Respiratory History Taking Flashcards
Breathlessness
● How is the patient normally?
(Is this acute/chronic/acute on chronic?)
● Onset, timing, duration, variability, diurnal variation.
● Exacerbating factors
e.g. allergic triggers, exertion, cold air
● Relieving factors e.g. rest, medication
● Associated symptoms
e.g. cough, sputum, haemoptysis, pain, wheezing, night sweats,
weight loss, oedema
● Severity
e.g. at rest? Only on exertion? Limiting ADLs?
Cough
● Onset, timing?
- less than 2 months = acute
- more than 2 months = chronic
● Duration?
● Variation?
e.g. recent change in a chronic cough, diurnal variation.
● Productive/unproductive?
Sputum
●Colour
- Rusty sputum suggests pneumococcal pneumonia.
- Frothy pink may indicate pulmonary oedema.
- Any haemoptysis?
● Consistency
e.g. viscous (fluid), mucous, purulent, frothy.
● Quantity (teaspoon, cupful etc.)
● Odour (fetid suggests bronchiectasis or a lung abscess).
Haemoptysis
● Origin (differentiate haemoptysis from haematemesis, was it coughed up?)
● Onset, timing, duration, variation
● Quantity
● Colour (fresh blood or dark altered blood)
● Consistency (liquid, clots, mixed with sputum)
● Sputum
● Chest pain
● Recent trauma to the chest or elsewhere?
● Recent/current DVT?
● Weight loss, fever, night sweats?
● Breathlessness?
● Bleeding or bruising elsewhere?
Past Medical History
● Previous Respiratory Problems:
- Pneumonia
- TB
- Measles/Pertussis
-Asthma
● Recent Surgery:
-Dental Surgery
-Abdo, Pelvic / Ortho Surgery are risks for DVT.
● Cardiac Disease - Angina, Orthopnea, Nocturnal Symptoms
● Immunocompromisation
What Respiratory Symptom do ACEi cause?
Cough
Amiodarone respiratory side effect?
Pulmonary Fibrosis
Family History
● Infection
● Genetics
● Alpha1-antitrypsin Deficiency
How to Calculate Pack Years?
Number of Packs Smoked per day * Number of years Smoked
