Omer Alamoudi, Professor, consultant Pulmonologist Signs and Symptoms of Respiratory Dis eases Signs and Symptoms of Respiratory Diseases Omer Alamoudi, Professor, consultant Pulmonologist MD, FRCP, FACP, FCCP

Signs and Symptoms of Respiratory Diseases Cardinal Symptoms Cough Sputum Hemoptysis Dyspnea Wheezes Chest pain

Signs and Symptoms of Respiratory Diseases Other presenting symptoms Apnea Hoarseness Stridor Snoring Fever Night sweating Weight loss

Signs and Symptoms of Respiratory Diseases Acute cough Acute bronchitis Pneumonia Pulmonary Embolism Left ventricular failure

Signs and Symptoms of Respiratory Diseases Chronic cough (>2 weeks) Bronchial asthma Chronic bronchitis Pulmonary fibrosis Lung cancer Drugs ( ACE inhibitors) Bronchiectasis

Signs and Symptoms of Respiratory Diseases Sputum Bronchiectasis (yellow, green, large amount, more in the morning) Lung abscess ( Foul smelling, more on lying on the other side of lesion) Pneumonia ( yellowish, streaks of blood) Pulmonary edema ( Pink frothy)

Signs and Symptoms of Respiratory Diseases Hemoptysis Massive >200 ml/episode Frank (fresh, bright red, no sputum) Causes Lung cancer ( clots) Tuberculosis, Bronchiectasis ( brisk & brief) Pulmonary infarction Pneumonia A/V malformation

Signs and Symptoms of Respiratory Diseases Dyspnea Sudden ( seconds) Pneumothorax ( Male, COPD, or Tall, thin) Pulmonary embolism ( Female, Pills)

Signs and Symptoms of Respiratory Diseases Dyspnea Acute dyspnea (hours to days) Bronchial asthma Pneumonia Massive pleural effusion Pulmonary edema (LVF, MS)

Signs and Symptoms of Respiratory Diseases Chronic dyspnea (months to Years) Chronic bronchitis Emphysema Pulmonary fibrosis Chronic thromboembolism

Signs and Symptoms of Respiratory Diseases Types of dyspnea Paroxysmal dyspnea Bronchial asthma (wheezes, no crackles) Left ventricular failure (crackles, cardiomegaly) Nocturnal dyspnea Bronchial asthma GERD LVF

Signs and Symptoms of Respiratory Diseases Wheezes (Rhonchi) Bronchial asthma COPD Pulmonary embolism Lung cancer Bronchiectasis LVF

Signs and Symptoms of Respiratory Diseases Chest pain Pulmonary infarction Pneumonia Acute pleurisy Tiet’z syndrome Angina pectoris

Signs and Symptoms of Respiratory Diseases General examination Sputum White mucoid Chronic bronchitis Purulent, yellow, green Suppurative lung syndrome Red TB, Ca lung, PE Frothy pink Pulmonary edema

Signs and Symptoms of Respiratory Diseases General examination Sputum White mucoid Chronic bronchitis Purulent, yellow, green Suppurative lung syndrome Red TB, Ca lung, PE Frothy pink Pulmonary edema

Signs and Symptoms of Respiratory Diseases General examination Respiratory rate (n=14±2) Cyanosis (>5gm% of Hb deoxygenated) Central (blue hands & tongue) Peripheral (blue hands & red tongue)

Signs and Symptoms of Respiratory Diseases Hands examination Central Cyanosis COPD, Asthma Pulmonary fibrosis Pneumonia, PE A/V malformation Cardiac Rt to Lt shunts Peripheral cyanosis Cold weather Low COP

Signs and Symptoms of Respiratory Diseases Clubbing of the fingers and toes Bronchiectasis Ca lung Lung abscess Pulmonary fibrosis Asbestosis Cystic fibrosis

Signs and Symptoms of Respiratory Diseases Hands examination Hypertrophic pulmonary osteoarthropathy Ca lung

Signs and Symptoms of Respiratory Diseases Hands examination Tremors Fine B2 agonist Flapping CO2 retention

Signs and Symptoms of Respiratory Diseases Head & neck Horner's syndrome Ptosis Enophthalmos Miosis Anhydrousis

Signs and Symptoms of Respiratory Diseases Head and neck Face SLE (Butterfly rash) Sarcoidosis (Lupus pernio)

Signs and Symptoms of Respiratory Diseases Head and Neck JVP CHF (Pulsatile) SVO (Non pulsatile)

Signs and Symptoms of Respiratory Diseases Chest examination Skin (scar) Thoracotomy

Signs and Symptoms of Respiratory Diseases Chest examination Shape Barrel shape (COPD)

Signs and Symptoms of Respiratory Diseases Chest examination Shape Kyphoscoliosis

Signs and Symptoms of Respiratory Diseases Chest examination Shape Pectus excavatum

Signs and Symptoms of Respiratory Diseases Head and Neck Fundi Papilledema

Signs and Symptoms of Respiratory Diseases Lymph nodes

Signs and Symptoms of Respiratory Diseases Chest examination Position of the trachea Shifted to the side of the lesion Fibrosis Collapse Shifted away Pleural effusion Tension Pneumothorax

Signs and Symptoms of Respiratory Diseases Chest examination Cardiac apex (dextrocardia) Chest expansion (n=3-5cm) Tactile Vocal fremitus Increased Consolidation Decreased Pleural effusion Collapse

Signs and Symptoms of Respiratory Diseases Chest examination Percussion Decreased Pleural effusion (stony dull) Consolidation (dull) Collapse Fibrosis Increased Pneumothorax & emphysema

Signs and Symptoms of Respiratory Diseases Auscultation Breathing sounds Vesicular Bronchial Aegophony Whispering pectrology

Signs and Symptoms of Respiratory Diseases Auscultation Decreased breath sound Pleural effusion Collapse/Atelectasis Pneumothorax & Obesity Increased breath sound Consolidation Cavity Top of pleural effusion

Signs and Symptoms of Respiratory Diseases Auscultation Wheeze (Rhonchi) Bilateral Asthma, COPD, LVF Unilateral FB Lung cancer Mucous plug

Signs and Symptoms of Respiratory Diseases Auscultation Crackles (crepitations) Fine Pulmonary fibrosis Coarse Bronchiectasis Pneumonia Pulmonary edema Friction rub Infection, Infarction, tumor

Signs and Symptoms of Respiratory Diseases Examination of systems related to respiratory disease CVS P2, Corpulmonale, CHF Abdomen Hepatosplenomegaly Renal Goodpastures syndrome

Signs and Symptoms of Respiratory Diseases Examination of systems related to respiratory disease Locomotor Rheumatoid arthritis, SLE, PAN, Bone pain CNS CO2 retention Epilepsy Cranial nerve palsy

Signs and Symptoms of Respiratory Diseases Examination of systems related to respiratory disease Skin erythema nodosum, vasuclitis heliotropic rash

Signs and Symptoms of Respiratory Diseases Quizzes 1 2 3 4 5

Signs and Symptoms of Respiratory Diseases Thank you

Signs and Symptoms of Respiratory Diseases Suggested Text book to read McLeod's sing and symptoms