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Fraser MD3001 > Respiratory History Taking > Flashcards

Respiratory History Taking Flashcards

1
Q

What are the seven symptoms that you must explore in history of presenting complaint?

A
  • Chest Pain,
  • Dysponea,
  • Cough,
  • Sputum
  • Haemoptysis,
  • wheeze,
  • systemic upset
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2
Q

Explain SOCRATES

A
  • Site
  • Onset
  • Character
  • Radiation
  • Associated symptoms
  • Timing
  • Exacerbators/relievers
  • Severity
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3
Q

What are the causes of central chest pain?

A
  • Tracheitis
  • Angina/MI,
  • Aortic dissection
  • Large PE,
  • Oesophagitis,
  • Lung tumour,
  • Mediastinal tumour.
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4
Q

What are some causes on non central chest pain?

A
  • Shingles,
  • Rib fracture,
  • Lung tumour,
  • Pneumonia,
  • PE.
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5
Q

What are some of the causes of pleural chest pain?

A
  • Pneumonia/TB,
  • Lung tumour/metastases/mesothelioma,
  • PE,
  • Pneumothorax.
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6
Q

What are some causes of chest wall chest pain?

A
  • Muscular/Rib injury.
  • Costochondritis,
  • Lung tumour,
  • Shingles
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7
Q

What questions to ask when patient complains of dysponea?

A
  • Anything that brings it on? makes it better? worse?
  • Can you exercise?
  • Breathlessness lying down?
  • Can you walk upstairs? How far can you walk?
  • Any other symptoms?
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8
Q

Describe the different speeds of onset of dyspnoea and their causes.

A

Mins - PE, pneumothorax, acute LVF, acute asthma, aspiration.
Hours to days - Pneumonia, asthma, COPD.
Weeks to months - Anaemia, plural effusion.
Months to years - COPD, pulmonary fibrosis, pulmonary TB.

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9
Q

What questions should you ask if patient complains of cough?

A
  • How long?
  • Is it a new problem?
  • When does it occur?
  • Anything make it worse/better?
  • Is it dry? Do you cough anything up?
  • Smoker?
  • Medications
  • Any other symptoms?
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10
Q

What are some causes of an acute cough?

A

Viral/bacterial infection, pneumonia, inhalation of foreign body or irritants.

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11
Q

What are some causes of chronic coughs?

A

Gastro-oesophageal reflux, asthma, COPD, smoking, post nasal drip, ACE inhibitors. Less common = Lung tumour, bronchiectasis or interstitial lung disease

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12
Q

What are some red flags for coughing?

A

Haemoptysis, breathlessness, weight loss, chest pain or smoker.

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13
Q

What questions should you ask about when they complain about sputum?

A
  • How often do you produce sputum?
  • How much?
  • Any blood?
  • Is it frothy or thick?
  • Abnormal smell or test?
  • Any other symptoms?
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14
Q

What is the appearance and cause of serous sputum?

A

A - Clear, watery, frothy and pink.

C - Acute pulmonary oedema?

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15
Q

What is the appearance and cause of mucoid sputum?

A

A - Clear, grey, whist and viscid.

C - COPD/asthma.

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16
Q

What is the appearance and cause of purulent sputum?

A

A - Yellow, green or brown.

C - Infection

17
Q

What is the appearance and cause of rusty sputum?

A

A - Rusty red,

C - Pneumococcal pneumonia.

18
Q

What questions do you ask if patient complains of haemoptysis?

A
  • When did you first notice the blood?
  • How many times?
  • How much blood?
  • Any other colours
  • Bleeding or bruising anywhere else?
  • Any blood thinners?
19
Q

What are some malignant cause of haemoptysis?

A

Bronchial carcinoma, metastatic lung cancer.

20
Q

What are some infective causes of heamoptysis?

A

Acute infections, bronchiectasis and TB

21
Q

What are some cardiac causes of haemoptysis?

A

Mitral valve disease, acute LVF

22
Q

What are some of the causes of vasculitis haemoptysis?

A

Wegener’s granulomatosis and good pasture’s syndrome.

23
Q

What are some other causes of haemoptysis?

A

Trauma, anticoagulation, clotting disorders

24
Q

What are questions to ask patients who complain about wheeze?

A
  • When does it occur and how long does it last for?
  • Exacerbators? relievers?
  • Inhaler use?
  • Exercise tolerance?
25
Q

What are some questions to ask about systemic upset?

A
  • Changes in appetite?
  • Weight loss?
  • Fever?
  • Tiredness?
26
Q

How do you take a medication history?

A

For each drug ask about:
- Name of medicine, what it is for, dose/strength? route? number of tablets/puffs a day? Type? how often? changes to dose? side effects?

  • Ask about over counters, alternative or recreational drugs.
  • Ask about allergies to medicine
  • Ask about concordance
27
Q

What is intentional and unintentional non-adherences?

A

Intentional - definite decision to NOT take meds.

Unintentional can be due to: Physical dexterity, reduced vision, cognitive impairment and poor understanding.

28
Q

Describe the process of questions for systems enquiry?

A

CVS - Palpitations? Syncope?

GI - Changes in bowels, abdo pain?

GU - Urinary symptoms? Last period?

Endocrine - Lumps in neck? Temperature intolerance?

MS - Aches? stiff joints, muscles or back?

CNS - headaches or fits?

Fraser MD3001 (23 decks)

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