Respiratory Disease Clinical Features

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Respiratory Disease Clinical Features:

Cough:
Major protective reflex mechanism – clears foreign bodies and mucous  protects lungs.
Drugs used to treat cough – opioids (codeine, dextromethorphan); diphenhydramine

Dyspnoea/Breathlessness:
Common symptom or cardiac and respiratory disease
Can be due to:
• Obstruction of airflow (eg asthma; bronchitis; emphysema)
• Restricted chest expansion (eg ankylosing spondylitis; obesity; weakness of respiratory muscles;)
• Decreased pulmonary compliance (eg pulmonary oedema; fibrosis)
• Cardiac (eg congenital heart disease, chronic cardiac failure)

Onset:
• Sudden (eg acute asthma; pneumothorax; pulmonary embolism; foreign body inhalation)
• Rapid (eg acute asthma; acute bronchitis; haemothorax; pulmonary oedema)
• Gradual (eg chronic asthma; pleural effusion; chronic bronchitis)
• Slow (eg emphysema, chronic bronchitis)

Sputum production:
Amount, character, odour, taste, viscosity  indicate possible cause

Haemoptysis:
Blood is coughed up – due to bleeding from the respiratory tract.
Most commonly due to neoplasm, bronchiectaisis, acute bronchitis, pulmonary infarction, tuberculosis, acute left ventricular failure

Wheezing:
Musical produced by air moving through narrowed bronchi – louder during expiration. Due to obstruction of airway.
Not to be confused with loud or laboured breathing.

Chest Pain:
If retrosternal or pleural  indicates respiratory cause.

Respiratory Failure:
Occurs when lung function is inadequate for metabolic requirements
Commonly due to – severe acute asthma, exacerbation of COPD, left ventricular failure, pulmonary embolism, pneumonia

Spirometry:
Measures functional lung capacity

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