Clinical Features of Respiratory diseases Flashcards

1
Q

What are the main defining clinical features for asthma?

A

Wheeze
Cough
Dyspnoea

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2
Q

What other causes of wheezing illness (other than asthma) are there?

A

COPD
Bronchiectasis
Bronchiolitis
Cystic Fibrosis

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3
Q

What are the essential investigations to do when diagnosing asthma?

A
Spirometry 
Full pulmonary function testing (To exclude COPD/ emphysema)
Reversibility with bronchodilator/oral corticosteroid
Peak flow (If spirometry is normal)
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4
Q

What other investigations can be useful in asthma? (Non-essential)

A

Chest X-ray (Will show hyper inflation)

Skin prick testing (Identifies allergens)

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5
Q

What 5 things do you look for to assess the severity of the asthma?

A
Ability to speak
HR
RR
PEFR
Oxygen sats/ABGs
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6
Q

What are the main symptoms for someone presenting with COPD?

A

Cough
Sputum
Dyspnoea
Wheeze

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7
Q

What are some of the signs for someone with COPD?

A
Tachypnoea
Use of respiratory  accessory muscles 
Hyperinflation (Barrel chest)
Quiet breath sounds
Flapping tremor
Cyanosis
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8
Q

What are the essential investigations in a COPD patient?

A

Spirometry
Full Pulmonary function testing (Increase in RV and TLC)
Reversibility to bronchodilator? (should be none)

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9
Q

What are some useful investigations for a COPD patient? (Non-essential)

A

CXR (hyperinflation + flat hemidiaphragms)
ECG: (RA + RV hypertrophy)
ABGs (Decreased PaO2 and potentially hypercapnia)

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10
Q

What are the signs of an acute exacerbation of COPD?

A
Increased cough with sputum
Increased dyspnoea
Increased wheeze
Increased oedema
Inability to sleep
Confusion
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11
Q

What are the general treatments for someone with COPD?

A

Smoking cessation
Improved nutrition
Treat obesity

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12
Q

What is the treatment for someone with severe COPD?

A

Combination of long-acting B2 agonist and corticosteroids (budesonide and formeterol)

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13
Q

What are the main clinical features of pneumonia?

A
Malaise
Fever
Pleuritic chest pain
Cough with purulent or rusty sputum
Dyspnoea
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14
Q

What are the main signs of pneumonia?

A
Pyrexia
Tachypnoea
Central cyanosis
Dullness on percussion of the affected lobes
Bronchial breath sounds
Increased vocal resonance
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15
Q

What are the investigations that should be done if pneumonia is suspected?

A

Serum biochemistry and Full blood count
Chest X-ray
Blood culture and throat swab
Sputum microscopy and culture

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16
Q

What are the main symptoms of Bronchiectasis?

A

Chronic cough
Daily sputum production
Occasional wheeze, dyspnoea and tiredness

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17
Q

What are the main signs in bronchiectasis?

A

Finger clubbing

Coarse crepitations

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18
Q

What investigations should be done if bronchiectasis is suspected?

A

CT thorax
Sputum culture
CF genotyping
Serum immunoglobulins

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19
Q

What may an empyema resemble on a chest x-ray?

A

Pleural effusion

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20
Q

What are the general common symptoms of URTIs?

A
Nasal congestion
Runny nose
Nasal breathing
Sneezing
Sore throat
Painful swallowing
Cough
Fever
Malaise
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21
Q

What are the main symptoms of the common cold?

A

Tickling nose
Sneezing
Clear nasal discharge

22
Q

What are the main causative organisms for tonsilitis?

A

Strep. Pyogenes
Adenovirus
EBV (If glandular fever)

23
Q

What are the main clinical features for epiglottitis?

A

Sudden onset of sore throat - painful swallowing
Dry cough
Muffled voice
Fever/ drooling

24
Q

What are the clinical features of glandular fever?

