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Respiratory Y3 > Resp - symptoms + signs > Flashcards

Resp - symptoms + signs Flashcards

1
Q

Symptoms of flash pulmonary odema (crash course 1000 SBAs p. 155 Q32)

A
  • Cough
  • Dyspnoea
  • Orthopnoea
  • Bilateral fine inspiratory crackles
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2
Q

Hydronephrosis symptoms + signs

A
  • Enlarged kidneys
  • Enlarged bladder
  • Renal failure
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3
Q

Empyema symptoms (as in pneumonia compliations)

A
  • Transient fever
  • SOB
  • Pleural effusion on the side of the resolving pneumonia
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4
Q

Symptoms in hypersensitivity pneumonitis 4-6h post allergen exposure

A
  • Cough
  • Dyspnoea
  • Fever
  • Rigors
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5
Q

Symptoms in hypersensitivity pneumonitis as the disease progresses

A
  • Progressive dyspnoea
  • Exertional dyspnoea
  • Weight loss
  • T1RF
  • Cor pulmonale
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6
Q

Acute phase of hypersensitivity pneumonitis signs

A
  • Alveolar infiltration with inflammatory cells (e.g. monoctes, macrophages/giant cells)
  • Poorly formed non-caseating granulomas
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7
Q

Chronic phase of hypersensitivity pneumonitis signs

A
  • Well formed granulomas
  • Obliterative bronchitis
  • Alveolar destruction (honeycombing of the lung)
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8
Q

Atypical pneumonia symptoms

A
  • Fever
  • Myalgia
  • Malaise
  • Dry cough
  • Dyspnoea
  • D+V
  • Anorexia
  • Hepatitis
  • Renal failure
  • Confusion
  • Coma
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9
Q

Pulmonary hypertension symptoms

A

Symptoms
• Progressive breathlessness, weakness, tiredness
• Exertional dizziness, syncope
• Oedema, ascites – occur late in the disease
• Angina, tachyarrhythmias (AF)

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10
Q

Pulmonary hypertension signs

A 
Signs – may be subtle/absent in early disease, associated with increased strain on the R side of the heart which eventually leads to HF
•	Right ventricular heave
•	Loud pulmonary S2
•	TR
•	PR 
•	Raised JVP
•	Peripheral oedema, ascites
•	p pulmonale
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11
Q

Extrapulmonary symptoms of lung cancer

A
  • Bone metastases - bony pain, hypercalcaemia
  • PTH-related peptide (PTHrP) - hypercalcaemia
    Assosciated with squamous cell carcinomas
    (hypercalcaemia causes - confusion, polydypsia, polyuria, hypotonia, hyporeflexia, muscle weakness)
  • HPOA (hypertrophic pulmonary osteoarthropathy) - dull, aching, swollen wrists/ankles - assosciated with adenocarcinomas
  • Ectopic ACTH - cushingoid (muslce weakness, oedema, skin hyperpigmentation)
  • ADH secretion - hyponatraemia

(ACTH+ADH secretion assosciated with small cell lung cancer)

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12
Q

Legionella buzzwords

A

smoking
overseas travel
hyponatraemia
deranged LFTs

flu like symptoms –> GI symptoms –> CNS symptoms

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13
Q

Klebsiella buzzwords

A

Alcoholics
Aspiration
Diabetics

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14
Q

Pseudomonas buzzwords

A 
CF
Bronchiectasis
Smoking 
Aspiration
HIV
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15
Q

Mycoplasma buzzwords

A

Flu like symptoms
Erythema multiforme
+ve cold agglutinins (autoimmune haemolytic anaemia)
Transverse myelitis

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16
Q

Pneumocystis Jiroveci (PCP) buzzwords

A
  • HIV, immunocompormised
  • Dry cough, exertional dyspnoea, bilateral crepitations
  • Dx: BAL
  • CXR: may be normal, or bilateral peri-hilar shadowing, bilateral interstitial infiltrates
    desaturation on exertion
17
Q

Strep Pneumoniae (pneumococcus) buzzwords

A
  • Eldelry, alcoholics, HIV, IVDU, hyposplenism

Features: fever, pleurisity, herpes labiallis

18
Q

Haemophilus influenzae buzzwords

A

Aspiration
COPD
HIV
IVDU

19
Q

Auscultation in pneumoniae

A

Coarse bibasal crackles
Bronchial breathing
Increased vocal resonance

20
Q

Lung abscess is a potential complication of pneumonia

Give the likely organism
Give some symptoms

A

Commonly Staph aureus

  • swinging fevers
  • persistent pneumonia
  • foul smelling sputum
21
Q

TB signs and symptoms

A 
Fever
Lethargy
Weight loss
Night sweats
Cough (+ green sputum)
Haemoptysis
Lymphadenopathy

Lungs

  • Cough (+green sputum)
  • Hemoptysis
  • TB pneumonia (LRTI)
  • Pleural effusion

Heart

  • Normocytic anaemia
  • Constrictive pericarditis
  • Pericardial effusion

Brain
- Meningitis

Spine

  • Pott’s disease
  • Spinal cord compression
  • Osteomyelitis

Skin

  • Erthytma nodosum
  • Clubbing

Kidneys
- Addison’s disease

Genitals

  • Epididymo-orhitis
  • Infertility
22
Q

Signs + symptoms of bronchiectasis

A 
Chronic cough (+green/yellow sputum)
Haemoptysis
SOB
Chest pain
Fever
Weight loss

