THE RESPIRATORY SYSTEM
COLIGH 3 SPUTLIM
-
Cough is a common
presenting respiratory symptom >
-
enables the airways
cleared of secretions 3
to be
foreign bodies
the duration of is important
> a sough
-
>
-
find out when the
cough first became a problem
·
a
sough of resent origin (particularly if associated with fever 3
other symptoms of respiratory tract infection) may be due to
a cute bronchitis or
preumonia
a chronic
cough 18 weeks) associated with wheezing may be due
·
to asthma lasthma can sometimes present only with a cough)
> a
-
change in the character of a chronic cough may indicate the
development of a new 3 serious underlying problem
cough that wakes patient from sleep may be of cardiac failure of the reflux of acid from the oesophagus into
a a
symptom
-
or
the upper airway that can occur when a
person lies down
-
patients' descriptions of their cough may be helpful
-
an immunocompromised patient with a cough often has an infectious cause e .
g TB
.
, Cryptococcus spp .,
etc .
-
enquire about the type of sputum produced I look at it if its available
of
diagnosis of bronchiectasis lobar pneumonia
a large volume
purulent/yellow/green) sputum suggests the or
-
-
foul-smelling dark-coloured sputum may indicate the presence of a lung abscess with anaerobic organisms
secretions from trachea should not be confused with
-
pink frothy the which ,
occur in
pulmonary oedema ,
sputum
-
rely on the patient's assessment of the taste of the
sputum
, HAEMOPTYSIS-coughing up of blood
-
can be a sinister sign of lung disease
-
must be distinguished from haematemesis (vomiting of blood) 3 from nasopharyngeal bleeding
-
ask how much blood has been produced
>
-
mild =< 20ml in 24 hours
·
appears as streaks of blood discolouring sputum
>
-
massive = 250ml in 24 hours = medical emergency
·
most common causes are carcinoma , Cystic fibrosis ,
bronchiectasis TB
DYSPNOEA (BREATHLESSNESS
-
the awareness that an abnormal amount of effort is required for breathing is called dyspnoed
-
careful questioning about the timing of onset , severity 3 pattern of dyspnoea is helpful in making the diagnosis
-
the patient may be aware of this only on heavy exertion or have much more limited exercise tolerance
-
dyspnoea can be graded from 1 to N :
>
-
class I -
present but no
disease dyspnoea/dyspnoea only on heavy exertion
> class
-
11-dyspnoea on moderate exertion
> class
-
III-dyspnoea on minimal exertion
>
-
class IV-dyspnoea at rest
-
the association of dyspnoea with wheeze suggests airways disease ,
which may be due to asthma or COPD
-
the duration 3 variability of the dyspnoea are important
>
-
worsens progressively over a
period of time
may be due to interstitial lung disease (1(D)
>
-
more rapid onset may be due to an acute respiratory infection or to pneumonitis
>
-
varies from day to day or even hour to hour
suggests a diagnosis of asthma
>
very rapid onset associated with sharp chest pain suggests a
pneumothorax
-
> described
-
by the patient as the inability to take a breath big enough to fill the
lungs&associated with sighing
suggests anxiety
>
-
occurs on moderate exertion may be due to the combination of obesity 3 a lack of physical fitness
COLIGH 3 SPUTLIM
-
Cough is a common
presenting respiratory symptom >
-
enables the airways
cleared of secretions 3
to be
foreign bodies
the duration of is important
> a sough
-
>
-
find out when the
cough first became a problem
·
a
sough of resent origin (particularly if associated with fever 3
other symptoms of respiratory tract infection) may be due to
a cute bronchitis or
preumonia
a chronic
cough 18 weeks) associated with wheezing may be due
·
to asthma lasthma can sometimes present only with a cough)
> a
-
change in the character of a chronic cough may indicate the
development of a new 3 serious underlying problem
cough that wakes patient from sleep may be of cardiac failure of the reflux of acid from the oesophagus into
a a
symptom
-
or
the upper airway that can occur when a
person lies down
-
patients' descriptions of their cough may be helpful
-
an immunocompromised patient with a cough often has an infectious cause e .
g TB
.
, Cryptococcus spp .,
etc .
-
enquire about the type of sputum produced I look at it if its available
of
diagnosis of bronchiectasis lobar pneumonia
a large volume
purulent/yellow/green) sputum suggests the or
-
-
foul-smelling dark-coloured sputum may indicate the presence of a lung abscess with anaerobic organisms
secretions from trachea should not be confused with
-
pink frothy the which ,
occur in
pulmonary oedema ,
sputum
-
rely on the patient's assessment of the taste of the
sputum
, HAEMOPTYSIS-coughing up of blood
-
can be a sinister sign of lung disease
-
must be distinguished from haematemesis (vomiting of blood) 3 from nasopharyngeal bleeding
-
ask how much blood has been produced
>
-
mild =< 20ml in 24 hours
·
appears as streaks of blood discolouring sputum
>
-
massive = 250ml in 24 hours = medical emergency
·
most common causes are carcinoma , Cystic fibrosis ,
bronchiectasis TB
DYSPNOEA (BREATHLESSNESS
-
the awareness that an abnormal amount of effort is required for breathing is called dyspnoed
-
careful questioning about the timing of onset , severity 3 pattern of dyspnoea is helpful in making the diagnosis
-
the patient may be aware of this only on heavy exertion or have much more limited exercise tolerance
-
dyspnoea can be graded from 1 to N :
>
-
class I -
present but no
disease dyspnoea/dyspnoea only on heavy exertion
> class
-
11-dyspnoea on moderate exertion
> class
-
III-dyspnoea on minimal exertion
>
-
class IV-dyspnoea at rest
-
the association of dyspnoea with wheeze suggests airways disease ,
which may be due to asthma or COPD
-
the duration 3 variability of the dyspnoea are important
>
-
worsens progressively over a
period of time
may be due to interstitial lung disease (1(D)
>
-
more rapid onset may be due to an acute respiratory infection or to pneumonitis
>
-
varies from day to day or even hour to hour
suggests a diagnosis of asthma
>
very rapid onset associated with sharp chest pain suggests a
pneumothorax
-
> described
-
by the patient as the inability to take a breath big enough to fill the
lungs&associated with sighing
suggests anxiety
>
-
occurs on moderate exertion may be due to the combination of obesity 3 a lack of physical fitness
