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48 Cards in this Set

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Asthma
CC: Dyspnea, cough, noisy breathing
Onset: hours to days
Key: Worse in spring, night, exertion, early morning. Mucus plugs with thick sputum. Episodic polyphonic wheeze
Other Sxs: chest tightness, cough, wheeze, pursed lip breathing.
Pulmonary Oedema (PE) (left-sided Heart failure)
CC: Dyspnea, haemoptysis
Onset: slow progression through weeks.
Key: Orthopnea, ankle oedema, pink frothy sputum. Hx of heart disease.
Other Sxs: cough, wheeze, sharp leuritic pain, fever. Gallops, murmurs.
Findings: Late insp. crackles in early PE.
Pneumonia
CC: Cough, dyspnea
Onset: acute over few days
Key Sxs: exposure Hx. Thick yellow sputum.
Other Sxs: Worse with exertion. Egophony (A to E).
Chronic Obstructive Pulmonary Disorder (COPD)
CC: Dyspnea
Onset: months to years
Key Sxs: exacerbated with irritant exposure. Hx of smoking. Occupational/familial.
Other sxs: pursed lip breathing.
Pleurisy ("devil's grip")
CC: chest pain
Onset: acute
Key Sxs: worse with deep inspiration
Other Sxs: severe, sharp, stabbing pain.
Pathology: inflammation of parietal pleura; viral or pneumonia caused.
Myocardial
CC: Chest Pain
Onset: minutes to hours
Key Sxs: radiating pain to jaw or left arm. Relief with NTG, rest.
Other Sxs: Dull chest pressure or tightness.
Neuritis (Herpes Zoster; Shingles)
CC: Chest pain
Onset: intermittent bouts of shooting pain lasting secs to mins.
Key Sxs: Dermatomal distribution, shock-like pain. Worsens with light touch but NOT respiration.
Musculoskeletal chest pain
CC: chest pain
Onset: variable
Key Sxs: pain waxes and wanes, worsens with motion, pressure. Hx of trauma.
Viral Croup
CC: cough
Onset:
Key Sxs: Dry barky stridor (upper airway infection). Relief with cool, moist air.
Post Nasal Drainage
CC: cough
Onset: chronic with seasonal variation
Key Sxs: clear, purulent sputum, triggered by irritants.
Gastro-oesophageal Reflux
CC: cough
Onset: chronic
Key Sxs: non-productive cough; throat-clearing, heartburn
Other Sxs: May awaken from sleep; morning/nocturnal.
Lung Cancer
CC: Haemoptysis
Onset: Sudden or intermittent production of flecks.
Key Sxs: Hx of smoking.
Other Sxs: pain less common. Weight loss, anorexia, dyspnea.
Epistaxis (nosebleed)
CC: Haemoptysis.
Onset:
Key Sxs: May be large volume. Hx of trauma, HTN.
Bronchitis
CC: Haemoptysis
Onset: chronic or acute.
Key Sxs: Resp. infection with blood-streaked sputum.
Other: Chronic form assoc. with smoking, wheeze, dyspnea.
Tracheomalacia (collapse of trachea)
CC: noisy breathing
Onset: chronic
Key Sxs: stridor during inspiration, common in infants or after airway injury. Worse with ↑'d resp. effort.
Foreign Body Aspiration
CC: noisy breathing
Onset: acute
Key Sx: monophoic wheezing
Other Sx: cough, signs of infxn, Hx of choking/vomitting, loss of consciousness.
Snoring
CC: noisy breathing
Onset: chronic
Key Sx: sonorous upper airway/throat noise with inspiration.
Other Sx: Assoc. nasal congestion, obesity, sleep disruption
Consolidation
CC:
Path.: Alveoli filled with fluid or blood cells, as in pneumonia, PE, hemorrhage.
Key findings: Late insp. crackles, ↑ fremitus
Atelectasis
CC:
Path.: Plug in mainstream bronchus obstructs air. Affected area collapses into airless state.
Key findings: no breath sounds (unless one-sided), no fremitus.
Pleural Effusion
CC:
Path: Fluid accumulates into pleural space.
Key Findings: ↓'d to absent breath sounds, possible pleural rub, ↓'d to absent fremitus
Pneumothorax
Path: air leaks into pleural space, usu. unilat.
Key Findings: ↓'d to absent breath sounds, possible pleural rub, ↓'d to absent fremitus (same as for pleural effusion)
Laryngitis
Cough: dry
Sputum: absent
Onset: acute
Assoc.: viral nasopharyngitis.
Tracheobronchitis
Cough: dry
Sputum: variable
Onset: acute
Assoc: often viral; burning retrosternal discomfort.
Mycoplasma/Febrile Pneumonias
Cough: Dry, hacking
Sputum: mucoid
Onset: acute
Assoc: febrile illness with malaise, heachache, dyspnea.
Bacterial Pneumonias
Cough:
Sputum: mucoid/purulent, may be blood-streaked.
Onset: acute
Assoc: high fever, chills, dyspnea, chest pain.
Bronchiectasis
Cough: chronic
Sputum: mucoid/purulent, often copious and foul-smelling.
Onset: chronic
Assoc: smoking. Wheezing, dyspnea.
Pulmonary Tuberculosis
Cough: Dry
Sputum: mucoid/purulent, may be blood-streaked.
Onset:
Assoc: anorexia, wit loss, fatigue, fever, night sweats
Lung Abscess
Cough:
Sputum: purulent, foul-smelling. May be blood-streaked.
Onset:
Assoc: febrile; poor dental hygiene. Loss of consciousness.
Pulmonary Emboli
Cough: dry to productive
Sputum: dark, bright red, or mixed with blood.
Onset: dyspnea, anxiety, chest pain, fever, DVT.
Assoc:
Paroxysmal Nocturnal Dyspnea (PND)
CC: Dyspnea
Onset: Sudden after a few hours of comfortable sleep.
Angina Pectoris
CC: Chest pain
Onset: Sudden
Features: Resolves with rest. Usu. left-sided, extends to middle of left arm.
Palpitations
Def.: Abnormal awareness of heart beat
Syncope
Def.: Abrupt los of conscious postural tone.
Mech: ↓ cerebral blood flow.
dysphagia
Difficulty swallowing

Notes: Solids vs. liquids (solids easier in achalasia), position.
polyphagia
excessive eating

Notes: Uncontrolled diabetes, malabsorption, anorexia nervosa.
odynophagia
painful swallowing

Oesophagitis?
Haematemesis
vomitting blood

blood vs. coffee grind; peptic ulcer, gastritis, oesophageal tear, oesophagitis, neoplasm, oesophageal varices.
dyspepsia
indigestion
eructation
belching
borborygmi
rumbling bowel sounds. Little clinical significance.
bloating/flatulence
Causes: malabsorption, bacterial overgrowth, obstruction, overeating.
colic
spasmodic abdominal pain; crescendo/descrescendo pattern.

Causes: obstruction, erratic peristalsis.
Steatorrhea
fatty stools

Cause: usu. fat malabsorption.
scybala
small, hard rounnded masses of stool; little clinical significance.
haematochezia
blood in stool

Causes: hemorrhoids, early sign of colon cancer.
melena
black stool from digested blood.

Causes: significant blood loss.
tensemus
rectal pain

Causes: proctitis, spasms from irritable bowel syndrome
hemorrhoids
Internal: will bleed, not palpable. May prolapse. Usually no discomfort.

External: visible, painful at times.