General signs + symptoms

Question 1

Ax chest pain?

Answer 1

Heart (referred)
Parietal pleura
Bones
Muscle
Skin
GI tract

Lungs are asensate except for pleura

Question 2

Cardiac pain features?

Answer 2

Central, crushing, heavy, tight
Left-sided
Can be epigastric
Often radiates –> left arm, neck, jaw/teeth

Question 3

Pleuritic pain features?

Answer 3

Sharp
Worse on inspiration
Easily locatable

Question 4

Lung pain?

Answer 4

No pain receptors but do contain J receptors = cough

Question 5

GI chest pain causes?

Answer 5

Oesophageal spasm
Trapped wind
Reflux oesophagi’s

Question 6

MSK chest pain features?

Answer 6

Usually worse on movement
Recent trauma
Reproducible

Question 7

Cardiac, respiratory, GI and muscular chest pain features?

Answer 7

Cardiac = tight
Respiratory = hurts to breathe
GI = on fire
Muscular = hurts to touch

Question 8

Causes of breathlessness?

Answer 8

Acute
PE, pneumothorax, pulmonary oedema

Subacute
Pneumonia, pulmonary oedema, pleural effusion, asthma/COPD

Chronic
COPD, pulmonary fibrosis, PE

Question 9

Cough <8 weeks?

Answer 9

Cough <8 weeks = almost always viral

Question 10

Sinister causes of cough?

Other non-viral causes of cough?

Answer 10

lung cancer, mesothelioma, pulmonary metastases

Other non-viral causes of cough = pulmonary fibrosis, sarcoidosis, pneumonitis (EAA)

Question 11

Sputum contains?

Answer 11

Sputum contains neutrophils, eosinophils, bacteria/fungus/virus

Question 12

Haemoptysis class?

Causes?

Answer 12

Massive = >500ml in 24 hours
Non-massive = <500ml in 24 hours

Big 4 = infection, carcinoma, PE, bronchiectasis
Others = cardiac, AVM, anticoagulation

Question 13

Drug history for resp?

Answer 13

ILD = nitrofurantoin, methotrexate, amiodarone, ACEI, bleomycin

Airways = B-blockers, contrast media, penicillamine

Vascular = phenytoin (PE), dexfenfluramine

Question 14

Social history for resp?

Answer 14

Asbestos
Coal mining
Farming
Pigeons/birds
Tobacco, cannabis
Foreign travel
Pets