32792_signs and symptoms of respiratory diseases

8/18/2019 32792_Signs and Symptoms of Respiratory Diseases

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Signs and Symptoms ofSigns and Symptoms of

Respiratory DisRespiratory Dis

Omer Alamoudi, Professor,Omer Alamoudi, Professor,

consultant Pulmonologistconsultant PulmonologistMD, FRCP, FACP, FCCPMD, FRCP, FACP, FCCP


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Respiratory DiseasesRespiratory Diseases

Cardinal SymptomsCardinal Symptoms

– CoughCough

– SputumSputum

– HemoptysisHemoptysis

– DyspneaDyspnea

– hee!eshee!es

– Chest painChest pain


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Other presenting symptomsOther presenting symptoms

– ApneaApnea

– HoarsenessHoarseness

– StridorStridor

– SnoringSnoring

– Fe"erFe"er– #ight s$eating#ight s$eating

– eight losseight loss


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Acute coughAcute cough

– Acute %ronchitisAcute %ronchitis

– PneumoniaPneumonia– PulmonaryPulmonary

&m%olism&m%olism

– 'eft "entricular'eft "entricular

failurefailure


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Chronic cough ()* $ee+sChronic cough ()* $ee+s

– -ronchial asthma-ronchial asthma

– Chronic %ronchitisChronic %ronchitis

– Pulmonary .%rosisPulmonary .%rosis

– 'ung cancer'ung cancer

– Drugs ( AC& inhi%itorsDrugs ( AC& inhi%itors

– -ronchiectasis-ronchiectasis


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SputumSputum – Bronchiectasis (yellow, green,Bronchiectasis (yellow, green,

large amount, more in thelarge amount, more in the

morning)morning)

– Lung abscess ( Foul smelling,Lung abscess ( Foul smelling,more on lying onmore on lying on thetheother side of lesion)other side of lesion)

– PneumoniaPneumonia ( yellowish,( yellowish,streaks of blood)streaks of blood)

– Pulmonary edema ( PinkPulmonary edema ( Pinkfrothy)frothy)


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HemoptysisHemoptysis– Massi"e )*// ml0episodeMassi"e )*// ml0episode

– Fran+ (fresh, %right red,Fran+ (fresh, %right red,

no sputumno sputum– CausesCauses

'ung cancer ( clots'ung cancer ( clots 1u%erculosis, 1u%erculosis,

-ronchiectasis ( %ris+ 2-ronchiectasis ( %ris+ 2

%rief%rief Pulmonary infarctionPulmonary infarction PneumoniaPneumonia A03 malformationA03 malformation


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DyspneaDyspnea

– Sudden ( secondsSudden ( seconds

Pneumothora4Pneumothora4( Male, COPD, or( Male, COPD, or 1all, thin 1all, thin

PulmonaryPulmonaryem%olism ( Female,em%olism ( Female,PillsPills

http://www.uhrad.com/spectarc/nuc027d2.jpg


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DyspneaDyspnea

– Acute dyspneaAcute dyspnea

(hours to days(hours to days

-ronchial-ronchial

asthmaasthma

PneumoniaPneumonia

Massi"e pleuralMassi"e pleural

e5usione5usion

PulmonaryPulmonary

edema ('3F, MSedema ('3F, MS


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Chronic dyspneaChronic dyspnea

(months to 6ears(months to 6ears

– Chronic %ronchitisChronic %ronchitis– &mphysema&mphysema

– PulmonaryPulmonary

.%rosis.%rosis

– ChronicChronicthrom%oem%olisthrom%oem%olis

mm


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1ypes of dyspnea 1ypes of dyspnea

– Paro4ysmal dyspneaParo4ysmal dyspnea

-ronchial asthma-ronchial asthma ($hee!es, no crac+les($hee!es, no crac+les 'eft "entricular failure (crac+les,'eft "entricular failure (crac+les,

cardiomegalycardiomegaly

– #octurnal dyspnea#octurnal dyspnea

-ronchial asthma-ronchial asthma 7&RD7&RD

'3F'3F


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hee!es (Rhonchihee!es (Rhonchi

