Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Block 3 - Resp > Lecture 9 - Respiratory Symptoms And Signs > Flashcards

Lecture 9 - Respiratory Symptoms And Signs Flashcards

(63 cards)

Start Studying
1
Q

Respiratory symptoms

A
  • dyspnoea
  • cough
  • haemoptysis
  • Chest pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Respiratory signs

A
  • Clubbing
  • Percussion
  • Auscultation
  • Vocal resonance and Fremitus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Symptom definition

A
  • any sensation or change in bodily function experienced by a patient that is associated with a particular disease
  • subjective sensation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sign Definition

A
  • evidence of disease pereceptible to the examining physician
  • objective observations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Differentiatl diagnosis

A
  • a list of two or more conditions which may share clinical symptoms or signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The diagnostic method:

A
  • 1) list a set of all possibilities of diagnosis
    2) Reorder these based on probability, incorporating your history and exam findings
    3) Test these differential diagnoses with further enquiry or investigations
    4) Re-evaluate your list of differentials
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Creating a differential diagnosis list - by types of pathology : I VINDICATE AIDS

A
  • Idiopathic
  • Vascular: Pulmonaru Embolus
  • infectious: Pneumonia
  • neoplastic: Lung Cancer
  • degenerative: COPD
  • inflammatory: Pleurisy
  • Congenital: Cyanotic heart disease
  • Autoimmune: Vasculitis
  • Traumatic: Pneumothorax
  • Endocrine and metabolic: Acidosis
  • Allergic: Asthma
  • Iatrogenic
  • Drugs: Methotrexate
  • Social: Anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Creating a differential diagnosis list - by systems review

A
  • Neurological: Neuromuscular disease
  • Endocrine/ Metabolic: Acidosis
  • Cardiovascular: AMI, APO, Valvular
  • Respiratory: a lot
  • Hematological: Anemia, Coagulopathy
  • Gastrointestinal: Reflux
  • Genitourinary: None
  • Reproductive: None
  • Musculoskeletal: Deconditioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Creating and prioritising a differential diagnosis list - by time course

A
  • suddon onset: Pulmonary embolism
  • Rapid onset - Asthma
  • Acute onset - Pneumonia
  • Sub-acute onset: TB
  • Chronic : neuromuscular disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Creating and prioritising a differential diagnosis list - as per John Murtagh

A

1) The probability diagnosis
2) The serious disorders not to be missed
3) The conditions which are often missed
4) The seven masquerade: Depression, diabetes, drugs, anemia, thyroid, spinal, UTI
5) Is the patient trying to tell me something: interpersonal conflicts, financial, drugs, fears, family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dyspnoea

A
  • subjective awareness of discomfort related to breathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dyspnoea - DDx: Sudden

A
  • Pneumothorax
  • pulmonary embolism
  • Myocardial infarct
  • Arrythmias
  • Aspiration
  • Anaphylaxis
  • Anxiety/psychogenic
  • Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dyspnoea - DDx - Acute

A
  • Asthma
  • pneumonia
  • pulmonary oedema
  • respiratory tract infection
  • lung tumour
  • Pleural effusion
  • Metabolic acidosis
  • Renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dyspnoae - DDx - Chronic

A
  • COPD
  • heart failure
  • arrhythmia
  • anemia
  • bronchiectasis
  • cystic fibrosis
  • Pulmonary hypertension
  • Pulmonary fibrosis
  • Neuromuscular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Variations of dyspnoea

A
  • Tachypnoea - rapid breathing
  • Hyperpnoea - increased volume breathing
  • Orthopneoa - Dyspnoea when lying supine
  • Paroxysmal noctunarl dyspnoae - waking with dyspnoae in the middle of the night (often associated with heart failure)
  • Platypnoea - Dyspnoea when sitting erect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mechanism of dyspnoea can be divided into

A
  • increased central respiratory drive
  • increase respiratory load
  • lung irritation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Dyspnoea - mechanisms

A
  • afferent signal: Mechanoreceptors/chemoreceptors/ lung receptors
  • Efferent smuscle fibres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Assessing/Measuring dyspnoea

A
  • MMRC

- Modified Borg scale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Cough receptors

