough
Pneumonia
Bronchiectasis
Asthma
Exercised?
Open air?

Question 5

Breathlessness questions

Answer 5

Onset
Duration
Intermittent
Relieving/exacerbating factors
Diurnal variation
Associated factors
-chest pain, palpitations

Question 6

Grade 1 MRC dyspnoea scale

Answer 6

Only SOB on severe exercise

Question 7

Grade 2 MRC dyspnoea scale

Answer 7

Short of breath on slight hill or hurrying

Question 8

Grade 3 MRC dyspnoea scale

Answer 8

Walks slower than most people. Stops after 15mins or 1 mile

Question 9

Grade 4 MRC dyspnoea scale

Answer 9

Stops after 100 yards, or after a few minutes

Question 10

Grade 5 MRC dyspnoea scale

Answer 10

Too breathlessness to leave house, or when undressing

Question 11

Questions to ask about breathlessness progression

Answer 11

Stable?
Progressive?
Speed of progression?
Exacerbations?

Question 12

Which childhood diseases can increase the chance of bronchiectasis

Answer 12

Whooping cough or pneumonia

Question 13

Questions to ask about wheeze

Answer 13

SOCRATES
Inspiration/expiration
Diurnal variation

Question 14

Questions to ask about cough

Answer 14

SOCRATES
Productive/dry?
Sputum? Nature? Volume?
Haemoptysis?

Question 15

Questions to ask about chest pain

Answer 15

SOCRATES

breathless? cough?

Question 16

‘0ther’ respiratory symptoms

Answer 16

Tiredness
Fever/night sweats
Weight loss
Collapses/falls

Question 17

Components of PMH

Answer 17

Check with patient and GP letter
Other medical problems
Cured cancers?

Question 18

What is wheeze

Answer 18

entirely expiratory noise

Question 19

What causes inspiratory musical noises

Answer 19

extrathoracic obstruction

Question 20

What is an inspiratory musical noise called

Answer 20

Stridor

Question 21

What causes wheeze

Answer 21

Reduction in airways calibre

Question 22

Questions for drug history

Answer 22

Ask patient
Check
-GP letter
-repeat prescription list
-integrated clinical portal
anything herbal/traditional/otc

Question 23

Drugs which cause unexplained breathlessness

Answer 23

Clopidogrel < ticagrelor

Question 24

Drugs which cause asthma

Answer 24

Aspirin/NSAIDs

Question 25

Drugs which cause cough

Answer 25

ACE inhibitors

Question 26

Drugs which cause wheeze

Answer 26

Beta blockers

Question 27

Drugs which cause pulmonary toxicity

Answer 27

Amiodarone

Question 28

Drugs which cause pneumonitis and fibrosis

Answer 28

Methotrexate

Question 29

What is a significant amount of sputum

Answer 29

A tea cup in a day

Question 30

What is blood in sputum a sign of

Answer 30

young=PE | old/smokes= cancer

Question 31

Drugs which cause pneumonitis

Answer 31

Nitrofurantoin

Question 32

Drugs which increase the risk of opportunistic infection

Answer 32

Steroids/immunosupressants

Question 33

Drugs which increase the risk of thromboembolism

Answer 33

Contraceptive pill

Question 34

Drugs which increase the risk pulmonary hypertension

Answer 34

Anorectogens (slimming pills)

Question 35

Localised, sharp, worse on inspiration pain

Answer 35

Pleural

Question 36

Which disease is often seen with severe tiredness

Answer 36

Sarcoidosis

Question 37

Rheumatological questions

Answer 37

Raynauds Joint pain/swelling Muscle aches/weakness

Question 38

Dermatological questions

Answer 38

Rashes Lumps and bumps Unusual bruises

Question 39

Opthalmological questions

Answer 39

Itchy eyes, dry eyes (mouth)

Question 40

GI questions

Answer 40

Acid in back of throat, heartburn, dysphagia, bowels

Question 41

Neurological questions

Answer 41

Fits Faints and funny turns Weakness

Question 42

Urological questions

Answer 42

Polyuria

Question 43

What is ticagrelor

Answer 43

P2Y12 inhibitor, antiplatelet

Question 44

Questions for personal and social history

Answer 44

``` Smoker (pack years? just tobacco?) Drinker? Lives with? Carer? Pets Hobbies Foreign travel ```

Question 45

Respiratory diseases where the family history is significant

Answer 45

Alpha 1 antitrypsin | Primary ciliary dyskinesia

Question 46

Acid reflux is associated with which respiratory disease

Answer 46

Pulmonary fibrosis

Question 47

What can budgies give you

Answer 47

EAA