Respiratory system examination
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This document discusses taking a thorough history for patients presenting with respiratory symptoms. It outlines key questions to ask about symptoms like breathlessness, cough, sputum production, hemoptysis, wheezing, and chest pain. Additional details should be gathered about smoking history, ear/nose/throat issues, and voice changes. A careful history is emphasized as central to evaluating respiratory diseases, which account for a large burden of mortality and healthcare visits.
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Sources for all imagery and sources listed in references section where possible. I do not claim ownership of any images or graphics. Slides for educational purposes only, and should not replace clinical judgement. No monetary gain was made for this work.
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*Re-upload of slides originally posted 16th April 2019.*
Note: Uploading to SlideShare causes disruption to slide layout. Original layout visible on download.
Case presentation of a patient (anonymised) seen in outpatient clinic during course of medical school studies.
NOTE: Slide 7 references the patient never having had a flu vaccination due to their egg allergy. Although trivalent influenza vaccinations are grown in embryonated hens' eggs, other preparations (such as the Influenza A-specific flu vaccine) are grown in mammalian cells and are therefore safe for patients with egg allergy.
Sources for all imagery and sources listed in references section where possible. I do not claim ownership of any images or graphics. Slides for educational purposes only, and should not replace clinical judgement. No monetary gain was made for this work.
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3. The second case involves a 45-year-old man with fever, runny nose, dizziness, and nausea/vomiting for several days. Examination found horizontal nystagmus, and he was diagnosed provisionally with vestibular neuritis. He was admitted and treated with medications, showing improvement after
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82006017 22508056-case-study-of-bronchitis
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Dd wheezy chest in infant for fm
The document defines a wheeze as a high-pitched sound caused by narrowed airways, discusses the differential diagnosis and symptoms of conditions that can cause wheezing like bronchiolitis, asthma, and pneumonia. It also provides details on the pathogenesis, diagnosis, treatment and prevention of bronchiolitis in infants, noting that the mainstay of treatment is supportive care while reserving medications for severe cases.
Diseases related to circulatory and respiratory system
This document discusses diseases that affect the respiratory and circulatory systems. It describes common respiratory illnesses like the common cold, influenza, pneumonia, tuberculosis, asthma, bronchitis, and emphysema. It also outlines circulatory conditions including atherosclerosis, stroke, coronary heart disease, hypertension, hemophilia, anemia, and leukemia. The document emphasizes that lifestyle factors like smoking can contribute to respiratory diseases, while conditions like atherosclerosis are linked to diet and exercise habits. Maintaining a healthy lifestyle can help prevent and manage issues with the respiratory and circulatory systems.
Breathlessness
This document discusses shortness of breath (dyspnoea), including its definition, grading scales, common causes, history taking, physical examination findings, differential diagnosis, initial investigations, and basic management. It defines dyspnoea as an uncomfortable sensation of breathing that feels inappropriate or disproportionate. Grading scales like the MRC and NYHA are described. Common causes involve the cardiovascular, respiratory, and other body systems. A thorough history and physical exam are important for determining the underlying etiology. Initial tests may include pulse oximetry, peak flow measurement, chest x-ray, ECG, and lung biopsy. Treatment is aimed at addressing the specific cause, and may involve pharmacological therapies, oxygen supplementation, or non-
Case study semester 4
This patient presented with progressive shortness of breath over the past year. Examination revealed crackles and clubbing, with imaging showing lower lobe fibrosis and upper lobe emphysema. Pulmonary function tests demonstrated preserved lung volumes with severely decreased diffusion capacity. The assessment is of combined pulmonary fibrosis and emphysema based on the characteristic findings on history, examination, imaging and pulmonary hypertension on echocardiogram. Treatment focuses on oxygen, pulmonary rehabilitation and monitoring given the limited effectiveness of medications for this condition.