Clubbing
Bibasal early inspiratory crackles
Rhonchi

23
Q

Lung cancer symptoms and signs

A

Primary tumour

  • Cough
  • Haemoptysis
  • SOB
  • Weight loss
  • Anorexia
  • Night sweats

Localised spread

  • Horner’s syndrome (sympathetic chain)
  • Bovine cough - L recurrent larryngeal nerve
  • SVC obstruction

Mets

  • Bone (bone pain, fractures)
  • Brain (headaches, blurry vision)
  • Liver (hepatomegaly)
  • Lymphadenopathy
24
Q

Mesothelioma symptoms + signs

A
  • Cough (dry) - NON PRODUCTIVE
  • SOB
  • Weight loss
  • Loss of appetite
  • Night sweats
  • Pleural friction rub
25
Q

Pneumonia symptoms + signs

A 
Typical
Fever
SOB (dyspnoea)
Cough (with green sputum)
Chest pain (pleuritic)
Confusion

Respiratory distress
Central/peripheral cyanosis
High HR, RR
Low BP (in sepsis), O2 sats

Reduced chest expansion
Dull percussion (over affected area)
Coarse bibasal crackles 
Bronchial breathing
Increased vocal resonance
26
Q

Clinical signs of life-threatening asthma

A
  • Altered conscious level
  • Exhaustion
  • Arrythmia
  • Hypotension
  • Cyanosis
  • Silent chest
  • Poor respiratory effort
  • PEF <33% best or predicted
  • SpO2 <92%
  • PaO2 <8 kPa [Normal O2 is 10-14kPa]
  • Normal PaCO2 (4.6-6.0 kPa)
27
Q

Signs of near fatal asthma (7)

A
  • Absent breath sounds
  • Decreased wheezing
  • Pulsus paradoxsus (SBP drop >12mmHg on inspiration, drop of <10mmHg is normal)
  • Cyanosis
  • Diaphoresis
  • Inability to speak in full sentences
  • Increased PaCO2 (>6 kPa)
28
Q

Acute severe asthma measurements

A

PEF 33-50% predicted
RR >25
HR >110
Inability to complete sentences in one breath

29
Q

Acute moderate asthma PEF

A

PEF >50-75% best or predicted

30
Q

Idiopathic pulmonary fibrosis symptoms + signs

A
  • Formation of scar tissue within the lungs
  • Dyspnoea on exertion
  • Cough (non-productive, non-responsive to antitussives)
  • Crackles (bibasal inspiratory crackles)
  • Clubbing
  • Systemic symptoms might be present – weight loss, fatigue, malaise
  • No wheeze
31
Q

Extrinsic pulmonary alveolitis

Hypersensitivity pneumonitis symptoms + signs

A 
Fever
Dry cough 
Inspiratory crackles
SOB
Anorexia
Weight loss
Fatigue
Chills
Nausea

Symptoms start 4-8h after exposure + resolve within days
Acute phase - may mimic pneumonia look at hx to decide dx
In chronic disease there are no systemic symptoms

pets, mushrooms, farmer, plumber, bird-keeper, malt-worker

32
Q

Pneumoconiosis signs + symptoms

A
  • Asbestosis – clubbing, bibasal inspiratory crackles
  • Silicosis – decreased breath sounds
  • SOB
  • Dry cough
  • Pt may be asymptomatic
  • Long latency
  • Coal worker, builder
33
Q

OSA obstructive sleep apnoea symptoms and signs

A
  • Loud snoring
  • Gasping and breath holding during sleep
  • Apnoeas
  • Irregular breathing at night
  • Insomnias
  • Restless, unrefreshing sleep
  • Excessive daytime sleepiness (due to sleep fragmentation) !!!
  • Irritability/personality change
  • Chronic fatigue
  • Unrefreshed sleep
  • Obese
  • Marfan’s syndrome
34
Q

Typical symptoms of mesenteric adenitis

A

griping abdominal pain 15-45 after eating

atherosclerotic RF in the Q

35
Q

Which organisms can cause lung abscesses

A

Staph aureus
Klebsiella
TB

36
Q

Silicosis signs + symptoms

A

 Cough
 SOB
 Unexplained weight loss

 Bilateral upper lobe involvement
 Hilar lymphadenopathy
 Eggshell calcification of the lymph nodes

37
Q

Signs + symptoms of cor pulmonale

A 
Loud S2 (P2)
Pansystolic murmur
Graham Steel murmur (early diastolic, PR)
R ventricular heave
Raised JVP
Hepatomegaly
Oedema
Tachycardia
Cyanosis
38
Q

Crackles

fine inspiratory
end expiratory

A

fine inspiratory
Pulmonary fibrosis
Pulmonary oedema

End expiratory
Consolidation (+bronchial breathing)

39
Q

Bilateral hilar lymphadenopathy

Bihilar

A

Infection - TB
Inflammation - sarcoidosis
malignancy - lymphoma

Respiratory Y3 (4 decks)

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