Clinical Symptoms of Respiratory System

Clinical symptoms in respiratory system

1. Cardinal Symptoms of the Respiratory System… Dr. Saswat

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3. Commonly reported respiratory symptoms…

4. Cough… Protective reflex???? Acute cough? Chronic cough? < 3 weeks >8 weeks

5. Onset: sudden/ gradual? Duration? Dry/ associated with expectoration? Diurnal variation? Postural variation? Associated hemoptysis ? Aggravating factors?

6. Dry cough?? Pleurisy. Acute trachea-bronchitis. ILD Brassy cough? Bovine cough? Nocturnal cough? Ca larynx RLN palsy Bronchial asthma, LVF.

7. Hemoptysis is expectoration of blood from the respiratory tract. D/d: bleeding from upper respiratory tract or GIT. Ask about: Appearance Amount Duration Associated with cough/food particles /epistaxis/ Massive hemoptysis : 400ml in a day or 100-150ml at one time.

8. Expectoration.

9. Profuse expectoration?? Mucoid/purulent/muco-purulent. Color : yellow/red/green/black/anchovy sauce . Postural variation? >100ml per day - Bronchiectasis Lung abscess Empyema thoracis rupturing into bronchus. Resolving stages of pneumonia

10. Dyspnea . Breathlessness inappropriate to the level of exertion or occurring at rest. Ask about: Duration. Progression. Aggravating and relieving factors. Postural variation.

11. mMRC ??? Modified Medical Research Council

12. Chest pain. Location. Type: pricking/dull aching/stabbing Radiation. Aggravating and relieving factors.

13. Reaching a diagnosis of the origin of the pain.

14. A typical pleuritic chest pain: Sharp/ stabbing in nature. Non-radiating Increased by cough and deep breathing.

15. Wheeze

16. OAD Intra-bronchial mass lesion/foreign body/lymph node. Wheeze vs stridor??

17. Case 1: A 50 year old female presents with increased cough since 10 days, which is associated with copious amounts of yellowish expectoration with foul smell. The cough and expectoration are more in left lateral position. What are your differential diagnosis? Bronchiectasis Lung abscess

18. Case 2: A 23 year old male with a height of 6’8” presents with a sudden onset of chest pain and dyspnea . The pain is localised to the right hemithorax with no radiation and increased on deep inspiration. What are the differentials? Pneumothorax. Pulmonary embolism

19. Case 3: A 60 year old male, smoker presents with cough and dyspnea since 1 month. The dyspnea is gradually progressive and the patient is now unable to walk 100 yards on a level road. He also complaints of a wheeze. 1. What is the grade of dyspnea ? 2. What is the most probable diagnosis? OAD, most probably COPD