Respiratory Lecture Flashcards
What are some common presenting complaints of respiratory pathologies?
Dyspnoea Hyperventilation Syndrome Cough Haemoptysis Wheezing
What are the 4 causes of Dyspnoea?
- Increased ventilatory demand
- Increased airway resistance
- Decreased ventilatory capacity
- Decreased pulmonary compliance
What could be some causes of acute dyspnoea?
LHF Angina Pneumothorax Pulmonary Embolism Asthma/bronchospasm Hyperventilation disorder
Compare and contrast features of pneumothorax and pulmonary embolism
Both:
Abrupt, sharp chest pain
Tachypnea
Spontaneous
Pneumothorax:
Diminished breath sounds and hyper resonance
Pulmonary Embolism:
Tachycardia
What are some Risk Factors of Pneumothorax?
Smoking
COPD
Thoracic injury
Marfan’s Syndrome
What are some Risk Factors of Pulmonary Embolism?
DVT Immobilisation Pregnancy Cancer Family History OCP/oestrogen-containing drugs
What are the 2 defining features of Asthma?
Prolonged expiratory phase
Use of secondary muscles of respiration
Name 2 conditions which are Pulmonary causes of sub-acute dyspnoea and 2 conditions which are Cardio causes of sub-acute dyspnoea ?
Pulmonary:
Pneumonia
COPD
Cardio:
Angina
CAD
Compare and Contrast patients with Pneumonia vs. COPD
Pneumonia: Patients generally look unwell Fever Productive cough Occasional pleuritic chest pain Areas of lung consolidation on examination
COPD: Effort on breathing Cough (may or may not be productive) Poor air movement Accessory respiratory muscle use Areas of hyper resonance on examination
What are some pulmonary causes of chronic dyspnoea?
- Lung disease: Obstructive, Restrictive or Interstitial
- Pleural Effusion
What are some cardiac causes of chronic dyspnoea?
- Heart failure
- Stable angina
- CAD
How does anaemia cause dyspnoea?
Decreased RBC’s means decreased oxygen molecules in body.
Compare and contrast Obstructive vs. Restrictive Lung Disease
Obstructive:
- Increased residual volume in lungs
E.g: COPD, Chronic Bronchitis, Asthma, Bronchiectasis
Restrictive:
- Decreased total capacity of lungs
E.g:
Intrinsic: Pneumonia, Tuberculosis, Sarcoidosis
Extrinsic: Scoliosis, Pleural Effusion, Rib Fracture
Neurological: Myasthenia Gravis, Muscular Dystrophy, Amyotrophic Lateral Sclerosis
What are some red flags of cough?
Dyspnoea
Haemoptysis
Weight loss
Risk factors for TB or HIV infection
What can acute cough arise from?
Upper respiratory tract infection Pneumonia Postnasal drip COPD Pulmonary embolism Heart failure
What are potential causes of chronic cough?
- Chronic bronchitis
- GERD
- Asthma
- ACE inhibitors ( used for HTN)
What are some characteristics of patients with chronic bronchitis?
- History of smoking
- Productive cough on most days
- Frequent clearing of the throat
- Some dyspnoea
What are some characteristics of patients with GERD?
- burning chest pain with certain foods, activities or positions
- cough is nocturnal or early morning
- sour taste in mouth and have some hoarseness
What causes Haemoptysis?
Bronchitis
Bronchiectasis
TB
Necrotising pneumonia
What are Haemoptysis Red Flags?
Massive haemoptysis (≥600mL in 24 hrs.) Back pain Malaise Weight loss Fatigue Extensive smoking history Dyspnoea at rest Absent or decreased breath sounds
What are the 3 Sources of Blood?
Haemoptysis:
True bleeding from the lungs
Shows frothy sputum and bright red blood
Pseudo-haemoptysis
Bleeding from the nasopharynx
May have bleeding from the nose without coughing or note a post-nasal drip
Haematemesis
Bleeding from the stomach/GI
Has nausea and vomiting with coffee-coloured, black or brown blood
What are the 2 most common causes of wheezing?
Asthma
COPD
Wheezing Red Flags are:
Accessory muscle use
Clinical signs of tiring
Decreased level of consciousness
Fixed inspiratory and expiratory wheezing
Swelling of the face and tongue (angioedema)
Acute causes of wheezing could be:
- allergic reaction
- heart failure
Intermittent/Recurrent causes of wheezing could be:
- asthma
- repeat exposure to irritants
Chronic causes of wheezing could be:
- bronchial obstruction
Sudden onset suggests foreign body aspiration
Gradual development suggests tumour or growing lymph node
