Signs and Symptoms

Question 1

COPD

Answer 1

. Breathlessness/shortness of breath
. Shortness of breath on exertion
. Waking up at night breathless
. Persistent productive cough
. Frequent chest infections
. Wheezing

Question 2

Asthma

Answer 2

. Wheezing
. Breathlessness
. Tight chest like a band around it
. Cough

Question 3

Bronchiectasis

Answer 3

. Persistent productive cough
. Shortness of breath

Question 4

Pneumonia

Answer 4

. Cough (dry or productive with yellow, green, brown, or blood stained sputum)
. Shortness of breath even on rest
. Rapid heartbeat
. High temp
. Generally unwell feeling
. Fevers
. Loss of appetite
. Chest pain

Question 5

Interstitial Lung Disease

Answer 5

. Shortness of breath
. Dry cough non productive
. Tiredness and weakness
. Loss of appetite
. Weight loss
. Chest discomfort
. Laboured breathing

Question 6

Sleep apnoea

Answer 6

. Day time sleepiness
. Loud snoring
. Episodes of stopping breathing when sleeping
. Abrupt awakings
. Dry mouth/ sore throat on awakening
. Headaches in morning
. Difficult concentrating
. Mood changes

Question 7

Lobar Collapse/Atelectasis

Answer 7

. Breathlessness
. Difficulty breathing
. Wheezing
. Coughing

Question 8

Angina

Answer 8

. Chest Pain/tightness/squeezing
. Dizziness
. Sweating
. Nausea/GI discomfort
. Shortness of Breath
. Pain/dull ache to chest, shoulders, arms, neck, jaw, back or stomach

Question 9

Heart Failure

Answer 9

. Tachycardia
. Shortness of breath
. Breathless laying down
. Fatigue
. Elevated JVP
. Enlarged heart
. Thurs and fourth heart sounds
. Bi Basel crackles
. Pleural effusion
. Ankle oedema
. Ascites
. Tender liver
. Light headed

Question 10

MI

Answer 10

. Severe chest pain/ heaviness/ tightness / squeezing across chest
. Radiating pain in other parts such as arms, jaw, neck, back, abdo
. Light headed or dizziness
. Sweating
. Shortness of breath
. Nausea
. Overwhelming anxiety or feeling of doom
. Coughing / wheezing

Question 11

Peripheral Vascular Disease

Answer 11

. Painful/aching legs when walking
. Hair loss on legs and feet
. Numbness/weakness to legs
. Slow growing / brittle nails
. Ulcers to feet or legs
. Changes of skin colour (blue/purple)
. Shiny skin
. Erectile dysfunction
. Muscle wastage

Question 12

Valve defects

Answer 12

. Chest pain/discomfort
. Palpitations
. Fatigue/weakness
. Dizziness
. Low or high BP
. Shortness of breath
. Abdominal pain
. Leg/ankle swelling
. Whooshing sound (murder) on auscultation

Question 13

Raised JVP

Answer 13

. Increased venous pressure of the Right atrium

Question 14

Left sided heart failure

Answer 14

Usually caused by coronary artery disease

Most common type of heart failure
Heart looses some ability to pump blood around the body

Question 15

Right sided heart failure

Answer 15

Heart looses some ability to move oxygen depleted blood to the lungs to allow the lungs to pick up new oxygen

Most commonly caused by left sided heart failure

Can happen when left side of the heart is normal

Question 16

What do you look for on hands/wrists/arms- cardiology

Answer 16

Jane way lesions, Oslar nodes & splinter haemorrhage = infective endocarditis

Raised Yellow deposits = hyperlipedemia

Clubbing = congenital heart disease, infective endocarditis

Cyanosis = poor peripheral perfusion & hypoxia

Tar staining = risk factor for cardiovascular disease, coronary artery disease & hypertension

Tugor test for dehydration.

Temperature of the hands .. cool could be poor peripheral perfusion… sweaty/clammy could be acute coronary syndrome

Capillary refill time = if more than two poor peripheral perfusion.

Radial pulse

Radio-radial delay - checking both radial pulses for any delays = Subclavian artery stenosis, Aortic dissection, Aortic coarctation

Collapsing pulse - check no pain to shoulder, hold the radial & brachial pulse, then raise arm above head quickly, if you can feel tapping pulse through the muscle bulk of the arm normal. If not can indicate fevers, aortic regurgitation, anaemia, thyrotoxicosis.

Check brachial pulse= bounding could mean co2 retention, slow aortic stenosis, thready sepsis or hypovolemia

Blood pressure… should do a laying and standing - postural hypotension

Question 17

What do you look for on neck - cardiology

Answer 17

Listen & Feel carotid pulse. Ask patient to hold breath for listening.

Look at jugular venous pressure. Should be no more than 3cm. Raised JVP = right sided heart failure, tricuspid regurgitation, constrictive pericarditis.
Apply pressure to the liver to see if it raises in normal people it should raise 1-2cm then drop after a couple of cardiac cycles. If it remained raised then it’s a positive hepatojugular response = right ventricular failure, left ventricular failure, restricted cardiomyopathy.