Symptoms in Respiratory Medicine (Week 1) Flashcards
What is a presenting complaint?
What the patient tells you is wrong with them, e.g Sudden onset chest pain Breathlessness on exertion Haemoptysis for 3 weeks 12 hours of abdominal pain
Is pneumonia a presenting complaint?
No. Pneumonia would PROMPT a presenting complaint of
Productive/unproductive cough
Fever
Pleuritic chest pain…
What mnemonic is useful for getting a history of a presenting complaint?
SOCRATES
Give two important characteristics of PLEURITIC chest pain.
- Sharp
2. Worse on INSPIRATION
Why is respiratory chest pain associated with the pleura rather than the lungs themselves?
The lungs have no pain receptors
What is a symptom?
Something the patient experiences, found by taking a history
What is a sign?
A physical variation from the norm, found by examining the patient
Is breathlessness a symptom or a sign?
Symptom
As breathlessness is a very subjective symptom, it is important to establish what is ____ for the patient.
normal
Name a cause of acute breathlessness.
- Pulmonary embolism
- Pneumothorax
- Pulmonary oedema (commonly triggered by heart failure)
Name a cause of subacute breathlessness.
- Pneumonia
- Pulmonary oedema
- Pleural effusion
- Asthma
- COPD
Name a cause of chronic breathlessness.
- COPD
- Pulmonary fibrosis
- Pulmonary embolism (less severe / accumulation of smaller ones)
Name the three major categories of cough.
- Dry cough
- Productive cough
- Haemoptysis
An acute, dry cough is almost always caused by a ____.
virus
Name a “sinister” cause of a chronic dry cough.
- Lung cancer
- Mesothelioma
- Pulmonary metastases
- Pulmonary fibrosis
- Sarcoidosis
- Hypersensitivity pneumonitis
What is the name given to the substance brought up by a productive cough?
Sputum
Name a couple of components of sputum.
- Neutrophils
- Eosinophils
- Bacteria/fungi/viruses
- Airway secretions
What is haemoptysis?
Coughing up blood
What is the definition of a massive haemoptysis?
> 500ml in 24 hours
What is the definition of a non-massive haemoptysis?
<500ml in 24 hours
Name the “Big Four” causes of haemoptysis.
- Infection
- Carcinoma
- Pulmonary embolism
- Bronchiectasis
Apart from your major “red flag” signs/symptoms, what should you ask about when taking a history?
-Unexplained weight loss
-Fevers/sweats
(so far, more will crop up as you do each system).
In a patient’s past medical history (PMX), what should be asked about (respiratory context)?
Childhood infection
Pulmonary embolism
Tuberculosis
In the family history (FX), what should be asked about (respiratory context)?
Atopy
COPD
In the social history (SX), what should be asked about (respiratory context)?
- Occupation/hobbies (asbestos exposure, coal mining, farming, PETS!!!!)
- Smoking
- Other drugs
- Foreign travel
Where should you look for a good clerking layout?
THIS LECTURE
