Symptoms and signs of respiratory disease

Question 1

List some common resp symptoms

Answer 1

SOB
Cough
Sputum
Hemoptysis
Wheeze
Chest pain

Question 2

Ex time-course of symptoms: COPD

Answer 2

Gradually gets worse, with episodes of exacerbation from which they may recover

Question 3

Voice alteration due to

Answer 3

Infiltration of recurrent laryngeal nerve in lung cancer

Question 4

Other relevant respiratory symptoms =

Answer 4

Peripheral oedema
Nocturnal dyspnoea
Swelling of face and arms
Nasal obstruction/secretions/sneezing
Voice alteration
Night sweats
Fever, chills
Weight loss, anorexia

Question 5

What can cause swelling of face and arms

Answer 5

Vena cava blocked by lung tumour

Question 6

Breathlessness =

Answer 6

Dyspnoea

Question 7

Increased respiratory rate =

Answer 7

Tachypnea

Question 8

Hypoxemia =

Answer 8

Low blood O2

Question 9

Breathlessness is often not associated with =

Answer 9

Tachypnea, hypoxemia

Question 10

What therapy doesn’t always work for SOB

Answer 10

O2

Question 11

Dyspnoea often related to:

Answer 11

• Work of breathing
• Resp muscle weakness
• Increased ventilation

Question 12

What causes increased ventilation?

Answer 12

Dead space

Metabolic acidosis

Question 13

Dead space =

Answer 13

Volume of air which is inhaled that does not take part in gas exchange

Question 14

Anatomical dead space =

Answer 14

Remains in the conducting airways

Question 15

Physiological dead space =

Answer 15

Alveoli poorly perfused

Question 16

Ex of causes of breathlessness (minutes)

Answer 16

PE
Pulmonary oedema
Pneumothorax
Anaphylaxis
Foreign body inhalation

Question 17

Ex of causes of breathlessness (hrs)

Answer 17

Pneumonia
Acute asthma
Pulmonary oedema

Question 18

Ex of causes of breathlessness (weeks)

Answer 18

Cancer
Anemia
Pleural effusion
Heart failure

Question 19

Ex of causes of breathlessness (months-years)

Answer 19

COPD
Interstitial lung disease
Pneumoconiosis
Pulmonary hypertension

Question 20

Pneumoconiosis is an

Answer 20

occupational lung disease

Question 21

Ex of interstitial lung disease

Answer 21

Pulmonary fibrosis

Question 22

Cough is mediated by what?

Answer 22

Vagus nerve

Question 23

Causes of cough:

Answer 23

• Infection
• Lung cancer
• Foreign body inhalation
• Pulmonary fibrosis
• Asthma
• ACE inhibitor

Question 24

Why do ACHi cause cough?

Answer 24

Break down bradykinin - cough and swelling.

Question 25

Ex of sputum colours

Answer 25

Mucoid Purulent Haemoptysis

Question 26

What is mucoid sputum a sign of

Answer 26

Viral infection, allergy

Question 27

What is purulent sputum a sign of

Answer 27

Bacteria | Asthma

Question 28

What causes the yellow colour of sputum?

Answer 28

Myeloperoxidases from neutrophils/eosinophils

Question 29

What may cause a large volume of sputum?

Answer 29

Bronchiectasis

Question 30

Bronchiectasis =

Answer 30

Abnormal dilation of airways, mucus build-up, increased infection risk

Question 31

What may cause a putrid taste to sputum

Answer 31

Anerobic bacteria

Question 32

How might anerobes survive in lung?

Answer 32

Abscesses

Question 33

Causes of haemoptysis =

Answer 33

``` Lung cancer TB Bronchiectasis Pulmonary oedema Pulmonary embolism Pneumonia ```

Question 34

Haemoptysis in pulmonary oedema is

Answer 34

Pink and frothy

Question 35

Haemoptysis in pneumonia

Answer 35

Rust coloured (mixing of blood and myeloperoxidases green)

Question 36

Wheeze =

Answer 36

Musical noise produced by air moving through narrowed airways

Question 37

Wheeze is heard on

Answer 37

Expiration

Question 38

Similar to wheeze, heard on inspiration

Answer 38

Stridor

Question 39

Causes of wheeze =

Answer 39

COPD Asthma Large airway obstruction: tumour, foreign body

Question 40

Causes of stridor =

Answer 40

epiglottis, forign body, trachea, larynx

Question 41

In asthma airways can be obstructed by:

Answer 41

``` Eosinophils Mucus plug Smooth muscle hypertrophy Goblet cell hyperplasia Basement membrane thickening ```

Question 42

What are there non of in the lung?

Answer 42

Nociceptors

Question 43

Where does pleuritic chest pain come from?

Answer 43

Parietal pleura - highly innervated

Question 44

Pleuritic chest pain feeling =

Answer 44

Sharp, stabbing, worse on inspiration, localised

Question 45

Causes of pleuritic chest pain =

Answer 45

Pneumonia Pulmonary embolism Pneumothorax

Question 46

DD of chest pain =

Answer 46

- Upper retrosternal - trachitis - Mediastinal tumor - MSK - Rib - Spinal root - Shingles

Question 47

Msk pain

Answer 47

Associated with trauma | Worse on inspiration

Question 48

Shingles =

Answer 48

Distributed in a dermatome

Question 49

Causes of trachea pushed away =

Answer 49

pleural effusion | pneumothorax

Question 50

Causes of trachea towards =

Answer 50

Collapse | Fibrosis

Question 51

Normal measure of cricosternal distance =

Answer 51

3-4 fingers

Question 52

Normal percussion is

Answer 52

Resonant

Question 53

Causes of dull percussion =

Answer 53

Consolidation Collapse Dense fibrosis

Question 54

Causes of stony dull percussion =

Answer 54

Pleural effusion

Question 55

Causes of hyperresonant percussion =

Answer 55

Pneumothorax

Question 56

Normal breath sound =

Answer 56

Vesicular

Question 57

What causes diminished but vesicular breathing =

Answer 57

Pneumothorax Collapse Effusion

Question 58

What causes absent breath sounds

Answer 58

Effusion | Pneumothorax

Question 59

What causes bronchial breathing

Answer 59

Consolidation

Question 60

Crackles are usually heard on

Answer 60

Inspiration

Question 61

Pathology of crackles =

Answer 61

Explosive opening of multiple occluded small airways

Question 62

What might a crackle due to larger airway secretions do

Answer 62

Clear with cough

Question 63

Causes of coarse crackles =

Answer 63

Pneumonia | Bronchiectasis

Question 64

Causes of fine crackles =

Answer 64

Pulmonary oedema | Pulmonary fibrosis

Question 65

Crackles in pulmonary fibrosis =

Answer 65

Fine end-inspiratory crackles

Question 66

Pleural rub =

Answer 66

Creaking sound made by inflammed pleural membranes

Question 67

Vocal resonance is increased in

Answer 67

Consolidation

Question 68

Whispering pectoriloquy =

Answer 68

Whispers sound clear over consolidation

Question 69

Causes of reduced vocal resonance =

Answer 69

Pleural effusion Pneumothorax Collapse