– -ronchial asthma-ronchial asthma

– COPDCOPD

– Pulmonary em%olismPulmonary em%olism

– 'ung cancer'ung cancer

– -ronchiectasis-ronchiectasis– '3F'3F


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Chest painChest pain

– Pulmonary infarctionPulmonary infarction

– PneumoniaPneumonia

– Acute pleurisyAcute pleurisy

– 1iet8! syndrome 1iet8! syndrome

– Angina pectorisAngina pectoris


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7eneral e4amination7eneral e4amination

– SputumSputum

hite mucoidhite mucoid Chronic %ronchitisChronic %ronchitis Purulent, yello$, greenPurulent, yello$, green Suppurati"eSuppurati"e

lunglung syndromesyndrome

RedRed 1-, Ca lung, P& 1-, Ca lung, P&

Frothy pin+Frothy pin+ Pulmonary edemaPulmonary edema


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General examinationGeneral examination– SputumSputum

hite mucoidhite mucoid– Chronic %ronchitisChronic %ronchitis

Purulent, yello$, greenPurulent, yello$, green– Suppurati"e lungSuppurati"e lung

syndromesyndrome RedRed

– 1-, Ca lung, P& 1-, Ca lung, P& Frothy pin+Frothy pin+

– Pulmonary edemaPulmonary edema


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7eneral e4amination7eneral e4amination

– Respiratory rate (n9:; of H%deo4ygenateddeo4ygenated Central (%lue hands 2 tongueCentral (%lue hands 2 tongue

Peripheral (%lue hands 2 red tonguePeripheral (%lue hands 2 red tongue


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Hands examinationHands examination Central CyanosisCentral Cyanosis

– COPD, AsthmaCOPD, Asthma

– Pulmonary .%rosisPulmonary .%rosis– Pneumonia, P&Pneumonia, P&

– A03 malformationA03 malformation

– Cardiac Rt to 'tCardiac Rt to 't

shuntsshunts Peripheral cyanosisPeripheral cyanosis

– Cold $eatherCold $eather

– 'o$ COP'o$ COP


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Clubbing of theClubbing of the

ngers and toesngers and toes

– -ronchiectasis-ronchiectasis– Ca lungCa lung

– 'ung a%scess'ung a%scess

– Pulmonary .%rosisPulmonary .%rosis

– As%estosisAs%estosis– Cystic .%rosisCystic .%rosis


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HandsHands

examinationexamination

HypertrophicHypertrophicpulmonarypulmonary

osteoarthropathyosteoarthropathy

– Ca lungCa lung


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Hands e4aminationHands e4amination

1remors 1remors

– FineFine -* agonist-* agonist

– FlappingFlapping CO* retentionCO* retention


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Head & neck Head & neck

Horner?sHorner?s

syndromesyndrome– PtosisPtosis

– &nophthalmos&nophthalmos

– MiosisMiosis

– AnhydrousisAnhydrousis


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Head and neck Head and neck

FaceFace

– S'&S'& (-utter@y(-utter@yrashrash

– SarcoidosisSarcoidosis

('upus('upus

perniopernio


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Head and #ec+Head and #ec+

3P 3P

– CHFCHF (Pulsatile(Pulsatile– S3OS3O (#on(#on

pulsatilepulsatile


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ChestChest

e4aminatione4amination

– S+in (scarS+in (scar– 1horacotomy 1horacotomy


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ChestChest


ShapeShape– -arrel shape-arrel shape

(COPD(COPD


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ChestChest


ShapeShape– ByphoscoliosisByphoscoliosis


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ChestChest


ShapeShape– PectusPectus

e4ca"atume4ca"atum


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Head and #ec+Head and #ec+

FundiFundi

– PapilledemaPapilledema


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'ymph nodes'ymph nodes


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Chest e4aminationChest e4amination

