Signs and symptoms of resp disease Flashcards
What are cardinal signs and symptoms of resp disease?
- chest pain
- breathlessness
- haemoptysis
- discoloured sputum
- coughing
What is the medical term of breathlessness?
dysponea
Is dysponea a symptom or a sign?
- symptoms
- common to resp conditions but not specific e.g.
- anaemia, heart failure, obesity
What do you want to know about the breathlessness?
- onset, timing, duration
- precipitating factors (position, weather, allergens)
- progression
- severity (stop you exercise/walking/stairs/speech)
What are some differentials of chest pain? (resp problems)
Pleura
- infection
- pneumothorax
- PE
Chest Wall
- rib fracture
- costochondritis
- shingles
Mediastinal Structures
- ACS
- Pericarditis
- GORD
- Aortic dissection
How would a patient describe pleuritic pain?
- sharp
- well-localised
- worse with coughing and breathing in
- referred pain to shoulder (intercostal and phrenic nerve)
What do you want to know about a cough (what will you ask the patient)?
- dry
- sputum
- blood
- how much
- seal cough (croup)
- timing of cough
What is the most common cause of cough?
URTI
What patients will have clear sputum with a cough?
chronic bronchitis
COPD
What patients will have yellow/green sputum?
infection (presence of neutrophils)
What patients will have large volumes of yellow/gree sputum?
bronchiectasis
What patients would have haemoptysis?
TB
-potential red flag for cancers
Why does a cough occur?
irritation of air wards, lung parenchyma or pleura
What are some non-respiratory causes of a cough?
LV heart failure
-GORD
Drugs
What are wheezes and striders?
abnormal breath sounds indicating narrowing within the airway causing turbulent flow of air
What does a wheeze sound like?
high pitched musical note on expiratiron
Why does a wheeze occur?
narrowing in the intrathoracic airways e.g. bronchial smooth muscle contraction, oedema, mucous
What does a stridor sound like?
high pitched constant loud sound on inspiration
Why does stridor occur?
narrowing in the extra thoracic airway (supra/infra glottis or trachea)
What are the 2 types of cyanosis and why do they occur?
Peripheral
- cold exposure and decreased cardiac output
- slowing of blood to peripheries due to vasoconstriction (increased oxygen extraction in blood so more deoxy present in area)
Central (mucous membranes)
-significant cardiac or respiratory cause due to increase in amount of deoxy Hb in blood arriving at tissues
What are the respiratory causes of clubbing?
-due to chronic infmallamtion e.g bronchiectasis, CF, lung cancer
Why would someone breath with pursed lips?
- commonly seen in COPD
- pursing lips increases resistance to outflow on expiration
- helps to maintain intrathoracic airway pressure allowing for the small airways to remain open for longer (prolonging period for gas exchange to occur and to allow more air to empty)
What is a barrel shaped chat?
- Increase AP diameter
- associated with hyper inflated lung in COPD
- air trapping
What till push trachea to same side of issue?
pulmonary fibrosis
