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Respiratory > Top of Disease Table - Hx > Flashcards

Top of Disease Table - Hx Flashcards

1
Q

What is important in the respiratory Hx

A 
Chest pain 
SOB - QUANTIFY
Cough
Exercise tolerance and how it changed 
Wheeze
Haemoptysis 
Recurrent infections 
Systemic Sx 
Sleep 
PMH 
- Resp support / pre-term at birth 
- Childhood illness 
DH and allergy
FH
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2
Q

What do you want to know about cough

A 
Productive
Colour and volume in cups
Any blood
Is it positional 
- Worse flat / early morning = GORD
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3
Q

What causes wheeze

A

Bronchial inflammation leading to constriction

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4
Q

What do you ask about sleep

A

Do you sleep through night
Do you wake up feeling SOB
Does your parter notice stop breathing

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5
Q

What in SH

A 
Occupation 
Exposure
Pets
Travel 
Smoking
Alcohol
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6
Q

What do you look for on inspection

A 
Sputum pot - look inside
O2 
Breathlessness
Pursed lip - severe emphysema
Cyanosis
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7
Q

What do you look for in hands

A

Red palms, flap, bounding pulse = CO2 retnetion
Tar staining NOT nicotine
Clubbing

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8
Q

What are other important aspect

A

Chest
JVP
LN - ALWAYS offer
Signs of RHF

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9
Q

What do you look in chest

A 
Hyperinflation
- Increased AP diameter
- Cricosternal 
- Use of accessory 
- Prolonged expiratory 
Signs of surgery or thoracoscopy
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10
Q

RHF

A

Raised JVP
Loud P2
RV heave
TR

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11
Q

What causes haemoptysis

A 
Lung cancer
Pulmonary oedema
TB
PE
LRTI
Bronchiectasis
Mitral stenosis 
Aspergilloma
Macroscopic polyangiitis
Good-pasture
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12
Q

Why does MS cause

A

Rupture of bronchial veins due to increase in LA pressure

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13
Q

How does it present

A

SOB
AF
Malar flush

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14
Q

What causes acute SOB

A 
Pulmonary oedema
MI
Pneumonia 
Endocarditis 
PE
Pneumothorax 
Arrythmia
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15
Q

What type of crackles in pulmonary oedema

A

Fine crackles

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16
Q

What type of crackles in fibrosis

A

Coarse crackles

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17
Q

What causes chronic SOB

A 
Heart failure
Asthma / COPD 
Aortic stenosis 
Lung cancer
Pulmonary fibrosis
Bronchiectasis
Anaemia
Obesity
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18
Q

How does HF present

A

Hx IHD / HTN
Orthopnoea and PND
Bibasal crackle
3rd HS

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19
Q

What causes cough

A 
URTI / LRTI 
TB
Drugs
Asthma / COPD 
Lung cancer
Reflux 
Oesophagtiis 
HF
Post-jnasal drip
A1-antitrypsin deficeincy
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20
Q

What drugs cause cough

A

ACEI

Ticagrelor

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21
Q

What is important to ask in lung ca

A

B symptoms

Hoarseness

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22
Q

What are red flags of cough suggesting TB / lymphoma / cancer

A

Fever / night sweat / weight loss
Haeomptysis
Dyspnoea

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23
Q

If chronic cough + sputum

A

COPD / bronchiectasis

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24
Q

What are bed sites test

A 
Sputum 
PEFR
Pulse oximetry 
ABG
Spirometry 
PFT
25
Q

What do you send sputum for

A

MC+S

PCR + ZN if infected

26
Q

What does colour

A

Clear = bronchitis
Yellow / green = infection
Red = blood
Black = smoke / coal

27
Q

When is PEFR useful

A

Asthma

28
Q

What gives you poor result in oximetry

A 
CO
Nail varnish
Skin colour 
Poor perfusion 
Moving
29
Q

If sats <92%

A

Do ABG

30
Q

What does spirometry measure

A

Lung volume

FEV1 and FVC

31
Q

What is obstructive pattern

A

FEV1 <80%
FVC NORMAL OR LOW
RATIO <70%
Can’t get air out fast but with prolonged expiration will get it all out

32
Q

What causes

A

Asthma
COPD
Bronchiectasis
CF

33
Q

What is restrictive pattern

A

FEV1 <80%
FVC <80%
Ratio >70%
Due to reduced lung volume and shallow breaths

34
Q

What causes restrictive

A 
Fibrosis
Interstitial pneumonia
Connective tissue 
Sarcoid
Pleural effusion
Neuromuscular 
Obesity
35
Q

What are PF

A

TLC
Residual volume
Gas transfer (KCO)

36
Q

What is TLC

A

Increased in obsruction

Reduced in restrictive due to reduced gas exchange

37
Q

What is KCO

A

Reduced in emphysema and interstitial lung

38
Q

What are radiological tests

A 
CXR
USS for drainage
X/Q
PET
CT
CTPA
Pulmonary angiography
39
Q

What is bronchoscopy

A

Tube via nose or mouth under LA to look through bronchioles

40
Q

When do you do

A

Suspect cancer
Pneumonia not resolving
Intersitial lung disease

41
Q

What can be done during

A

BAL and sent to lab

42
Q

When do you do BAL

A 
Malignancy
Pneumonia
Bronchiectasis 
Suspected TB with -ve sputum
ILD
43
Q

What is needed pre-procedure

A 
FBC
Coaulation
CXR
CT
Spiroemtrry
ABG
44
Q

What are complications

A

Hypoxia
Bleeding
Pneumothorax

45
Q

How do you do lung biopsy

A

Percutaneous
Transbronchial at bronchoscopy
Open

46
Q

When do you do mediastinoscopy/ / thoracoscopy

A

Pleural lesion
Drain effusion
Pleurodesis
Require GA

47
Q

What causes clubbing

A 
CLUBBING 
Cyanotic HD
Lung disease
UC and Chrons
Birth defect - congenital
Biliary cirrhoiss
IE
Neoplasia
GI malabsorption (coeliac)
48
Q

What are the lung disease causes

A 
ABCDEF
Abscess
Bronchiectasis
CF
DONT say COPD 
Empyema
Fibrosis
49
Q

Ix SOB

A 
A-E
Hx + exam 
- Quantify SOB - worse in morn / even / position 
CXR
ECG
ABG or VBG
Bloods
\+- CT
50
Q

ABG or VBG

A

ABG if severe hypoxic/ suspecting type II

51
Q

Resp causes SOB

A 
Obstruction
Anaphylaxis
PE
Pneumothorax
COPD / asthma
Pneumonia
Pleural effusion
Neoplasm
Fibrosis
52
Q

Cardiac

A 
ACS
Oedema
Arrythmia
Tamponade
Myocarditis
Cardiomyopathy
53
Q

Infectious

A

Pneumonia

Epiglottitis

54
Q

Traumati

A 
Pneumothorax
Haemothorx
Tamponade
Flail chest
Rib fracture
55
Q

Abdominal

A

Ascites
Obesity
Pregnancy

56
Q

Psychogenic

A

Panic attack

57
Q

Metabolic

A

Acidosis
POisoning
Renal failure

58
Q

Haematological

A

CO poison

Anaemia

59
Q

Neuromuscular

A

CVA

GBS

Respiratory (23 decks)

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