Respiratory Symptoms and Signs Flashcards

1
Q

Chest pain - sharp and aggravated by breathing or movement

A
  • musculoskeletal injury or inflammation
  • chest wall pain (eg. Tietze’s syndrome)
  • pneumonia with pleurisy
  • PE/infarction
  • pneumothorax (tension, moderate or mild)
  • pericarditis
  • referred cervical root pain
  • shingles
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2
Q

Sudden breathlessness - onset over seconds

A
  • PE/infarction
  • pneumothorax (tension, moderate or mild)
  • anaphylaxis
  • inhalation of foreign body
  • cadiac arrhythmia
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3
Q

Acute breathlessness, wheeze +/- cough

A
  • exacerbation of asthma
  • exacerbation of COPD
  • acute viral or bacterial bronchitis
  • acute left ventricular failure
  • anaphylaxis
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4
Q

Chronic breathlessness

A
  • obesity and muscle deconditioning
  • asthma precipitated by allergens
  • COPD caused by smoking, smoke pollution, A1 anti-trypsin deficiency
  • left ventricular dysfunction
  • pulmonary fibrosis/interstitial lung disease
  • neuromuscular disease complicated by respiratory failur
  • pulmonary hypertension
  • psychogenic
  • chronic thrombo-emboli with or without pulmonary hypertension
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5
Q

Frank haemoptysis (or sputum streaked with blood)

A
  • acute viral or bacterial bronchitis
  • PE/infarction
  • carcinoma of the lung
  • pulmonary TB
  • URTI
  • lung abscess
  • bronchectasis
  • Wegener’s granulomatosis
  • pneumonia
  • pulmonary arterio-venous malformation
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6
Q

Cough with sputum

A
  • chronic bronchitis
  • acute viral bronchitis
  • acute bacterial bronchitis
  • pneumonia
  • lung abscess
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7
Q

Persistent cough with no sputum

A
  • smoking
  • chronic asthma
  • GORD
  • post-nasal drip
  • viral infection with slow recovery
  • COPD caused by smoking, smoke pollution, A1-antitrypsin deficiency
  • carcinoma of the lung
  • pulmonary TB
  • interstitial lung disease
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8
Q

Hoarseness

A
  • inhaled steroids
  • chronic laryngitis
  • Singer’s nodes
  • laryngeal carcinoma
  • vocal cord paresis
  • functional hoarseness
  • myxoedma
  • acromegaly
  • Sicca syndrome
  • granulomas
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9
Q

Respiratory rate low (<10)

A
  • CO2 marcosis
  • drugs (eg. opiates, alcohol, benzodiazepines, muscle relaxants)
  • raised intracranial pressure
  • head injury
  • acute neuromuscular disease
  • severe hypothermia
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10
Q

Chest wall abnormatlities

A
  • pectus carinatum
  • pectus excavatum
  • kyphosis
  • scoliosis
  • absence of part of the chest wall bone structure
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11
Q

Bilateral poor chest expansion

A
  • obesity possibly causing obesity hypoventilation syndrome
  • emphysema
  • pulmonary fibrosis/interstitial lung disease
  • muscular dystrophy
  • motor neurone disease
  • MS
  • Guillain-Barré syndrome
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12
Q

Unilateral poor chest expansion

A
  • pneumothorax
  • flail segment folowing trauma
  • extensive consolidation due to bacterial infection, but possibly to do with autoimmune disease, malignancy or drugs
  • fractured ribs
  • pleural effusion
  • musculoskeletal
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13
Q

Trachea displaced

A
  • pushed by contralateral tension pneumothorax
  • pulled by ipsilateral pneumothorax
  • pulled by ipslateral upper lobe fibrosis, collapse or removal
  • pushed by contralateral pleaurl effusion
  • scoliosis
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14
Q

Reduced tactile vocal fremitus

A
  • pleural effusion
  • pneumothorax
  • collapsed lobe with no consolidation
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15
Q

Increased tactile vocal fremitus

A
  • Extensive consolidation due to bacterial infection, but possibly autoimmune disease, malignancy or drugs
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16
Q

Stony dull percussion

A
  • transudates
  • LVF, SVC obstruction, pericarditis, peritoneal dialysis
  • low albumin states
17
Q

Dull to percussion but not stony dull

A
  • consolidation due to bacterial infection, but possibly autoimmune disease, malignancy or drugs
  • pulmonary oedema
  • elevated hemidiaphragm
  • severe fibrosis/collapse
  • severe pleural thickening
18
Q

Hyper-resonant percussion

A
  • emphysema
  • large bullae
  • pneumothorax
19
Q

Reduced breath sounds

A
  • poor respiratory effort
  • endobronchial obstruction
  • severe asthma or anaphylaxis
  • obesity
  • pneumothorax
  • pleural effusion
  • emphysema
  • large bullae
  • consolidation due to bacterial infection, but possibly autoimmune disease, malignancy or drugs
20
Q

Bronchial breathing

A
  • consolidation due to bacterial infection, but possibly autoimmune disease, malignancy or drugs
  • lung cavity
  • pulmonary fibrosis/interstitial lung disease
21
Q

Fine inspiratory crackles

A
  • incidental due to normal secretions
  • pulmonary oedema
  • pulmonary oededma due to acute lung injury
  • pulmonary fibrosis/interstitial lung disease
  • chronic bronchitis
  • emphysema
  • consolidation due to bacterial infection, but possibly autoimmune disease, malignancy or drugs
22
Q

Coarse crackles

A
  • bronchiectasis

- pulmonary fibrosis/interstitial lung disease

23
Q

Pleural rub

A
  • pneumonia with pleurisy
  • PE/infarction
  • severe pleural thickening
24
Q

Stridor +/- inspiratory wheeze

A
  • epiglottitis
  • croup
  • inhaled foreign body
  • rapidly progressing laryngomalacia
  • laryngeal papillomas
  • anaphylaxis causing laryngeal oedema
25
Q

Inspiratory monophonic wheeze

A
  • acute bilateral vocal cord paralysis
  • inhalation of foreign body
  • tracheal tumours or stenosis after ventilation
  • extrinsic compression of large airways by mediastinal masses
  • extrinsic compression by oesophageal tumours
  • tracheal blunt trauma
26
Q

Expiratory monophonic wheeze

A
  • endobronchial carcinoma
  • acute bilateral vocal cord paralysis
  • inhalation of foreign body
  • tracheal tumours
  • extrinsic compression by mediastinal masses
  • extrinsic compression by oesophageal tumours
  • tracheal blunt trauma
27
Q

Expiratory polyphonic, high-pitched wheeze

A
  • exacerbation of asthma
  • ‘Wheezy bronchitis’
  • viral wheeze
  • anaphylaxis
  • pulmonary oedema due to acute left ventricular failure or chronic (congestive) cardiac failure due to ischaemic heart disease, mitral stenosis