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Respiratory > Top of Disease Table - Hx > Flashcards

Top of Disease Table - Hx Flashcards

(59 cards)

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1
Q

What is important in the respiratory Hx

A 
Chest pain 
SOB - QUANTIFY
Cough
Exercise tolerance and how it changed 
Wheeze
Haemoptysis 
Recurrent infections 
Systemic Sx 
Sleep 
PMH 
- Resp support / pre-term at birth 
- Childhood illness 
DH and allergy
FH
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2
Q

What do you want to know about cough

A 
Productive
Colour and volume in cups
Any blood
Is it positional 
- Worse flat / early morning = GORD
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3
Q

What causes wheeze

A

Bronchial inflammation leading to constriction

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4
Q

What do you ask about sleep

A

Do you sleep through night
Do you wake up feeling SOB
Does your parter notice stop breathing

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5
Q

What in SH

A 
Occupation 
Exposure
Pets
Travel 
Smoking
Alcohol
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6
Q

What do you look for on inspection

A 
Sputum pot - look inside
O2 
Breathlessness
Pursed lip - severe emphysema
Cyanosis
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7
Q

What do you look for in hands

A

Red palms, flap, bounding pulse = CO2 retnetion
Tar staining NOT nicotine
Clubbing

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8
Q

What are other important aspect

A

Chest
JVP
LN - ALWAYS offer
Signs of RHF

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9
Q

What do you look in chest

A 
Hyperinflation
- Increased AP diameter
- Cricosternal 
- Use of accessory 
- Prolonged expiratory 
Signs of surgery or thoracoscopy
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10
Q

RHF

A

Raised JVP
Loud P2
RV heave
TR

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11
Q

What causes haemoptysis

A 
Lung cancer
Pulmonary oedema
TB
PE
LRTI
Bronchiectasis
Mitral stenosis 
Aspergilloma
Macroscopic polyangiitis
Good-pasture
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12
Q

Why does MS cause

A

Rupture of bronchial veins due to increase in LA pressure

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13
Q

How does it present

A

SOB
AF
Malar flush

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14
Q

What causes acute SOB

A 
Pulmonary oedema
MI
Pneumonia 
Endocarditis 
PE
Pneumothorax 
Arrythmia
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15
Q

What type of crackles in pulmonary oedema

A

Fine crackles

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16
Q

What type of crackles in fibrosis

A

Coarse crackles

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17
Q

What causes chronic SOB

A 
Heart failure
Asthma / COPD 
Aortic stenosis 
Lung cancer
Pulmonary fibrosis
Bronchiectasis
Anaemia
Obesity
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18
Q

How does HF present

A

Hx IHD / HTN
Orthopnoea and PND
Bibasal crackle
3rd HS

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19
Q

What causes cough

A 
URTI / LRTI 
TB
Drugs
Asthma / COPD 
Lung cancer
Reflux 
Oesophagtiis 
HF
Post-jnasal drip
A1-antitrypsin deficeincy
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20
Q

What drugs cause cough

A

ACEI

Ticagrelor

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21
Q

What is important to ask in lung ca

A

B symptoms

Hoarseness

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22
Q

What are red flags of cough suggesting TB / lymphoma / cancer

A

Fever / night sweat / weight loss
Haeomptysis
Dyspnoea

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23
Q

If chronic cough + sputum

A

COPD / bronchiectasis

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24
Q

What are bed sites test

Study These Flashcards
A 
Sputum 
PEFR
Pulse oximetry 
ABG
Spirometry 
PFT
25
What do you send sputum for
MC+S | PCR + ZN if infected
26
What does colour
Clear = bronchitis Yellow / green = infection Red = blood Black = smoke / coal
27
When is PEFR useful
Asthma
28
What gives you poor result in oximetry
``` CO Nail varnish Skin colour Poor perfusion Moving ```
29
If sats <92%
Do ABG
30
What does spirometry measure
Lung volume | FEV1 and FVC
31
What is obstructive pattern
FEV1 <80% FVC NORMAL OR LOW RATIO <70% Can't get air out fast but with prolonged expiration will get it all out
32
What causes
Asthma COPD Bronchiectasis CF
33
What is restrictive pattern
FEV1 <80% FVC <80% Ratio >70% Due to reduced lung volume and shallow breaths
34
What causes restrictive
``` Fibrosis Interstitial pneumonia Connective tissue Sarcoid Pleural effusion Neuromuscular Obesity ```
35
What are PF
TLC Residual volume Gas transfer (KCO)
36
What is TLC
Increased in obsruction | Reduced in restrictive due to reduced gas exchange
37
What is KCO
Reduced in emphysema and interstitial lung
38
What are radiological tests
``` CXR USS for drainage X/Q PET CT CTPA Pulmonary angiography ```
39
What is bronchoscopy
Tube via nose or mouth under LA to look through bronchioles
40
When do you do
Suspect cancer Pneumonia not resolving Intersitial lung disease
41
What can be done during
BAL and sent to lab
42
When do you do BAL
``` Malignancy Pneumonia Bronchiectasis Suspected TB with -ve sputum ILD ```
43
What is needed pre-procedure
``` FBC Coaulation CXR CT Spiroemtrry ABG ```
44
What are complications
Hypoxia Bleeding Pneumothorax
45
How do you do lung biopsy
Percutaneous Transbronchial at bronchoscopy Open
46
When do you do mediastinoscopy/ / thoracoscopy
Pleural lesion Drain effusion Pleurodesis Require GA
47
What causes clubbing
``` CLUBBING Cyanotic HD Lung disease UC and Chrons Birth defect - congenital Biliary cirrhoiss IE Neoplasia GI malabsorption (coeliac) ```
48
What are the lung disease causes
``` ABCDEF Abscess Bronchiectasis CF DONT say COPD Empyema Fibrosis ```
49
Ix SOB
``` A-E Hx + exam - Quantify SOB - worse in morn / even / position CXR ECG ABG or VBG Bloods +- CT ```
50
ABG or VBG
ABG if severe hypoxic/ suspecting type II
51
Resp causes SOB
``` Obstruction Anaphylaxis PE Pneumothorax COPD / asthma Pneumonia Pleural effusion Neoplasm Fibrosis ```
52
Cardiac
``` ACS Oedema Arrythmia Tamponade Myocarditis Cardiomyopathy ```
53
Infectious
Pneumonia | Epiglottitis
54
Traumati
``` Pneumothorax Haemothorx Tamponade Flail chest Rib fracture ```
55
Abdominal
Ascites Obesity Pregnancy
56
Psychogenic
Panic attack
57
Metabolic
Acidosis POisoning Renal failure
58
Haematological
CO poison | Anaemia
59
Neuromuscular
CVA | GBS

Respiratory (23 decks)

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