Signs and symptoms of resp disease

Question 1

What are cardinal signs and symptoms of resp disease?

Answer 1

• chest pain
• breathlessness
• haemoptysis
• discoloured sputum
• coughing

Question 2

What is the medical term of breathlessness?

Answer 2

dysponea

Question 3

Is dysponea a symptom or a sign?

Answer 3

• symptoms
• common to resp conditions but not specific e.g.
• anaemia, heart failure, obesity

Question 4

What do you want to know about the breathlessness?

Answer 4

• onset, timing, duration
• precipitating factors (position, weather, allergens)
• progression
• severity (stop you exercise/walking/stairs/speech)

Question 5

What are some differentials of chest pain? (resp problems)

Answer 5

Pleura

• infection
• pneumothorax
• PE

Chest Wall

• rib fracture
• costochondritis
• shingles

Mediastinal Structures

• ACS
• Pericarditis
• GORD
• Aortic dissection

Question 6

How would a patient describe pleuritic pain?

Answer 6

• sharp
• well-localised
• worse with coughing and breathing in
• referred pain to shoulder (intercostal and phrenic nerve)

Question 7

What do you want to know about a cough (what will you ask the patient)?

Answer 7

• dry
• sputum
• blood
• how much
• seal cough (croup)
• timing of cough

Question 8

What is the most common cause of cough?

Answer 8

URTI

Question 9

What patients will have clear sputum with a cough?

Answer 9

chronic bronchitis

COPD

Question 10

What patients will have yellow/green sputum?

Answer 10

infection (presence of neutrophils)

Question 11

What patients will have large volumes of yellow/gree sputum?

Answer 11

bronchiectasis

Question 12

What patients would have haemoptysis?

Answer 12

TB

-potential red flag for cancers

Question 13

Why does a cough occur?

Answer 13

irritation of air wards, lung parenchyma or pleura

Question 14

What are some non-respiratory causes of a cough?

Answer 14

LV heart failure
-GORD
Drugs

Question 15

What are wheezes and striders?

Answer 15

abnormal breath sounds indicating narrowing within the airway causing turbulent flow of air

Question 16

What does a wheeze sound like?

Answer 16

high pitched musical note on expiratiron

Question 17

Why does a wheeze occur?

Answer 17

narrowing in the intrathoracic airways e.g. bronchial smooth muscle contraction, oedema, mucous

Question 18

What does a stridor sound like?

Answer 18

high pitched constant loud sound on inspiration

Question 19

Why does stridor occur?

Answer 19

narrowing in the extra thoracic airway (supra/infra glottis or trachea)

Question 20

What are the 2 types of cyanosis and why do they occur?

Answer 20

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

Question 21

What are the respiratory causes of clubbing?

Answer 21

-due to chronic infmallamtion e.g bronchiectasis, CF, lung cancer

Question 22

Why would someone breath with pursed lips?

Answer 22

• 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)

Question 23

What is a barrel shaped chat?

Answer 23

• Increase AP diameter
• associated with hyper inflated lung in COPD
• air trapping

Question 24

What till push trachea to same side of issue?

Answer 24

pulmonary fibrosis

Question 25

What will push trachea away from issue?

Answer 25

PE (tension)

Question 26

What would hearing crackles suggest?

Answer 26

if fine, PF

if course, COPD, Bronchiectasis

Question 27

What are normal breath sounds called?

Answer 27

vesicular breath soudns

Question 28

What is stoney dull percussion common with?

Answer 28

pleural effusion