A

1) lung receptors: Type 1 receptors
- rapidly adapting (myelinated)
- found in airway epithelium
- stimulated by exogenous and endogenous substances
- cough
2) Larynx and Carina - Very sensitive to foreign bodies/vapors
3) Terminal bronchiole and alveoli - sensitive to chemical stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cough DDx - Acute

A
  • inhaled foreign body
  • aspiration
  • Respiratory infection
  • inhaled irritiants
  • Left ventricular failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  • Cough DDx- Chronic
A
  • COPD
  • Bronchiectasis/CF
  • Pulmonary Oedema
  • Tuberculosis
  • Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cough - DDx - Chronic, non productive

A
  • Asthma
  • Post nasal drip
  • Gastro-oesophagal reflux
  • Drugs
  • Lung Cancer
  • Pulmonary Fibrosis
  • TB
  • whooping cough (pertussis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cough types

A
  • Barking
  • Honking
  • Paroxysmal
  • Stacatto
  • Wet cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sputum

A
  • Fairly non-specific sign
  • Sputum is mucous secretion from glands in the tracheobronchial tree: any irrititant increases sputum production
  • green colour more likely to be bacterial infection
  • change in colour or volume usually indicates infection, particularly in COPD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Sputum investigations
- Examine appearance and odour - Microscopy, Gram stain and culture - Cytology: Makignancy, cell count
26
Hemoptysis
- coughing up blood or blood stained sputum 1) Volume and type - blood flecks in sputum - blood stained/streaked sputum - old clots vs Fresh - Frank Hemoptysis
27
Chest pain
- relatively non-specific and carries a long differential diagnosis list - pleuritic chet pain: pain on inspiration/breathing. More specific for respiratory problems
28
4 steps to a resp exam
- inspect - palpate - percuss - auscultate
29
Clubbing
- characteristic bulging of the distal finger and nail bed Develops in 5 stages
30
Dyspnoea - DDx: Sudden
- Pneumothorax - pulmonary embolism - Myocardial infarct - Arrythmias - Aspiration - Anaphylaxis - Anxiety/psychogenic - Trauma
31
Dyspnoea - DDx - Acute
- Asthma - pneumonia - pulmonary oedema - respiratory tract infection - lung tumour - Pleural effusion - Metabolic acidosis - Renal failure
32
Dyspnoae - DDx - Chronic
- COPD - heart failure - arrhythmia - anemia - bronchiectasis - cystic fibrosis - Pulmonary hypertension - Pulmonary fibrosis - Neuromuscular
33
Variations of dyspnoea
- Tachypnoea - rapid breathing - Hyperpnoea - increased volume breathing - Orthopneoa - Dyspnoea when lying supine - Paroxysmal noctunarl dyspnoae - waking with dyspnoae in the middle of the night (often associated with heart failure) - Platypnoea - Dyspnoea when sitting erect
34
Mechanism of dyspnoea can be divided into
- increased central respiratory drive - increase respiratory load - lung irritation
35
Dyspnoea - mechanisms
- afferent signal: Mechanoreceptors/chemoreceptors/ lung receptors - Efferent smuscle fibres
36
Assessing/Measuring dyspnoea
- MMRC | - Modified Borg scale
37
Cough receptors
1) lung receptors: Type 1 receptors - rapidly adapting (myelinated) - found in airway epithelium - stimulated by exogenous and endogenous substances - cough 2) Larynx and Carina - Very sensitive to foreign bodies/vapors 3) Terminal bronchiole and alveoli - sensitive to chemical stimuli
38
Cough DDx - Acute
- inhaled foreign body - aspiration - Respiratory infection - inhaled irritiants - Left ventricular failure
39
- Cough DDx- Chronic
- COPD - Bronchiectasis/CF - Pulmonary Oedema - Tuberculosis - Smoking
40
Cough - DDx - Chronic, non productive
- Asthma - Post nasal drip - Gastro-oesophagal reflux - Drugs - Lung Cancer - Pulmonary Fibrosis - TB - whooping cough (pertussis)
41
Cough types
- Barking - Honking - Paroxysmal - Stacatto - Wet cough
42
Sputum
- Fairly non-specific sign - Sputum is mucous secretion from glands in the tracheobronchial tree: any irrititant increases sputum production - green colour more likely to be bacterial infection - change in colour or volume usually indicates infection, particularly in COPD
43
Sputum investigations
- Examine appearance and odour - Microscopy, Gram stain and culture - Cytology: Makignancy, cell count
