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Flashcards in Cough and breathlessness Deck (21)
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1
Q

what is the difference between signs and symptoms

A

Signs – observed

Symptoms – experienced by patients

2
Q

what is the difference between SOB and tight chest

A

SOB inc RR and dec SaO2

Tight chest dec PEFR and wheeze

3
Q

what is a cough

A

Ptussive reflex
Irritation – medulla – inspiration – closed glottis – contraction – expulsion
Protective – aspiration and clearance
Can be problematic – oedema and rib fractures
vagus nerve stimulation

4
Q

what are types of coughs

A
whooping and barking
productive
bovine
smokers
fruity vs dry
acute, subacute, chronic
5
Q

what are causes of cough

A

Chronic
Irritation or infection
Acute
Medications, asthma, rhinitis, oesophageal reflex, cancer

6
Q

what does sputum look like

A

quantity, colour, smell, blood

7
Q

what does haemoptysis

A

frothy and pink, bright red or dark (altered)

8
Q

what is dyspnoea

A

Red flag
Obstructive or restrictive
Acute – trauma and obstruction, infection, PTX, PE, panic
Chronic – anaemia, HF, metabolic, COPD, asthma, fibrosis, cancer

9
Q

how can dyspnoea be treated

A
ABCs
Syrups and linctus
Avoidance 
Quarantine
Antibiotics 
Inhalers
10
Q

what are the impacts of a cough

A

affects sleep, affects carer/partner, pain in ribs (can get associated rib fractures) and throat (can get associated vocal cord oedema affecting voice),
stress incontinence, cough syncope

11
Q

how can a cough categories

A
duration - acute:<2weeks, persistent:2-8weeks, chronic:>8weeks
pattern
sound
triggers
sputum 
nature of onset

food relationship, factors that make it worse, haemoptysis

12
Q

what does the colour of the haemoptysis mean

A

Bright red (pulmonary infarct, rupture of pharynx capillaries)
Rusty (pneumonia)
Pink and frothy (heart failure or other causes of pulmonary oedema)

13
Q

common causes of haemoptysis

A

Acute infection, bronchial carcinoma, TB, PI

occasionally trauma, vascular abnormalities, bleeding disorders

14
Q

what are naso and nasopharyngeal considerations for a cough

A

rhinosinusitis - cough, post nasal drip, clear throat/tickle, congestion, nasal discharge, hoarseness - resolve cough
URTI

15
Q

What are tracheo-bronchial considerations for a cough

A
Asthma
COPD
Bronchiectasis
Cancer (bronchogenic carcinoma, SCLC, environmental)
Infection (acute - CAP, chronic - TB)
16
Q

What (gastro-oesophageal origin) might cause a cough

A

GORD/reflux
may have no gastric symptoms
cough receptors in oesophagus - aspirate stomach contents
confirm with successful anti-GORD therapy

17
Q

What medication can cause a cough

A

ACE inhibitors

possibly beta blockers

18
Q

what is SOB

A

difficult or laboured breathing, associated with a distressing feeling of not being able to breathe enough / get enough air in (dyspnoea)
Same history as cough

19
Q

What are causes of SOB

A
sudden - inhaled foreign body, Ptx, PE
days - pneumonia, HF
weeks - Pleural effusion, anaemia
months - cancer, fibrosis
years - muscle weakness, COPD, fibrosis, obesity
20
Q

what is hyperventilation

A

‘inappropriate’ over-breathing…often associated with sensation of dyspnoea
significant proportion of chronic SOB in a community setting
likely cause of SOB in younger rather than older person

21
Q

what is hyperventilation characterised by

A

SOB, sighing speech and worse with stress rather than exercise
Physical symptom of anxiety (inc. palpitations)
Management -reassurance, rebreathing and relaxation techniques