Respiratory Tract Diseases
COPD (Chronic Obstructive Pulmonary Disease):
Causes: long term exposure to toxic particles and smoking
Symptoms:
- Breathlessness = dyspnoe
- Productive coughing
- Fatigue
Findings on examination:
- Dyspnoe
- Wheeze
- Decreased breath sounds
Investigations:
- Spirometry (decreased Forced Expiratory Volume 1 (FEV1))
- Blood gasses (decreased O2, increased CO2)
- X-ray (enlarged lung volume, low flattened diaphragm)
Upper Respiratory tract Infection (URI) common cold, hay fever, sinusitis, etc.
Causes: virusses (rhinovirus!), bacteria or fungi
Symptoms:
Cough/Sneezing
Sore throat
Runny nose
Headache
Findings on examination:
Symptoms which lead to the diagnosis (investigations often not necessary).
Investigations:
Hay fever: skin prick test or measuring of IgE antibodies
Blood test for virus, bactium or fungus
Pneumonia
Causes: virusses, bacteria or fungi
Symptoms:
Cough
Fever
Chest pain
Breathlessness
Findings on examination:
Rapid breathing
Increased temperature
Changed skin colour (due to lack of oxygen)
Investigations:
X-ray (white areas)
Blood test (WBC high)
Bronchoscopy
,Pulmonary Embolism
Causes: often a deep venous thrombosis (DVT) in the leg
Symptoms:
Breathlessness
Chest pain
Coughing (with blood = hemoptysis)
Findings on examination:
Rapid breathing
Arrhythmia
Cyanosis, increased heart rate, sweating collapse
(Swollen, painful, red, warm leg in case of DVT)
Investigations:
Ventilation/perfusion scan, VQ scan (to localize)
Pulmonary angiography (look for blood cloth)
CT-scan (look for blood cloth)
Blood test (high D-dimer)
ECG (dysfunction of the right side of the heart)
Pneumothorax
Causes: COPD, asthma, cyctic fibrosis, lung infections, lung cancer, trauma to chest/lung
Symptoms:
Unilateral chest pain
(increasing) dyspnoe (leading to severe oxygen shortage and cardiac arrest)
Findings on examination:
Breathlessness
Pale
Tachycardia
Investigations:
X-ray (black lung)
CT-scan
Ultrasound
Asthma
Causes: allergens (e.g. dust), chemicals, drugs, etc.
Symptoms:
Wheezing attacks of shortness of breath
Cough
Chest tightness
Findings on examination:
Decreased breathing sounds
Wheezing
Eczema
Investigations:
Spirometry
Skin test for allergies
Blood gasses (decreased O2, increased CO2)
, Gastrointestinal Diseases
Cystitis (inflammation of the bladder)
Causes: bacteria (E. coli!), virusses, fungi, chemotherapy/radiotherapy
Symptoms:
Painful voiding
Frequent urination
Heamaturia
Abdominal pain
Findings on examination:
Constant urination impulse
Smelly urine (with blood)
Increased temperature
Investigations:
Urine culture
Cytoscopy (+ biopsy to look for inflammation)
Less common: imaging with X-ray/CT/Ultrasound/MRI
Cholelithiasis = gallstones, mostly in gallbladder
Causes: Obesity, fat diet, diabetes mellitus,
Symptoms:
Abdominal colic pain
Nausea and vomiting
Dark urine and clay-colored stools (when stones block the billary tract)
Findings on examination:
Right upper quadrant abdominal tenderness
Jaundice (when stones block the billary tract)
Increased temperarture (when stones block the billary tract)
Investigations:
Blood tests (inflammatory markers cholecystitis?)
ERCP (Endoscopic Retrograde CholangioPancreaticography) to localize and remove
CT-scan
Cholecystitis (inflammation of the gallbladder)
Causes: cholelithiasis stasis of the gall infection by E.coli
Symptoms:
Severe pain in the right upper quadrant of the abdomen or in the epigastric region
Nausea (with vomiting)
Diarrhea
Findings on examination:
Emphyema (extended gallbladder by pus)
Increased temperature
Jaundice (normally not in cholecystitis, so this indicates complications!)
Investigations:
X-ray (to look for gallstones and inflammation)
Ultrasound (to look for gallstones and inflammation)
Blood test (to look for inflammatory markers)
