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
2
Q
Sudden breathlessness - onset over seconds
A
- PE/infarction
- pneumothorax (tension, moderate or mild)
- anaphylaxis
- inhalation of foreign body
- cadiac arrhythmia
3
Q
Acute breathlessness, wheeze +/- cough
A
- exacerbation of asthma
- exacerbation of COPD
- acute viral or bacterial bronchitis
- acute left ventricular failure
- anaphylaxis
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
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
6
Q
Cough with sputum
A
- chronic bronchitis
- acute viral bronchitis
- acute bacterial bronchitis
- pneumonia
- lung abscess
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
8
Q
Hoarseness
A
- inhaled steroids
- chronic laryngitis
- Singer’s nodes
- laryngeal carcinoma
- vocal cord paresis
- functional hoarseness
- myxoedma
- acromegaly
- Sicca syndrome
- granulomas
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
10
Q
Chest wall abnormatlities
A
- pectus carinatum
- pectus excavatum
- kyphosis
- scoliosis
- absence of part of the chest wall bone structure
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
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
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
14
Q
Reduced tactile vocal fremitus
A
- pleural effusion
- pneumothorax
- collapsed lobe with no consolidation
15
Q
Increased tactile vocal fremitus
A
- Extensive consolidation due to bacterial infection, but possibly autoimmune disease, malignancy or drugs
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
Inspiratory monophonic wheeze
- 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
Expiratory monophonic wheeze
- 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
Expiratory polyphonic, high-pitched wheeze
- 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