GROUP 2 RMHN PULMONARY HEART DISEASE.pptx
- Pulmonary heart disease (PHD), also known as cor pulmonale, refers to enlarged and failing of the right ventricle of the heart in response to increased pressure in the lungs.
- The pathophysiology involves elevated pulmonary vascular resistance which increases pulmonary arterial pressure and right ventricular workload, leading to hypertrophy.
- Risk factors include lung diseases, obesity, sleep apnea, altitude and certain drugs. Signs include cyanosis, edema and shortness of breath. Treatment aims to reduce afterload and support the heart.
Approach to. . dyspnea.pptx
1. Dyspnea, or breathlessness, is a common and debilitating symptom that affects many patients presenting to hospitals and clinics.
2. Dyspnea can have cardiac or pulmonary causes, and a thorough assessment is needed to determine the underlying reason for the symptom. Key parts of the assessment include evaluating dyspnea based on exertion level, as well as signs like orthopnea and paroxysmal nocturnal dyspnea.
3. Grading scales like NYHA and mMRC can help classify the severity of dyspnea and predict outcomes. Features like duration of symptoms and time between dyspnea and edema onset also provide useful clinical information.
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4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
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Respiratory system examination
- 1. Respiratory System Examination By Dr. Walid G. Babikr MRCPI By Dr. Walid G. Babikr
- 2. Introduction • Diseases of the respiratory system account for a third of deaths in most countries. • Accounts for a major proportion of visits and time a way from work and school. • Key to success is clear and carefully recorded history. • Symptoms range from trivial to extremely distressing By Dr. Walid G. Babikr
- 3. The History • Most patients with respiratory disease will present with one or more of the following symptoms: • BREATHLESSNESS Breathlessness inappropriate to the level of physical exertion is called ‘dyspnea’ By Dr. Walid G. Babikr
- 4. • What is the mechanism of dyspnea ? • People with cardiac disease may become dysnpneic as well. • Is the dyspnea related only to exertion? • How far can the patient walk without feeling short of breath? • Is there variability of symptoms? • Variable airway obstruction due to asthma is very often worse at night and in the early morning. By Dr. Walid G. Babikr
- 5. Cough • May be dry or productive of sputum. • How long has the cough been present? • Is the cough worse at any time of day or night? • Is the cough aggravated by any thing e.g.. dust, pollen or cold air? By Dr. Walid G. Babikr
- 6. SPUTUM • Is sputum produced? • Ask for a description of its color and consistency. • How much is produced? By Dr. Walid G. Babikr
- 7. HEMOPTESIS • Means the coughing of blood in the sputum. • Careful evaluation is mandatory. • Ask specifically about it ‘Is there any blood in the sputum?’ • Is it fresh or altered blood? • How often has it been seen and for how long? Any associated conditions e.g.. epistaxis By Dr. Walid G. Babikr
- 8. WHEEZING • Always ask whether the patient hears any noises coming from his chest. • Sometimes it will have been noticed by others but not by he patient. • Strider may sometimes be mistaken as wheezes ‘by both patient and doctor'. This is serious finding indicates narrowing of the larynx, trachea or main bronchi. By Dr. Walid G. Babikr
- 9. CHEST PAIN • Can be musculoskeletal caused by bouts of cough. • Chest pain caused by lung disease usually arises from the pleura ’a sharp or stabbing pain and is made worse by deep breathing and coughing. By Dr. Walid G. Babikr
- 10. OTHER SYMPTOMS • Ear, nose and throat Is there any recurrent sinusitis-may be linked with asthma or less commonly with bronchiectasis. • Is there any change in the voice? This may indicate involvement of the left recurrent laryngeal nerve by a carcinoma of the lung. By Dr. Walid G. Babikr
- 11. THE SMOKING HISTORY • Always take a full smoking history-be sympathetic and non condemnatory. • Advise for stopping smoking should be left at the end ..not at the spot. • Simply asking do you smoke? is not enough. By Dr. Walid G. Babikr