Questions on presenting problems of respiratory system
Rimikri
SOLVES
Presenting problems
What are the common presentations (symptoms) of respiratory diseases?
- Cough
- Sputum
- Wheeze
- Breathlessness
- Chest pain
- Hemoptysis.
Cough
What are the causes of cough?
- Acute cough (<3 weeks)
- Viral respiratory tract infection (rhinitis/sinusitis)
- Bacterial infection (acute bronchitis)
- Inhaled foreign body
- Pneumonia
- Acute extrinsic allergic alveolitis.
- Chronic cough (>8 weeks)
- COPD
- Asthma
- Tuberculosis
- Lung carcinoma
- Bronchiectasis
- Interstitial lung disease.
- GERD
- Postviral bronchial hyper-reactivity
- Rhinitis/sinusitis
- Cigaret smoking
- Drugs, especially ACE inhibitors.
What are the 'Red flag' symptoms associated with cough?
- Hemoptysis
- Breathlessness
- Fever
- Chest pain
- Weight loss.
What are the causes of cough with normal chest X-ray?
- GERD
- Cough variant asthma
- Postnasal drip (rhinitis/sinusitis)
- Postviral bronchial hyper-reactivity
- Cigaret smoking
- Drugs, especially ACE inhibitors
- Viral respiratory tract infection
- Bacterial infection (acute bronchitis)
- Inhalation of irritant dusts/fumes.
What are the causes of productive cough?
- Pneumonia
- Bronchiectasis
- Lung abscess
- Acute pulmonary edema
- Chronic bronchitis/COPD
- Cystic fibrosis
- Alveolar cell cancer.
Sputum
What are the causes of purulent sputum?
- Pneumonia
- Bronchiectasis
- Lung abscess
- COPD (infective exacerbation)
- Cystic fibrosis.
What are the causes of copious amount of sputum?
- Bronchiectasis
- Rupture of a lung abscess or empyema into the bronchial tree
- Pulmonary edema
- Alveolar cell cancer.
What is the cause of rusty sputum?
Pneumococcal pneumonia is the cause of rusty sputum.
What are the causes of frothy sputum?
- Pulmonary edema
- Alveolar cell carcinoma.
Wheeze and stridor
What is wheeze?
Musical sound produced by obstruction of small bronchus and bronchioles.
What are the causes of wheeze?
- Asthma
- COPD.
* Pre-exam preparation for medicine, HN Sarker
What is stridor?
Sound produced by obstruction of large bronchus whether intrathoracic or extrathoracic.
Breathlessness/ dyspnea
What are the causes of breathlessness according to time frame?
- Minutes
- Pulmonary thromboembolism
- Pneumothorax
- Acute left ventricular failure
- Acute severe asthma
- Inhaled foreign body.
- Hours to days
- Pneumonia
- Asthma
- Exacerbation of COPD.
- Weeks to months
- Anemia
- Pleural effusion
- Respiratory neuromuscular disorders.
- Months to years
- COPD
- Pulmonary fibrosis
- Pulmonary tuberculosis.
What are the causes of chronic breathlessness, according to lung and heart cause?
Lung causes are:
- Chronic obstructive pulmonary disease
- Chronic asthma
- Chronic pulmonary thromboembolism
- Bronchial carcinoma
- Interstitial lung diseases: Sarcoidosis, fibrosing alveolitis, and extrinsic allergic alveolitis.
- Lymphatic carcinomatosis
- Large pleural effusion(s).
Heart causes are:
- Chronic congestive cardiac failure
- Myocardial ischemia.
Read more about dyspnoea at Symptoms of cardiovascular disease
Tell the MRC grading of dyspnea.
See more about dyspnoea at COPD
* Davidson’s Principles and Practice of Medicine, 22nd Edition Page: 674
Hemoptysis
What is hemoptysis?
Hemoptysis means coughing up blood.
What is massive hemoptysis?
Coughing out 200ml of blood in 24 hours.
Tell six common causes of hemoptysis.
- Tuberculosis
- Bronchial carcinoma
- Bronchiectasis
- Pneumonia
- Mitral stenosis
- Pulmonary infarction.
