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
