Respiratory History Taking Flashcards
What is the structure of a standard medical history taking?
- Presenting Complaint
- History of Presenting Compliant
- Past Medical History
- Medication/allergies (drug history)
- Social History
- Family History
- Systems Review
What are the 7 areas asked about when the HPC is linked to the respiratory system?
- Chest Pain
- Dyspnoea
- Cough
- Sputum
- Haemoptysis
- Wheeze
- Systemic Upset
What type of chest pain is more specific to the respiratory system?
pleuritic pain
What are the main causes of central chest pain?
- Tracheitis
- Angina/MI
- Aortic Dissection
- massive PE
- Oesophagitis
- Lung tumour/ metastases
- Mediastinal tumour/mediastinitis
What are the main causes of non-central chest pain?
- shingles
- lung tumour
- PE
- rib fracture
- pneumonia
What are the main causes of pleural chest pain?
- pneumonia
- brocnhiectasis
- TB
- Lung tumour/metastases/mesothelioma
- PE
- Pneumothorax
What are the characteristics of pleuritic pain?
sharp on coughing and inspiration
What are the main causes of pain in the chest wall?
- Muscular/rib injury
- Costchondritis
- Lung tumour/ bony metastases/ mesothelioma
- Shingles
What is dyspnoea?
Shortness of breath
What conditions cause an onset of dyspnoea in a matter of minutes
- PE
- pneumothorax
- acute LVF
- acute asthma
- inhaled foreign body
What conditions cause an onset of dyspnoea in a few hours to days?
- pneumonia
- asth,a
- exacerbation of COPD
What conditions cause an onset of dyspnoea in a few weeks to months?
- anaemia
- pleural effusion
- respiratory neuromusuclar disorders
What conditions cause an onset of dyspnoea in a few months to years
- COPD
- pulmonary fibrosis
- pulmonary TB
What are the main respiratory causes of SOB?
- Airways - asthma, CF, tumour, foreign body
- PArenchyma - pneumonia, pulmonary fibrosis, sarcoidosis, TB
- Pulmonary circulation - PE
- Pleural - oneumothorax, pleural effusion
- chest wall - kyphoscolosis, ankylosing spondylitis
- neuromuscular - mysthenia gravis, Guillian-Barre syndrome
Cardiovascular causes of SOB
cardiac failure (LVF) associated with angina or MI
non cardio-respiratory causes of SOB
anaemia, obesity, hyperventilation, anxiety, matabolic acidosis
What are the potential causes of an acute cough?
- viral or bacterial infection
- pneumonia
- inhalation of foreign bodies
- irritants
What are the main causes of chronic cough?
- Common
- gastro-oesphgeal reflux
- asthma
- COPD
- Smoking
- post-nasal drip
- occupational or irritants
- medication (ACE I)
- Less common
- lung tumour
- bronchiectasis
- interstitial lung disease
What are the red flags associated with a cough
- haemoptysis
- breathlessness
- weight loss
- chest pain
- smoker
Common cause of a productive cough
Infection
Bronchiectasis
Common cause(s) of a persistent ‘moist’ cough worst in the morning
COPD
Common cause(s) of an associated wheeze
ASthma
COPD
Common cause(s) of a painful cough
tracheitis
Common cause(s) of a harsh/barking cough
laryngitis
laryngeal tumour
Common cause(s) of a chronic, dry cough
intersitial lung disease
Common cause(s) of a persistent cough with haemoptysis?
bronchial carcinoma
Common cause(s) of a bovine (non-explosive) cough
left recurrent laryngeal nerve invasion
neuromuscular disorders
What colour is serous sputum and what does it indicate?
Clear watery or frothy pink
Acute pulmonary oedema
Describe a mucoid sputum and what it is a result of
clear, grey/ white, viscid
COPD/Asthma
What colour is a ourulent sputum and what is it a result of?
yellow, green, brown
infection
What causes a rusty red sputum?
pneumococcal pneumonia
Malignant cause of haemopysis
broncjial carcinoma
metastaic lung disease
Infective cause of haemopysis
Acute infection
brinchiectasis
TB
Vascular cause of haemopysis
pulmonary infarction or pulmonary embolus
cardiac cause of haemopysis
mitral valve disease
Acute LVF
Vasculitis cause of haemopysis
Wegener’s syndrome
Hood pasture’s syndrome
What does sytemic upset refer to?
change in appetite
weight loss
fever
tiredness
