Signs and Symptoms of Pulmonary Diseases Flashcards
What is dyspnea?
Is subjective symptom of shortness of breath/ difficulty in breathing.
What are the 3 symptoms associated with dyspnea?
They are air hunger, increased effort to breathe, feeling of chest tightness,
What are the two branches of dyspnea?
They are intermittent dyspnea and then persistent dyspnea.
What are the types of intermittent dyspnea?
They are orthopnea (dyspnea when lying flat)
Trepopnea (when lying sideways)
Platypnea ( when sitting up)
What is paroxysmal nocturnal dyspnea?
Sudden onset of shortness of breath occurring during sleep. .
What can diseases can cause persistent dyspnea?
Asthma, pneumonia, pulmonary edema, pulmonary fibrosis, pneumothorax, emphysema, chronic bronchitis, emphysema, obesity
What type of dyspnea does asthma cause?
Episodic
What type of dyspnea does pulmonary edema cause?
abrupt
What type of dyspnea does pneumothorax cause?
Sudden onset, moderate to severe.
What is cough?
A normal defense of the lung in order to expel irritants. Coordinated forced expiration interrupted by closure of the glottis.
What are the most common chronic cough causes?
They are smoking, post nasal drip, GERD, Asthma, ACE inhibitor use.
What is the description of acute cough?
Less than 3 weeks
What can be the cause of acute cough?
Acute URI, LRI, Acute sinusitis, bronchitis, chronic condition exacerbation (asthma)
What the description for subacute cough?
3- 8 weeks of cough
What can be the cause of subacute cough?
Post - infection, pertussis, pneumonia
What is chronic cough?
More than 8 weeks
What can be cause of chronic cough?
Post-nasal drip, GERD, asthma, non-asthmatic eosinophilic bronchitis
What are the 2 steps involved in studying cough in a person?
- determine onset, acuity
- then listen to the cough
- ask about sputum
4.
What can wheezing cough mean?
bronchospasm, asthma, allergies, congestive heart failure
What can morning cough mean?
cough due to smoking
What can nocturnal cough indicate?
upper airway cough syndrome, congestive heart failures
What does rust colored, purulent sputum mean?
Pneumococcal pneumonia
What does red currant jelly indicate?
klebsiella pneumoniae infection
What does pink, frothy sputum indicate?
pulmonary edema
What does bloody sputum indicate?
pulmonary emboli, bronchiectasis, abcess, tuberculosis, TB, tumor, cardiac causes, bleeding disorders
if there is hemoptysis, what should be the next step in diagnosis?
If the blood is from mouth/nose/ and not GI in nature: It should be seen whether there blood tinged sputum or clots of blood
For blood tinged sputum, what can be the cause of this?
smoking, infection, tumors
For clot of blood sputum, what can be the cause of this?
cavitary lesion, lung tumor, cardiac disease, pulmonary embolism
How can you tell that something is hemoptysis vs hematemesis?
Hemoptysis is when there is frothy and bright red sputum
What are the 3 B’s of hemoptysis?
They are bronchitis, bronchiectasis, bronchogenic carcinoma + Active TB
What can be the airway cause of hemoptysis?
It can be due to the 3Bs + anything with the word bronchial in it.
What can be the parenchymal causes of hemoptysis?
They can be TB
What can be the vascular cause of hemoptysis?
PE, vascular malformation, mitral stenosis, and LVF
What should you when patient complains of chest pain?
You should first rule of myocardial infarction, and then describe the pain and localize it.
What are the 2 types of chest pain in the
There is visceral and chest wall/pleuritic chest pain.
What is visceral chest pain?
It is hard to pinpoint the location. The intensity varies, deep/superficial, constant intermittent often causes aching sensation.
What can cause visceral chest pain?
Neoplasm of airways/mediastinum, abnormalities of heart, aorta, and pericardium, esophageal pain
What chest wall/pleuritic chest pain?
Sharp, well localized pain, increases by deep breath or cough.
Chest wall/pleuritic pain can be caused by:
Disease of the parietal pleura (infection, tumor, trauma)
Intercostal nerve irritation (herpes zoster, spinal nerve root disease)
somatic dysfunction of ribs or thoracic vertebrae
costo-chondritis
What does wheezing indicate?
It indicates asthma.
What are the steps to pulmonary patient evaluation?
- Inspection
- Palpation
- Percussion
What are the steps for percussion?
- look at facial expression
- Posture
- Accessory muscle use
- chest configuration
- respiratory rate and pattern, skin color
- nails/ hands
- skin on chest
- look at nose and throat
What are some clues for central cyanosis and peripheral cyanosis?
Central Cyanosis: very low paO2, lung problems (gas exchange/shunting)
Peripheral Cyanosis: excessive extraction of blood in the extremities (heart, thrombosis, low temp, low volume)
What is clubbing?
Loss of angle between nail and terminal phalanx, increased curvature, increases sponginess, widening or terminal phalanx.
What are palpation methods?
Feel for areas of tenderness, symmetry, of chest excursion, tactile Fremitus (touch with 99, increases with increases with tissue density AND decreases with decreased tissue density) ,
Percussion involves what methods?
Dull: consolidated (pneumonia)
Hyperresonant: less dense (emphysema .pneumothorax)
What are auscultation methods?
Vocal Fremitus (Pectoriloquy) Tests for consolidation: Normal Muffled
- Bronchophony: voices will be louder and clearer than abnormal
- Whispered pectriloquy: 99 clear is abnormal
- Egophony: EEE will sound like AAA if abnormal
Crackles are what and what are they caused by?
Consolidation of fluid in the alveoli. Excess airway secretion is the cause.
Bronchitis, respiratory infections, pulmonary edema, Atelectasis, fibrosis, CHF
Wheezing is caused by what and indicates what?
Asthma, pulmonary edema, bronchitis, CHF, Foreign body, tumor
Rhoncus
larger airway (sounds underwater) causes like bronchitis
Pleural Rub is what and what is caused by?
walking on snow and inflammation of pleura and caused by pneumonia and pulmonary infarction
