Sign and symptoms of respiratory disease

Question 1

what are the Main Respiratory Symptoms

Answer 1

Dyspnea
Wheeze
Cough
Sputum
Hemoptysis
Chest Pain

Question 2

what are different kinds of dyspnea

Answer 2

gradual & progressive
episodic
diurnal variability
orthopnea 
paroxysmal nocturnal dyspnea (PND)

Question 3

what is wheezing

Answer 3

• whistling or sighing noise on expiration

- air passing through a narrow tube & indicating airway obstruction

Question 4

what is coughing

Answer 4

• Protective Mechanism that clears the lungs, bronchi or trachea of irritants
• dry or associated with mucous production

Question 5

what stimulate irritant receptors

Answer 5

• inflammation
• infectious agents
• excessive secretion
• noxious gas
• hot/cold air
• mechanicall stimulation

Question 6

what are the common cause of noproductive cause

Answer 6

Irritation of the airways
Inflammation of the airways
Mucous accumulation
Tumors

Question 7

how to evulate productive cough

Answer 7

strength
--> strong or weak
Frequency 
pitch loudness 
Sputum or not
-->color
-->odor
-->amount 
-->consistency

Question 8

what is hemoptysis

Answer 8

coughing up of blood

Question 9

What investigation is required for hemotypsis?

Answer 9

CXR 
bronchoscopy
CT
sputum cytology
microbiology

Question 10

What is chest pain

Answer 10

• most common complaint among pt with cardiopulmonary problem

2 types

• pleuritic
• non-pleuritic

Question 11

What is the cut point of fever

Answer 11

more than 98.6 F or 37C

Question 12

What is increased body tempearture associated with

Answer 12

pneumonia
lung abscess
TB
fungal disease

Question 13

What is the general apperance of a person with respiratory disease / condition

Answer 13

Use of accessory muscles
pursed-lip breathing
substernal & intercostal retractions splinting
decreased chest expansion
abnormal skin colour
presence of edema
distension
clubbing

Question 14

features of digitial clubbing

Answer 14

population
- patients with chronic respiratory disorders

appearance
- bulbous swelling of the terminal phalanges of the finger and toes

Question 15

features of cyanosis

Answer 15

population
- patient with severe respiratory disorder

color

• blue-grey or purplish discoloration of the mucous membranes, fingertips, or toes
• these areas contains at least 5g/dL of reduced hemoglobin

Question 16

feature of acrocyanosis

Answer 16

caused by vasoconstriction by cold and becomes hypoxic

Question 17

feature of central cyanosis

Answer 17

mucous membranes of lips and mouth is almost always a sign of hypoxemia

Question 18

what is lethargy

Answer 18

• drowsy
• partially awakens to stimulation
• follow commands
• do things slowly

Question 19

what is obtundation

Answer 19

• difficult to arouse
• needs constant stimulation to follow a command
• drift back to sleep between stimulation

Question 20

what is stupor

Answer 20

• only arouse to constant and vigorous stimulation
• pain stimulation is needed
• response is an attempt to withdrawal from painful stimulation

Question 21

what is coma

Answer 21

• doesn’t respond to continuous or painful stimulation

- no verbal sounds or movement

Question 22

what causes Pulsus Paradoxus

Answer 22

• aka paradoxical pulse, occurs in asthma exacerbation
• Change in BP with respiration with intrapleural swings
• ↓ Blood pressure during inspiration
• ↑ Blood pressure during expiration

Question 23

what is Pulsus Alternans

Answer 23

• alternation of strong and weak beats of the arterial pulse
• cause by alternate strong and weak ventricular contractions
• failing ventricle

Question 24

what causes oxygen failure

Answer 24

1. hypoxemia

2. shunt (normal perfusion, low to no ventilation)

Question 25

what causes ventilatory failure

Answer 25

1. neurological - ->depression of respiratory center 2. obstruction to exhalation 3. failure to clear increase level of co2

Question 26

what is the result of chronic hypoxemia

Answer 26

Vitals - increase RR - increase MV, - decrease PACO2 - increase WOB Complication pulmonary hypertension

Question 27

what complication can pulmonary hypertension cause?

Answer 27

cor pulmonale

Question 28

What can cor pulmonale lead to

Answer 28

- HR & contraction to compensate - increase workload - increase ischemia/infarction - JVD - hepatomegaly - pedal edema

Question 29

What is the deal with ventilatory failure

Answer 29

- when respiratory disease worsens , WOB increase to a point where O2 consumption is more than the gained O2 - lead to decrease alveolar ventilation and hypercarbia

Question 30

what are the changes in vitals and physiology and hypercarbia

Answer 30

- increase paco2, decrease ph - lead to narcotic effect (look flush and disoriented) - -> cerebral, peripheral blood vasodilation - ->pulmonary vasoconstriction

Question 31

what is the clinical features of O2 failure

Answer 31

- increase HR, BP, RR - decrease Pao2, Sao2, Cao2 - chronic hypoxemia can lead to polycythemia

Question 32

what is the clinical features of ventilatory failure

Answer 32

- due to increase CO2 | - ->headache, decrease alertness, flush

Question 33

How to tell of ventilatory failure is caused by drug OD

Answer 33

impede central drive inability to protect airway pupil size alteration

Question 34

treatment of o2 failure?

Answer 34

supplemental O2 administration intubation and mechanical ventilation Chemical paralysis to decrease O2 consumption may use NIPPV if appropriate

Question 35

treatment of ventilatory failure

Answer 35

intubation and mechanical ventilation may use NIPPV if appropriate respiratory stimulants