specific questions to ask in a resp history

Question 1

what ares should be asked to the resp system in a resp history

Answer 1

cough
sputum
SOB
wheeze
fever
night sweats

Question 2

Deeper questioning of breathlessness

Answer 2

how are you normally?
when did it come on and how long has it been going on
has it got worse
did it come on gradually/sudden
does vary during times of day
does anything make it worse - cold, allergies, lying down
anything make it better - rest etc
severity - is it at rest/exertion/ does it effect ADLs

Question 3

deeper questioning of cough

Answer 3

when did it come on
how long have you had it
did it come on suddenly or gradually
is this a change from normal
is it productive or unproductive
where do you feel it come from
does it change at night/when you lie down

Question 4

deeper questioning for sputum

Answer 4

when did it start
how long has it been going on for
is it all the time, does it get better/worse at certain points of day
what is the colour
what is the consistency
how much are you bringing up and how regularly
does it smell
any blood in the sputum

Question 5

deeper questioning for haemoptysis

Answer 5

was it coughed up as opposed to being sick
when did it start
how long has it been going on for
when does it occur
is it everytime you cough
how much blood is there
what is the colour - fresh/dark
what is the consistency - clots, liquid etc)
is there any sputum with it
do you have any chest pain
any recent trauma to chest or anywhere
and recent/past DVT
any recent weight loss/fever or night sweats
any breathlessness
and bleeding or bruising anywhere

Question 6

specific PMHx for resp history

Answer 6

and prev. pneumonia, tuberculosis, severe measles, whooping cough or asthma

any prev/ surgery specifically dental work or abdo/pelvic or ortho surgery

any angina/orthopnoea/paroxysmal nocturnal dyspnoea

Question 7

specific drug history for resp history

Answer 7

any inhalers, steroids, ACE-i, amiodarone, beta-blockers, NSAIDs, O2 therapy

are you up to date with current vaccines - flu, COVID, TB

Question 8

specific social history for resp history

Answer 8

occupation,
smoking - packs/year
pets
overseas travel
living conditions - damp
alcohol
exercise/ADL

Question 9

specific family history for resp history

Answer 9

any family you live with recently been ill
any history of allergies - asthma
anything called alpha-1 antitripsin deficiency