Respiratory signs and symptoms

Question 1

Cardinal respiratory symptoms (5)

Answer 1

1) Breathlessness
2) cough
3) sputum (phlegm)
4) Haemoptysis (coughing up blood)
5) chest pain

Question 2

MRC dyspnoea scale

Answer 2

Measures degree of breathlessness in relation to activity

grade 1= not troubled by breathlessness except on strenuous exercise

grade 5= too breathless to leave the house, or brethless when dressing/ undressing

Question 3

ECOG/ WHO score

Answer 3

Measurement of how much a disease affects the day to day functioning of a patient

0= fully active, able to carry on all predisease performance without restriction

5= dead

Question 4

Cough things to ask

Answer 4

Acute/ chronic

Wet/dry

Time of day

Relation to eating

Relation to speaking

VAS scores (draw a straight line with severity of cough marked)

LCQ-19 item questionnnaire that assesses cough related QoL (3 domains physical, psychological and social) higher score is better

Question 5

Breathlessness things to ask

Answer 5

MRC dyspnoea scale and ECOG performance grade

Effect on lung/ heart/ muscles

Acute/ chronic

Continuous/ episodic

Limitation

Question 6

Sputum things to ask

Answer 6

Clear liquid = ok

Green = indicates innate response -= maybe infection

Blood (haemoptysis) present is a red flag

Question 7

Chronic bronchitis symptoms

Answer 7

Symptoms

Chronic, productive cough

Haemoptysis

Mild dyspnoea initially

Cyanosis (due to hypoxaemia)

Peripheral oedema (due to pulmonale)

Crackles, wheezes

Prolonged expiration

Obese

Question 8

Chornic bronchitis complications

Answer 8

Pulmonary hypertension

Cor pulmonale

Question 9

Emphysema phenotype symptoms

Answer 9

Dyspnoea

Minimal cough

Pink skin, pursed lips

Accessory muscle use

Cachexia

Decreased breath sounds

Tachypnoea

Question 10

Emphysema complications

Answer 10

Pneumothorax

weight loss

Question 11

vesicular breath sound

Answer 11

normal quality of breath sounds in healthy individuals

Question 12

Bronchial breath sounds

Answer 12

harsh sounding

inspiration and expiration are equal

Associated with consolidation

Question 13

Quiet breathing sounds

Answer 13

suggests reduced air entry into that part of the lung

e.g., pleural effusion, pneumothorax

Question 14

wheeze breathing sound

Answer 14

continuous, coarse, whistling

produced by turbulent airflow in the respiratory airways

May be polyphonic (mulitple notes) obstriuctive airway disease

May be monophonic (single note) large airway obstruction

Question 15

Stridor breathing sound

Answer 15

inspiratory

high pitched extra-thoracic breath sound resulting from turbulent airflow through narrowed upper airways

implies large airway obstruction

exaggerated by huffing

Question 16

coarse crackles breathing sound

Answer 16

discontinous

brief

popping lung sound

associated with pneumonia, bronchiectasis and pulmonary oedema

Question 17

fine end respiratory crackles breathing sound

Answer 17

velcro sounding

synonymous with pulmonary fibrosis

Question 18

tactile vocal fremitus/ vocal resonance

Answer 18

increased vibration over an area suggests increased tissue density (e.g., consolidation, tumour, lobar collapse)

Decreased virbration over an area suggests presence of fluid or air outside lung (pleural effusion, pneumothorax)