A
Sore throat
Cervical lymphadenopathy
Fever
Hepatitis
Fine red skin rash
25
Q

If tonsilitis is suspected, what two main investigations would you carry out?

A

Throat swab

Blood film

26
Q

What are the investigations recommended if pulmonary embolism is suspected?

A
ABGs ( May show hypoxia and hypocapnia)
D-dimer (negative result excludes PE)
ECG
CXR
FBCs, U+Es
V/Q scan - V/Q mismatch can be very useful
27
Q

What are the investigations recommended for Deep vein thrombosis?

A

D-dimer (helpful if -ve)
Ultrasound (Ifd-dimer +ve)
Venogram

28
Q

What are the symptoms of Pulmonary embolism?

A

Breathlessness
Pleuritic Chest pain
Cough
Haemoptysis

29
Q

What are the major signs of Pulmonary hypertension?

A
Cyanosis
Tachypnoea
Tachycardia
Raised JVP
Pleural Rub/effusion
30
Q

What are the main clinical features of a DVT?

A
Leg swelling
Redness
Tenderness
Oedema
Tight calves
Mild fever
31
Q

What are the symptoms of pulmonary hypertension?

A
Dyspnoea
Fatigue
Weakness
Angina
Syncope
Chest tightness
32
Q

What are the main signs of pulmonary hypertension?

A

RV heave
Ejection systolic murmur
Peripheral oedema
Hepatomegaly

33
Q

What are the main investigations to do when PHT is suspected?

A
CXR
ECG
Pulmonary Function test
V/Q scan
Echo
High resolution CT
34
Q

What are the signs of bronchitis?

A

Wheeze
Increased RR
Hyperinflation

35
Q

What are the main symptoms of bronchitis?

A

Breathlessness
Cough
Sputum

36
Q

What are the main signs of lung cancer?

A
Lymphadenopathy
Weight Loss
Hoarse voice
Eyelid drop
Clubbing
Pleural effusion
37
Q

What are the main symptoms of lung cancer?

A
Shoulder pain 
Cough
Haemoptysis
SOB
Malaise
38
Q

Which investigations would be done if lung cancer is suspected?

A
CXR
Biopsy
Sputum
Cytology
Bronchoscopy
Fine needle aspiration
CT/ MRI/ PET
39
Q

What g/l would a transudate be?

A
40
Q

What are the main signs of a pleural effusion?

A

Decreased Chest expansion
Bronchial breath sounds
Increased JVP
Deviated trachea (Large effusion)

41
Q

What are the main symptoms of a pleural effusion?

A

SOB (Increasing)
Pleuritic chest pain
Dry cough

42
Q

What are the main signs of a pneumothorax?

A

Decreased Chest expansion
Absent breath sounds
Deviated trachea

43
Q

What are the main signs of sarcoidosis?

A

Lymphadenopathy
Spleen affected
Abnormal CXR

44
Q

What are the main symptoms of Sarcoidosis?

A

SOB
Cough
Erythema nodosum (red lumps on skin)

45
Q

What are the main signs of hypersensitive pneumonitis?

A

Crackles
Wheeze
Increased Resp rate

46
Q

What are the main symptoms of Hypersensitive pneumonitis?

A
Fever
Dry cough
Chills 
Malaise
SOB
47
Q

What are the main signs of tuberculosis?

A
Erythema nodosum 
Night sweats
Pleural effusion
Cough
Mucus in sputum
Haemoptysis
48
Q

What are the main signs of cystic fibrosis?

A
Cyanosis
Finger clubbing
Pancreatic insufficiency
Failure to thrive 
Offensive stools
Recurrent chest infections
Lung abscess
49
Q

What are the main symptoms of cystic fibrosis?

A
Male infertility (95%)
Nasal polyps
50
Q

What are the main signs of sleep apnoea?

A

Snoring
Unrefreshing sleep
Daytime solemnence
Decreased levels of concentration