This is a draft cheat sheet. It is a work in progress and is not finished yet.
Red Flag Symptoms:
F |
Fever |
L |
Lethargy |
A |
Anorexia |
W |
Weight Loss |
S |
Night Sweats |
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Symptoms:
Cough: |
Chronology, Timing, Exacerbating, Type
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Sputum: |
Acute Onset:
Chronic:
Amount and Colour: |
Infection
Post Nasal Drip/COPD/Bronchiectasis/Lung Cancer/TB/CCF/ACE Inhibitor
Purulent => Infection
Foul Smelling and Tasting => Anaerobic Infection
"Rusty" => Pneumococcal Pneumonia
Pink and Frothy/Foamy => Pulmonary Oedema
Copious, Frothy, and Saliva like => Bronchoalveolar carcinoma)
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Haemoptysis: |
Chronology, Amount |
Lung Cancer/Bronchiectasis/Exacerbation of COPD/Pulmonary Infarction/TB/Lung Abscess/Heart Failure/Bleeding Diatheses (Increased susceptibility to bleeding or bruising)
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Breathlessness: |
Chronology, Onset, Precipitating Events, Severity, Associated with wheeze/cough
|
Stridor: |
Upper Respiratory Tract - Inspiratory |
An abnormal, high-pitched respiratory sound produced by irregular airflow in a narrowed airway.
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Wheeze: |
Lower Respiratory Tract - Expiratory |
Pleuritic Chest Pain: |
Parietal Pleura/Chest Wall |
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Asthma:
A chronic inflammatory disorder of the airways causing reversible airways obstruction |
Diagnosis by clinical features and spirometry |
Episodic |
Reversible either spontaneously or with treatment |
Airway hyper-responsiveness to a wide range of stimuli |
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Risk Factors: |
• Particularly common in the second decade of life.
• Much more common in western developed countries.
• Potent Senstisers in the workplace |
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Symptoms: |
• Recurrent episodes of wheezing
• Episodic Breathlessness
• Chest Tightness
• Coughing - Particularly at night or in the early morning |
|
Clinical Features: |
• Increased Respiratory and Pulse Rate
• Pulsus Paradoxus - An exaggerated fall in a patient's BP (>10mmHg) during inspiration
• Reduced air entry
• Using muscles of inspiration
• Wheeze -> Silent chest = Severe Attack
• Inability to Speak -> Severe Attack
• Cyanosis, Clammy, Sweating, Confused -> Life Threatening Attack |
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Triggers: |
Specific:
• Allergen
• Occupational
Non-Specific:
• Exercise
• Cold
• Atmospheric Pollutants - Smoking, Environmental
• Emotion
• Medications - NSAIDS, Beta Blockers |
|
Management: |
• Patient and family education about asthma, and participation in treatment
• Avoidance of identified causes where possible
• Use of the lowest effective does of convenient medications to minimize short-term and long-term side-effects |
Treatment: |
• Occasional use of inhaled short-acting β2-adrenoreceptor agonists - bronchodilators
• Introduction of regular preventer therapy
• Moderate dose of inhaled steroid and add-on therapy
• Continuous or frequent use of oral steroids |
COPD:
Airflow limitation (obstruction) that is not fully reversible, generally progressive. |
|
Risk Factors: |
• Rare under 40y/o - common in elderly
• Industrialised countries
• Lower income groups
• Rates rising in women, but plateaued in men
• Smokers |
|
Causes: |
• Tobacco smoke -> 95% of cases
• Indoor air pollution -> cooking with biomass fuels
• Occupational exposures - Coal dust, silica, cadmium
• Low birthweight, childhood infections, maternal smoking -> Lower maximally attained lung function
• Infections - Adenovirus, HIV
• Cannabis Smoking
• Genetic factors - α1-antiproteinase deficiency, Airway hyper-reactivity |
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General Signs: |
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