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Clinical Features of Respiratory diseases Flashcards

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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?

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A

Tickling nose
Sneezing
Clear nasal discharge

22
Q

What are the main causative organisms for tonsilitis?

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A

Strep. Pyogenes
Adenovirus
EBV (If glandular fever)

23
Q

What are the main clinical features for epiglottitis?

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A

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

24
Q

What are the clinical features of glandular fever?

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A 
Sore throat
Cervical lymphadenopathy
Fever
Hepatitis
Fine red skin rash
25
If tonsilitis is suspected, what two main investigations would you carry out?
Throat swab | Blood film
26
What are the investigations recommended if pulmonary embolism is suspected?
``` 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
What are the investigations recommended for Deep vein thrombosis?
D-dimer (helpful if -ve) Ultrasound (Ifd-dimer +ve) Venogram
28
What are the symptoms of Pulmonary embolism?
Breathlessness Pleuritic Chest pain Cough Haemoptysis
29
What are the major signs of Pulmonary hypertension?
``` Cyanosis Tachypnoea Tachycardia Raised JVP Pleural Rub/effusion ```
30
What are the main clinical features of a DVT?
``` Leg swelling Redness Tenderness Oedema Tight calves Mild fever ```
31
What are the symptoms of pulmonary hypertension?
``` Dyspnoea Fatigue Weakness Angina Syncope Chest tightness ```
32
What are the main signs of pulmonary hypertension?
RV heave Ejection systolic murmur Peripheral oedema Hepatomegaly
33
What are the main investigations to do when PHT is suspected?
``` CXR ECG Pulmonary Function test V/Q scan Echo High resolution CT ```
34
What are the signs of bronchitis?
Wheeze Increased RR Hyperinflation
35
What are the main symptoms of bronchitis?
Breathlessness Cough Sputum
36
What are the main signs of lung cancer?
``` Lymphadenopathy Weight Loss Hoarse voice Eyelid drop Clubbing Pleural effusion ```
37
What are the main symptoms of lung cancer?
``` Shoulder pain Cough Haemoptysis SOB Malaise ```
38
Which investigations would be done if lung cancer is suspected?
``` CXR Biopsy Sputum Cytology Bronchoscopy Fine needle aspiration CT/ MRI/ PET ```
39
What g/l would a transudate be?
40
What are the main signs of a pleural effusion?
Decreased Chest expansion Bronchial breath sounds Increased JVP Deviated trachea (Large effusion)
41
What are the main symptoms of a pleural effusion?
SOB (Increasing) Pleuritic chest pain Dry cough
42
What are the main signs of a pneumothorax?
Decreased Chest expansion Absent breath sounds Deviated trachea
43
What are the main signs of sarcoidosis?
Lymphadenopathy Spleen affected Abnormal CXR
44
What are the main symptoms of Sarcoidosis?
SOB Cough Erythema nodosum (red lumps on skin)
45
What are the main signs of hypersensitive pneumonitis?
Crackles Wheeze Increased Resp rate
46
What are the main symptoms of Hypersensitive pneumonitis?
``` Fever Dry cough Chills Malaise SOB ```
47
What are the main signs of tuberculosis?
``` Erythema nodosum Night sweats Pleural effusion Cough Mucus in sputum Haemoptysis ```
48
What are the main signs of cystic fibrosis?
``` Cyanosis Finger clubbing Pancreatic insufficiency Failure to thrive Offensive stools Recurrent chest infections Lung abscess ```
49
What are the main symptoms of cystic fibrosis?
``` Male infertility (95%) Nasal polyps ```
50
What are the main signs of sleep apnoea?
Snoring Unrefreshing sleep Daytime solemnence Decreased levels of concentration

Respiratory Block (21 decks)

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