Brethlessness Flashcards
(20 cards)
• Is the wheeze worse during or after exercise?
If it occurs during exercise and limits it, this suggests COPD; in asthma, wheeze and tightness usually appear after exercise
Do you wake with wheeze during the night?
Asthma
Do you have hay fever or other allergies?
Is it (wheezing) worse on waking in the morning and relieved by clearing sputum?
COPD
Do you smoke?
Smoking is suggestive of COPD, though patients with asthma occasionally smoke.
Are there daily volumes of yellow or green sputum, sometimes with blood?
This suggests possible bronchiectasis.
Affects children and some adults
Often present at night
Associated wheeze, atopy
Asthma – ‘cough-variant asthma’
History of smoking and intermittent sputum
Chronic obstructive pulmonary disease
Recent acute-onset cough and sputum
Persisting airway reactivity following acute bronchitis
Daily purulent sputum for long periods
Pneumonia or whooping cough in childhood
Recurrent haemoptysis
Bronchiectasis
Persistent cough, especially in smokers
Any haemoptysis
Pneumonia that fails to clear in 4–6 weeks
Lung cancer
Chronic sneezing, nasal blockage/discharge
Rhinitis with postnasal drip
Heartburn or regurgitation of acid after eating, bending or lying
Nocturnal as well as daytime cough
Heartburn or regurgitation of acid after eating, bending or lying
Nocturnal as well as daytime cough
Patient on angiotensin-converting enzyme inhibitors
Drug effects
Persistent dry cough
Fine inspiratory crackles at bases
Interstitial lung diseases
Long history with no signs and negative investigations – diagnosis of exclusion
Idiopathic cough
Clear (mucoid)
COPD/bronchiectasis without current infection/rhinitis.
Yellow (mucopurulent)
acute lower respiratory tract infection/asthma.
Green (purulent)
current infection – acute disease or exacerbation of chronic disease, such as COPD
Red/brown (rusty)
pneumococcal pneumonia ( Fig. 5.3B ). Try to distinguish between rusty and frank red blood