44
Hemoptysis
- coughing up blood or blood stained sputum 1) Volume and type - blood flecks in sputum - blood stained/streaked sputum - old clots vs Fresh - Frank Hemoptysis
45
Chest pain
- relatively non-specific and carries a long differential diagnosis list - pleuritic chet pain: pain on inspiration/breathing. More specific for respiratory problems
46
4 steps to a resp exam
- inspect - palpate - percuss - auscultate
47
Clubbing
- characteristic bulging of the nail bed May develop in 5 stages 1) Softening of the nail bed 2) Loss of the normal
48
Clubbing mechanism
- not very understood - Normal pulmonary circulation disruption -> megakaryocyte not broken into fragments -> deposition in circulation of extremities -> platelet growth factors released -> proliferation of muscle cells and fibroblasts -> clubbing
49
Clubbing DDx
- Respiratory: suppuratie lung disease, idiopathic pulmonary fibrosis - Malignancy: Lung cancer, lymphoma - CardiacL congenital cyanotic heart disease, infective endocarditis - Gastrointestinal: Liver cirrhosis, inflammatory bowel disease COPD alone is not a cause of clubbing - think lung cancewr
50
Percussion notes
- air : hyperresonant - Infiltrate: Dull, Percussion, note - normal lung: resonant (normal) - effusion: stony dull
51
How sound travels
- Air: 343 m/s - Water: 1484m/s - Normal lung parenchyma: 70m/s - sound generally does not like interfaces
52
Adventitious sounds
- Wheeze - Crackles - Stridor - Rubs
53
Crackles
- inspiratory - non-continuous, popping sounds - caused by opening of obstructed airways - course crackles: wet - low pitched: sound made by fluid secretion in airway (Pneumonia, COPD, Pulmonary oedema, IPF) - Fine crackles: dry, velcro-like sounds. Sounds made by stiff alveoli popping open (DDx: pulmonary fibrosis, radiation pneumonitis)
54
Auscultation sounds
- air: absent breath sounds - Infiltrate: reduced breath sounds/coarse crackles - normal lung: normal vesicular breath sounds - effusion: absent breath sounds
55
Wheeze
- expiratory - continuous, high-pitched - polyphonic, musical sounds - occurs in multiple airways simultaneously DDx: - asthma - pulmonary oedema - cardiac wheeze - small airway trauma
56
Stridor
- inspiratory: above the glottis - expiratory: below the thoracic inlet - Biphasic: fixed obstruction in either constant location - Loud, monophonic with constant pitch - cause: any large airway obstruciton - DDx: tumours, croup, foreign bodies, aspiration, vocal cord dysfunction, sub-glottic stenosis, laryngomalacia
57
Pleural rubs
- rubbing.scratiching sound heard over inflammed pleura - can be heard in both inspiration and expiration - not to be confused with pericardial rib, which is independent of respiration - Mechanism: inflammation of the pleura and loss of the normal pleural lubrication - DDx: pleurisy, PE, Pneumonia, TB, Serositis
58
Bronchial breath sounds
- increased clarity and loudness of breath sounds - soft/non-musical - same sound as that heard when listening over the trachea with your stethoscope - indicates that patient airway is surrounded by consolidated lung tissue - DDx: Consolidation
59
Cocal resonance
- normal lung tissue only transmits higher pitched sounds - consolidated lung tissue transmits both high and low pitched sounds - more difficult to hear in woman - normal vocal resonance: muffled sounds - consolidated lung: sounds more clear - Pleural effusion: decreased/absent vocal resonance
60
Signs of consolidation
- bronchophony: voice is louder than normal and higher vocal resonance - whispering pectoriloquy: whispered words are clearly heard - Aegophony: nasal, bleating quality to the sound
61
Vocal fremitus
- the vibration felt when placing the hands on the back of a patient and asing them to speak - similar findings to that found in vocal resonance
62
Vocal resonance sounds
- air: absent - infiltate: increased vocal resonance/fremitus - normal lung: normal vocal resonance - Effusion: absent/reduced vocal resonance
63
Signs of pulmonary consolidation
- decreased chest expansion on affected side - dull to percussion - decreased breath sounds, with inspiratory crackles - bronchial breath sounds - increased vocal resonance with: bronchophony, whispering pectoriloquy, aegophony

Block 3 - Resp (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions