Signs and symptom of respiratory disease Flashcards
What are the 6 cardinal symptoms of respiratory disease?
- dyspnoea
- cough
- chest pain
- wheeze and stridor
- sputum
- haemopytsis
What other relevant history should be asked about in respiratory history?
- childhood illness
- occupation
- pets
- travel
- smoking
- medications
- allergic disorders
- nasal symptoms
- phychosocial history (anxiety ect)
What could cause immediate onset dyspnoea?
PE, pneumothorax- due to ruptured bullae for example
What should cause acute onset (mins- hrs) dyspnoea? (5)
- Asthma
- PE
- pneumonia
- LVF/ MI
- Hyperventilation syndrome (physchological hyperventilation)
- anxiety attack
- anaemia (if exersizing)
What could cause gradual onset (days) dyspnoea? (3)
- lobar collapse (non pneumothorax)
- pleural effusion
- anaemia
What could cause chronic dyspnoea?
- COPD
- Bronchiectasis
- idiopathic plumonary fibrosis/ intersitial lung disease
- obesity
- anaemia
- deconditioning (unfit)
What questions should be asked about dyspnoea in a history?
- Timing and precipitation
- quality
- duration
- effect of position
- if relieved by inhaler
What is the pathophysiology behind a cough?
- something irritates mechano and/ or chemoreceptors in the oesphagus, diaphragm, larynx, pharynx ect
- pressure built up against closed vocal cords (valsalva menouvre)
- vocal cords adduct quickly
- forced expulsion or air
What could cause a acute cough (<3 weeks)?
- upper and lower tract infections
- exacerbations of COPD, asthma ect
- PE
- foreign bodies
- reflux
- some drugs (ACEi)
What could cause a chronic cough?
asthma COPD bronchiectasis cystic fibrosis lung cancer intersitial lung disease pleurisy smoking ACEi heart failure some infections (TB)
What is a wheeze and what causes it?
A muscial sound heard on expiration.
Caused by: asthma, COPD, bronchitis, somtimes LVF and bronchiectasis
Why can a wheeze be heard in asthma?
airways narrowing-> on expiration, a positive intra pulmonary pressure is generated, which further narrows airways-> whistling created
What is stridor?
a coarse inspiratory wheeze, caused by upper airway obstruction
What may cause increased sputum production?
- infection (sputum often yellow/ green)
- smoking
- COPD
- bronchiectasis
- acute asthma
- lung cancer
- LVF (pink and throthy)
What causes haemoptysis?
usually infections- pneumonia, tb, bronchiectasis, bronchitis
Also lung cancer, PE, anticoagulants and LVF
List 3 respiratory causes of clubbing?
- lung cancer
- mesothelioma
- bronchiectasis
- empyema
- interstitial lung disease
How does standing leaning over a table help pts suffering from COPD?
Theyve lost elastin, so struggle to expire. It fixes their shoulder girdle so their lattisimus dorsi can contract to help them expire.
How does purse lipped breathing help pts suffering from COPD?
It increases intrapulmonary pressure on expiration to help hold the alveoli open so ensures they dont completely deflate/ collapse, this makes them easier to reinflate. The airways are venerable to collapse due to mucus blocking and loss of lung parenchyma which normally holds airways open
How does COPD lead to a barrel chest?
- Loss of elastin= loss of opposition to outward force of ribs
- also, loss of elastin= loss of air expulsion= hyperinflation
What cause a stoney dull sound to precussion?
pleural effusion
What sound will consolidation, pneumothorax, COPD and lung collapse make to precussion?
Pneumothorax and COPD: hyperresonant
Consolidation and lung collapse: dull
What could cause fine crackles to auscultation?
- interstital lung disease/ idiopathic pulmonary fibrosis
- consolidation
- LVF (consolidation)
What could cause coarse crackles to auscultation?
- COPD
- bronchiectasis
MUCUS
What may cause a pleural friction rub?
pleurisy, pericarditis, pulmonary infraction due to PE
