Symptoms of respiratory system

Question 1

Acute Dyspnea

Answer 1

1. Bronchial Obstruction
2. Larynx Obstruction
3. Asthma
4. Spontaneous pneumothorax
5. Acute pulmonary embolism ( ventilation / perfusion mismatch )

Question 2

Chronic Dyspnea

Answer 2

1. COPD
2. Pure emphysema
3. Extensive pulmonary fibrosis
4. Agonic status

Question 3

Physchogenic Dyspnea

Answer 3

Deep respiratory effort at variable intervals

no objective diagnosis features

Question 4

Changes in respiratory cycle

Answer 4

1. Chake stones respiration
2. Sleep apnea syndrome
3. Kussmaul respiration
4. Biot respiration

Question 5

Cheyne - Stokes respiration

Answer 5

altering periods of acceleration and deceleration with apnea periods of variable duration ( 15-60 sec)
tachypnea = anxious
apnea = somnolent
when apnea is longer = seizures

Question 6

Cheyne - Stokes respiration is due to

Answer 6

depression of the exitability in respiratory centers
- sign of CNS depression in :
> left ventricular failure with low output
> brain hemorrhages , brain tumors
>morphin use
> normal subjects at high altitude

Question 7

Sleep apnea syndrome ( SAS )

Answer 7

• caused by soft tissue collapse in pharynx
• Normal ventilation altering with periods of apnea , during sleep
• Associated with COPD ,obesity , hypertension
• patient feels -> sleepy + dizzy
• snorring

Question 8

Kussmaul respiration

Answer 8

cycles of high amplitude respiratory movements , separated by short pauses
- Appear in METABOLIC ACIDOSIS

Question 9

Biot respiration

Answer 9

periods of apnea + normal respiration or hyperpnea

• brain tumors
• meningitis
• agonic status

Question 10

Cough and sputum ( what is it ?)

Answer 10

its a reflex that either blocks foreign body penetration into the airways / expels mucus / pus accumulation in the bronchial tree

Question 11

Cough and sputum - excitation

Answer 11

comes from special receptors who’s stimulation provokes deep inspiration - > glotic shut down -> sudden + strong expiration

Question 12

Dry cough

Answer 12

• no expectoration

- acute inflammatory airway conditions , airway compression

Question 13

wet cough

Answer 13

• expectoration

- acute / chronic conditions

Question 14

Aphonic cough

Answer 14

• laryngeal conditions

- laryngeal cancer

Question 15

Barking cough

Answer 15

• tracheobronchial compression

Question 16

Bitonal cough

Answer 16

• left vocal cord paralysis , due to left recurrent laryngeal nerve
• lymph nodes in mediastinum , aneurysm , tumor

Question 17

Cavernous cough

Answer 17

• metallic sound , in caverns - 6 cm with free drainage bronchi

Question 18

Convulsive cough

Answer 18

• in paroxysmal crisis
• starts with a deep breath -> short and rapid cough -> air is evacuated from lungs
• at the end of crisis inspiration is deep and associated with wheezing due to glotic spasm
• patient becomes cyanotic and vomits

Question 19

cough with emesis

Answer 19

• appear in tuberculosis

- appear in esophageal - bronchial fistulae

Question 20

Irritation cough

Answer 20

appear in acute + chronic lung diseases

chronic bronchitis in smokers

Question 21

Morning cough

Answer 21

due to secretion evacuation in chronic bronchitis + bronchiectasis

Question 22

Evening cough

Answer 22

• concomitant

- with fever increase in the evening in tuberculosis

Question 23

Effort cough

Answer 23

appear in pulmonary and cardiac diseases

Question 24

Continuous cough

Answer 24

pulmonary tuberculosis - laryngitis, tracheobroncial compression

Question 25

Position cough

Answer 25

determined by position changes in pleural effusions , lung abcesses ,bronchiestasis

Question 26

Cough in massive pleural effusion drainage

Answer 26

can appear when the visceral pleura makes contact with the needle -> cardioinhibitory reflex

