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Summary - Approach to Patients with Respiratory Diseases - Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2), ISBN: 9781259644030 Physical Diagnosis (PD) $7.49   Add to cart

Summary

Summary - Approach to Patients with Respiratory Diseases - Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2), ISBN: 9781259644030 Physical Diagnosis (PD)

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This is a summary of the approach to patients with respiratory diseases. It tackles the cardinal signs and symptoms of respiratory diseases and the suggestive etiologies.

Last document update: 3 year ago

Preview 1 out of 3  pages

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  • Chapter 278
  • May 25, 2021
  • May 25, 2021
  • 3
  • 2020/2021
  • Summary
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Available practice questions

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Some examples from this set of practice questions

1.

It is referred to as the high-pitched whistling noise produced by movement of air through narrowed or compressed small airways. It is commonly heard among patients with obstructive lung diseases.

Answer: Wheezing

2.

Stridor is commonly heard among patients with foreign body aspiration. What is the mechanism behind the production of this sound?

Answer: Rapid, turbulent flow of air through a narrow/partially obstructed segment of extra thoracic upper airway

3.

Cyanosis is a sign of:

Answer: Hypoxemia

4.

Chronic cough lasting for more than 8 weeks can be observed in patients with:

Answer: Obstructive lung diseases GERD/ postnasal drip

5.

Dyspnea described as air hunger or sense of suffocation may be indicative of:

Answer: Heart failure

HPIM Chapter 278  Chronic disorders s/a tracheomalacia
APPROACH TO THE PATIENT WITH DISEASE OF THE o Hemoptysis
RESPIRATORY SYSTEM  >1 symptom: identify which symptom is primary
 Identify other constitutional symptoms:
 Cardinal symptoms: cough and/or dyspnea o Fever
 Categories o Weight loss
o Night sweats
 Dyspnea
o Useful descriptive words:
 Dyspnea with chest tightness/ inability to get a deep
breath  COPD
 Air hunger/ sense of suffocation  CHF
o Tempo of dyspnea:
 Acute SOB: laryngeal edema, bronchospasm, MI, PE,
PTX
 Gradual progression of dyspnea on exertion:
INTERSTITIAL PULMONARY FIBROSIS/COPD
 Intermittent episodes of dyspnea/ cough/chest
tightness: Asthma
o What to ask?
 Factors that incite/relieve dyspnea
 Determine degree of activity that results in SOB
(dyspnea on exertion)
 Cough
o Duration
o Productive/nonproductive
 Quality of sputum – blood-streaked, frankly bloody
o Timing
 Acute cough productive of phlegm  infection of
respiratory system
HISTORY  Upper airways: sinusitis, tracheitis
 Common symptoms  Lower airways: bronchitis, bronchiectasis
o Dyspnea  Lung parenchyma: pneumonia
o Cough  Chronic cough (>8wks)
o Chest pain  Obstructive Lung Diseases
o Wheezing  Nonrespiratory diseases: GERD/postnasal drip
 High-pitched whistling noise produced by movement  Persistent nonproductive cough
of air through narrowed or compressed small  Interstitial pulmonary fibrosis
airways  Other symptoms
 Airflow through a narrowed or compressed segment o Wheezing – suggestive of airway disease (Asthma)
of a small airway becomes turbulent, causing o Hemoptysis
vibration of airway walls  Respiratory tract infection, bronchogenic carcinoma,
 More common during expiration because increased PE
intrathoracic pressure during this phase narrows the o Chest pain
airways and airways narrow as lung volume  NOTE: Lung parenchyma is not innervated by pain
decreases. fibers; chest pain results from diseases of parietal
o Stridor pleura or pulmonary vascular diseases
 High-pitched, whistling, predominantly inspiratory o Diseases of the lung  strain R side of the heart  cor
sound pulmonale, abdominal bloating, distention, pedal
 D/t rapid, turbulent flow of air through a narrow/ edema
partially obstructed segment of extrathoracic upper  Additional History
airway (pharynx, epiglottis, larynx, extrathoracic o Cigarette smoking, secondhand smoke, inhalational
trachea) exposures (occupational and envt’l)
 Acute disorders s/a foreign body aspiration

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