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