Question 27

Mucous sputum

Answer 27

transparent

Question 28

Serous sputum

Answer 28

white colour

Question 29

Purulent sputum

Answer 29

creamy , yellow - green colour

Question 30

Blood sputum

Answer 30

hemoptysis

Question 31

combination sputum

Answer 31

seromucous sputum , mucopurulent sputum , mucous - bloody sputum

Question 32

Rusty sputum

Answer 32

Mucofibrinous , aerated , viscous - pneumococcus pneumonia

Question 33

Pearled sputum

Answer 33

at the end of asthma crisis

Question 34

Pseudomembranous sputum

Answer 34

high amount of mucus and fibrin , appearaance of bronchial tree cast

Question 35

Vomica

Answer 35

``` = sudden elimination after cough effort of a clloection which has penetrated the airways - can be : > pus > serous , liquid > blood ```

Question 36

Vomica appear from

Answer 36

- pulmonary parenchyma : abcess , hidatidosis - pleural cavity - Mediastinum : mediastinitis - Abdominal : underdiphragmatic abcess The evacuation can be associated with intense , tearing chest pain , dyspnea , anxiety

Question 37

Vomica quantiny + differential diagnosis

Answer 37

``` large : 1-2 lt Medium : 250 -300 ml Differential Dg : - vomiting - pseudovomica > smaller quantity ```

Question 38

Hemoptysis definition

Answer 38

evacuation of fresh , bright - red , aereated blood after cough , from tracheobronchial tree / pulmonary tissue

Question 39

Hemoptysis : what does the patient feel ?

Answer 39

- Retrosternal heatsensation appears before the onset of hemoptysis - Sometimes the patient has a special metallic taste, - he is anxious, pale and dyspneic

Question 40

Hemoptysis

Answer 40

Small hemoptysis = <100ml · Medium hemoptysis = 100-500ml · Large hemoptysis = >500ml · Fractioned = hour or days, small amounts of blood - In sudden, massive hemoptysis —> death by asphyxiation; patient shouldn’t be moved - At the end of bleeding, the expectoration becomes black in colour

Question 41

Hemoptysis Differential Diagnosis

Answer 41

blood from the oral cavity, pharynx, epistaxis

Question 42

Hemoptysis - causes : 1,2,3,4

Answer 42

1. Pulmonary Tuberculosis - from the onset of the disease - 1st sign or in evolution it can be massive 2. Chronic bronchitis + bronchiectasis : small hemoptysis 3. Acute bronchitis : very rare , due to bronchial mucosa hiperemia - viral etiology / irritant gases 4. Bronchiopulmonary cancer

Question 43

Hemoptysis - causes : 5,6,7,8

Answer 43

5. Cardiac causes : mitral stenosis , LV failure ( rare ) , pulmonary embolism with infarction , ruptured aortic aneurysm ( very rare ) 6. Thoracic trauma 7. Hematologic bleeding disorders 8. Endometriosis = diesease in which tissue that normally grows inside the uterus grows outside it

Question 44

Chest pain cause : 1-7

Answer 44

1. Pulmonary disease 2. Cardiac disease 3. Vascular disease 4. GI disease ( esophagus ) 5. Spine disease 6. Irradiation pain from abdominal aria ( acute cholecystitis ) 7. Chest wall

Question 45

Chest pain in pulmonary disorders : Stitch

Answer 45

- similar to point knfe hit - acute , high intensity - accentuated with respiration , cough - due to irritation of nerve endings in the parietal pleura - appears in various respiratory conditions

Question 46

Lobar pneumonia

Answer 46

= under the nipple, pathognomonic if its accompanied by shivering & temperature raise

Question 47

Pneumothorax

Answer 47

At the nipple or subscapular

Question 48

Pulmonary embolism with pulmonary infarction

Answer 48

= blood streaked sputum

Question 49

Purulent pleural effusions

Answer 49

= skin hyperestesia