– Position of thePosition of the

tracheatrachea Shifted to the sideShifted to the side

of the lesionof the lesion

– Fi%rosisFi%rosis

– CollapseCollapse

Shifted a$ayShifted a$ay– Pleural e5usionPleural e5usion

– 1ension 1ension

Pneumothora4Pneumothora4


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Chest e4aminationChest e4amination– Cardiac ape4Cardiac ape4

(de4trocardia(de4trocardia

– Chest e4pansionChest e4pansion(n9=cm(n9=cm

– 1actile 3ocal fremitus 1actile 3ocal fremitus EncreasedEncreased

– ConsolidationConsolidation DecreasedDecreased

– Pleural e5usionPleural e5usion



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Chest e4aminationChest e4amination

– PercussionPercussion DecreasedDecreased

– Pleural e5usionPleural e5usion(stony dull(stony dull

– ConsolidationConsolidation(dull(dull


– Fi%rosisFi%rosis EncreasedEncreased

– Pneumothora4Pneumothora42 emphysema2 emphysema


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AuscultationAuscultation

– -reathing sounds-reathing sounds

3esicular3esicular -ronchial-ronchial

AegophonyAegophony

hispering pectrologyhispering pectrology


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– Decreased %reath soundDecreased %reath sound

Pleural e5usionPleural e5usion Collapse0AtelectasisCollapse0Atelectasis

Pneumothora4 2 O%esityPneumothora4 2 O%esity

– Encreased %reath soundEncreased %reath sound ConsolidationConsolidation Ca"ityCa"ity

1op of pleural e5usion 1op of pleural e5usion


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– hee!e (Rhonchihee!e (Rhonchi

– -ilateral-ilateral Asthma, COPD, '3FAsthma, COPD, '3F

– nilateralnilateral F-F-

'ung cancer'ung cancer

Mucous plugMucous plug


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AuscultationAuscultation– Crac+lesCrac+les

(crepitations(crepitations

FineFine– Pulmonary .%rosisPulmonary .%rosis

CoarseCoarse

– -ronchiectasis-ronchiectasis

– PneumoniaPneumonia

– Pulmonary edemaPulmonary edema Friction ru%Friction ru%

– Enfection,Enfection,Enfarction, tumorEnfarction, tumor


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xamination ofxamination of

systems related tosystems related to

respiratory diseaserespiratory disease

– C3SC3S P*, Corpulmonale,P*, Corpulmonale,

CHFCHF

– A%domenA%domen HepatosplenomegalHepatosplenomegal

yy– RenalRenal

7oodpastures7oodpastures

syndromesyndrome


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xamination ofxamination ofsystems related tosystems related torespiratoryrespiratory

diseasedisease 'ocomotor'ocomotor RheumatoidRheumatoid

arthritis, S'&, PA#,arthritis, S'&, PA#,-one pain-one pain

– C#SC#S CO* retentionCO* retention &pilepsy&pilepsy Cranial ner"e palsyCranial ner"e palsy

Si d S t fSi d S t f


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xamination ofxamination of

systems relatedsystems related

to respiratoryto respiratory

diseasedisease

Skin

erythema nodosum,

vasuclitisheliotropic rash


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Gui!!esGui!!es

– ::

– **–

– ;;

– ==


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Signs and SymptomsSigns and Symptoms

of Respiratoryof RespiratoryDiseasesDiseases

1han+ you 1han+ you


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Signs and SymptomsSigns and Symptoms

of Respiratoryof RespiratoryDiseasesDiseases Suggested 1e4t %oo+ to readSuggested 1e4t %oo+ to read

– Mc'eod?s sing and symptomsMc'eod?s sing and symptoms

32792_signs and symptoms of respiratory diseases

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