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Flashcards in Respiratory and Drug Taking History Deck (35)
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1

What question must you ask specifically in a respiratory history taking? (7)

- Chest pain
- Dyspnoea
- Cough
- Sputum
- Haemoptysis
- Wheeze
- Systemic upset

2

What does a sharp stabbing pain upon inspiration usually equate to?

Pleuritic pain

3

What diseases can cause central pain?

- Tracheitis
- Angina/MI
- Aortic dissection
- Massive PE
- Oesophagitis
- Lung tumour / metastases
- Mediastinal tumour / mediastinitis

4

What diseases can non central chest pain indicate?

- Shingles
- Lung tumour
- PE
- Rib fracture
- Pneumonia

5

What diseases can pleural chest pain indicate?

- Pneumonia / Bronchiectasis / TB
- Lung tumour / metastases / mesothelioma
- PE
- Pneumothorax

6

What can chest wall pain indicate?

- Muscular / rib injury
- Costochondritis
- Lung tumour / bony metastases / mesothelioma
- Shingles (herpes zoster)

7

What questions should you ask when someone has dyspnoea?

- Is there anything that brings it on?
- Does anything make it better or worse?
- Are you always breathless? Is it when you walk/exercise?
- Do you get breathless lying down?
- How far can you walk normally? How far can you walk now? i.e exercise tolerance
- How do you manage walking uphill / up stairs?
- Is there anything it stops you from doing?
- Have you noticed any other symptoms?
- Consider - cough, sputum, chest pain, palpitations, wheeze, stridor

8

When does dyspnoea come on in a number of minutes?

- PE
- Pneumothorax
- Acute LVF
- Acute asthma
- Inhaled foreign body

9

When does dyspnoea come on in a number of hours?

- Pneumonia
- Asthma
- Exacerbation of COPD

10

When is the speed of onet of dyspnoea weeks to months?

- Anaemia
- Pleural effusion
- Respiratory neuromuscular disorders

11

When is the speed of onet of dyspnoea from months to years?

- COPD
- Pulmonary fibrosis
- Pulmonary TB

12

What are the respiratory causes of dyspnoea?

- Airways e.g asthma, COPD, bronchiectasis, cystic fibrosis, laryngeal tumour, foreign body, lung tumour
- Parenchyma e.g pneumonia, pulmonary fibrosis, sarcoidosis, TB
- Pulmonary circulation e.g PE
- Pleural e.g pneumothorax, pleural effusion
- Chest wall e.g kyphoscoliosis, ankylosing spondylitis
- Neuromuscular e.g myasthenia gravis, Guillain-Barre syndrome

13

What can the non cardio-respiratory causes of dyspnoea be?

- Anaemia
- Obesity
- Hyperventilation
- Anxiety
- Metabolic acidosis

14

What questions should you ask when someone has a cough?

- How long have you had it?
- Is it a new problem?
- When does it occur?
- Is there anything that makes it better or worse?
- Is it a dry cough Do you cough anything up?
- Do you smoke
- Has your medication changed recently?
- Do you experience any other symptoms?

15

What are the likely causes of an acute cough?

- Viral or bacterial infection
- Pneumonia
- Inhalation if foreign body
- Irritants

16

What are the likely causes of chronic coughs?

Common
- Gastro-oesophageal reflux
- Asthma
- COPD
- Smoking
- Post-nasal drip
- Occupationlor other irritants
- Medication (ACEi)
Less common
- Lung tumour
- Bronchiectasis
- Interstitial lung disease

17

What are the 'red flags' when someone has a cough?

- Haemoptysis
- Breathlessness
- Weight loss
- Chest pain
- Smoker

18

What are the common causes of a productive cough?

- Infection
- Bronchiectasis

19

What are the common causes of a persistant 'moist' cough worst in morning?

COPD

20

What are the common causes of a cough associated with a wheeze?

Asthma/COPD

21

What usually the cause of a painful cough?

Tracheitis

22

What is usually the cause of a harsh/barking cough?

Laryngitis / laryngeal tumour

23

What is the commonest cause of a chronic, dry cough?

Interstitial lung disease

24

What is the common cause of a persistant cough with haemoptysis?

Bronchial carcinoma

25

What is the cause of a 'bovine' (non-explosive cough)?

- Left recurrent laryngeal nerve invasion (secondary to malignancy)
- Neuromuscular disorder

26

What questions should you ask about sputum?

- How often do you produce sputum when you cough?
- How much sputum do you cough up? Has this changed?
- What colour is it? Has the colour changed
- Is there any blood?
- Is it frothy or thick?
- Is there any abnormal smell or taste?
- Have you been experiencing any other symptoms? (e.g fever, dyspnoea, pain)

27

What questions should you ask about haemoptysis?

- When did you first notice blood in your sputum?
- How many times has it happened?
- How much blood is there?
- Are there any other colours in the sputum apart from blood?
- Have you noticed any bleeding or bruising anywhere else?
- Are you taking any medication to thin the blood?
- Have you noticed any other symptoms? (e.g breathlessness / chest pain / cough / weight loss

28

What are important questions to ask with relation to systemic upset?

- Change in appetite
- Weight loss
- Fever
- Tiredness / lethargy

29

Why should you ensure you have an accurate medication history?

- Improves patient safety
- Reduces medication errors / near misses
- Reduces missed doses in hospital
- Reduces delays to treatment
- Savings to NHS from prevented errors
- Improves therapeutic outcomes

30

What is intentional non-adherence?

a definite decision to not take medicine(s)