Symptoms and Signs in RESP

Question 1

What are some common respiratory symptoms?

Answer 1

• Cough
• Dyspnoea
• Dysphonia (hoarseness)
• Wheeze
• Stridor
• Stertor
• Sputum
• Haemoptysis
• Chest pain
• Respiratory pattern
• Weight loss
• Rigor/Chills
• Night sweats

Question 2

What are the characteristics of cough?

Answer 2

• Acute: < 3 weeks
• Subacute: 3-8 weeks
• Chronic cough: > 8 weeks

Question 3

What could a chronic dry cough mean?

Answer 3

Interstitial lung disease - fibrosis

Question 4

What could a moist cough mean?

Answer 4

• bronchiectasis
• lower respiratory tract infections

Question 5

What could bovine cough with hoarsness mean?

bovine = feeble non-explosive

Answer 5

• lung cancer

Question 6

What could a barking cough mean?

Answer 6

• Croup (laryngotracheobronchitis)

Question 7

What are red flad symptoms associated with cough?

Answer 7

• Haemoptysis
• SOB
• Fever
• Chest pain
• Weight loss

Question 8

What is dysphonia?

Answer 8

• hoarseness
• laryngitis
• damage to left recurrent laryngeal nerve

Question 9

What is a wheeze?

Answer 9

• high-pitched whistling sound
• monophonic: lung mass
• polyphonic: COPD/asthma

caused by narrowing airways

Question 10

What is stridor?

Answer 10

• High pitched harsh inspiratory sound
• caused by airway obstruction
• epiglottis, malacia

Question 11

What is stertor?

Answer 11

• Muffled “hot potato” speech
• Naso-oropharyngeal blockage
• tonsil abscess

low pitched

Question 12

What does purulent (thick yellow) sputum indicate?

Answer 12

• Infections; pneumonia, abscess

Question 13

What does serous (frothy) sputum indicate?

Answer 13

Acute pulmonary oedema

Question 14

What does mucoid sputum indicate?

clear, white

Answer 14

COPD/asthma

Question 15

What does bloody sputum indicate?

Answer 15

• Lung cancer
• rusty red pneumococcal infection

Question 16

What are the three ypes of chest pain associated with respiratory diseases?

Answer 16

• Pleural pain: sharp, stabbing - pulmonary embolism
• Chest wall pain: sudden after vigorous coughing, painful on palpation - MSK injury
• Mediastinal pain: central, retrosternal - dusts, invasive mediastinal lymph nodes

Question 17

What are B symptoms?

Answer 17

• Weight loss
• Night sweats
• Fever + rigors

usually happen together and are in more severe disease

Question 18

What are common respiratory signs on general inspection?

Answer 18

• Accessory muscle use
• Cachexia
• Cyanosis
• Altered mental status
• Thoracotomy scar

Question 19

What respiratory signs are seen in hands?

Answer 19

• Clubbing
• Discolouration of nails and fingers
• CO2 retention; asterixis, bounding pulse

Question 20

What respiratory sings are seen on closer inspection and palpation?

Answer 20

• Displaced or central trachea
• Chest shape
• Chest expansion
• Tactile fremitus

Question 21

What respiratory signs are seen on percussion?

Answer 21

• Resonant/Hyper resonant
• Dull/Stony dull

Question 22

What resp. signs are seen on auscultation?

Answer 22

• Vesicular vs Bronchial breathing
• Crackles
• Wheeze
• Pleural rub

Question 23

What does it mean when the trachea is pulled to the abnormal side?

Answer 23

• Atelectasis, pneumothorax, unilaterel fibrosis, pneumonectomy

Question 24

What does it mean when the trachea is pushed away from abnormal side?

Answer 24

• Large pleural effusion, Tension pneumothorax

Question 25

What are the three chest shapes seen in resp. disease?

Answer 25

- Barrel chest - Pectus Carinatum (outward) - Pectus Excavatum (inward)

Question 26

What are the two types of chest expansion when its reduced?

Answer 26

- **Symmetrically** reduced; obstructive, restrictive - **Unilaterally** reduced; pneumothorax, pleural effusion | unilateral will ony affect one side of chest

Question 27

What is tactile fremitus?

Answer 27

- transmission of sound waves from trachea to chest wall - Increased: Consolidation - Decreased: Atelectasis | increased with more dense LUNG

Question 28

What is difference between consolidation and atelectasis?

Answer 28

Consolidation: some air in lungs replaced with fluid + **↑ lung size** Atelectasis: air in lungs removed + **↓ lung size**, collapsed lung

Question 29

What is assessed on percussion? | resp. diseases

Answer 29

- Resonant: normal - Hyper resonant: pneumothorax, COPD - Dull: pneumonia, atelectasis - Stony Dull: pleural effusion, lung cancer | increases with density

Question 30

What are vesicular breath sounds?

Answer 30

- Soft, low-pitched - normal breath sounds - inspiratory 2x expiratory time

Question 31

What are bronchial breath sounds?

Answer 31

- loud, harsh, clear - due to **consolidation** - inspiratory = expiratory time

Question 32

What is a wheeze?

Answer 32

- **Expiratory** sound - COPD, asthma

Question 33

What are creps?

Answer 33

- Inspiratory sound - **fluid in alveoli** | pneumonia, pulmonary oedema, fibrosis

Question 34

What is a Rub?

Answer 34

- Rare - both inspiratory and expiratory - **inflammation of pleura** | pulmonary infarct, pneumonia, chest drain

Question 35

What are common symptoms and signs of pneumonia?

Answer 35

- **Purulent** sputum Signs - reduced chest expansion - **tactile fremitus increased** - **dull** percussion - Auscultation: decreased vesicular breathing, **COARSE CREPS**

Question 36

What are common symptoms and signs of lung cancer?

Answer 36

Symptoms: - **Haemoptysis** - Hoarsness - night sweats, weight loss - bone pain, headache, jaundice Signs: - **Horner's syndrome** - reduced chest expansion - **stony dull** percussion - **Pembertons sign**: red face when hands are raised

Question 37

What are commone symptoms and signs of idiopathic pulmonary fibrosis?

Answer 37

Symptoms: - progressive SOB Signs: - tachypnoea - decreased chest expansion - clubbing - **Fine inspiratory creps bilaterally**

Question 38

What are common symptoms and signs of PE?

Answer 38

Symptoms: - pleuritic chest pain Signs - tachypnoea, tachycardia | pleural rub and right HF rare

Question 39

What are common signs of pleural effusion?

Answer 39

- **trachea pushed opposite side** - **stony dull** percussion - **decreased tactile fremitus**

Question 40

What are common symptoms and sings of pneumothorax?

Answer 40

Symptoms: - Acute **unilateral pleuritic chest pain** Signs: - **trachea** pulled towards, but in tension pneumothorax pulled OPPOSITE - **Hyper resonant** percussion - **decreased tactile fremitus**