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Signs and Symptoms ofSigns and Symptoms of
Respiratory DisRespiratory Dis
Omer Alamoudi, Professor,Omer Alamoudi, Professor,
consultant Pulmonologistconsultant PulmonologistMD, FRCP, FACP, FCCPMD, FRCP, FACP, FCCP
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Cardinal SymptomsCardinal Symptoms
– CoughCough
– SputumSputum
– HemoptysisHemoptysis
– DyspneaDyspnea
– hee!eshee!es
– Chest painChest pain
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Other presenting symptomsOther presenting symptoms
– ApneaApnea
– HoarsenessHoarseness
– StridorStridor
– SnoringSnoring
– Fe"erFe"er– #ight s$eating#ight s$eating
– eight losseight loss
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Acute coughAcute cough
– Acute %ronchitisAcute %ronchitis
– PneumoniaPneumonia– PulmonaryPulmonary
&m%olism&m%olism
– 'eft "entricular'eft "entricular
failurefailure
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Chronic cough ()* $ee+sChronic cough ()* $ee+s
– -ronchial asthma-ronchial asthma
– Chronic %ronchitisChronic %ronchitis
– Pulmonary .%rosisPulmonary .%rosis
– 'ung cancer'ung cancer
– Drugs ( AC& inhi%itorsDrugs ( AC& inhi%itors
– -ronchiectasis-ronchiectasis
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
SputumSputum – Bronchiectasis (yellow, green,Bronchiectasis (yellow, green,
large amount, more in thelarge amount, more in the
morning)morning)
– Lung abscess ( Foul smelling,Lung abscess ( Foul smelling,more on lying onmore on lying on thetheother side of lesion)other side of lesion)
– PneumoniaPneumonia ( yellowish,( yellowish,streaks of blood)streaks of blood)
– Pulmonary edema ( PinkPulmonary edema ( Pinkfrothy)frothy)
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
HemoptysisHemoptysis– Massi"e )*// ml0episodeMassi"e )*// ml0episode
– Fran+ (fresh, %right red,Fran+ (fresh, %right red,
no sputumno sputum– CausesCauses
'ung cancer ( clots'ung cancer ( clots 1u%erculosis, 1u%erculosis,
-ronchiectasis ( %ris+ 2-ronchiectasis ( %ris+ 2
%rief%rief Pulmonary infarctionPulmonary infarction PneumoniaPneumonia A03 malformationA03 malformation
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
DyspneaDyspnea
– Sudden ( secondsSudden ( seconds
Pneumothora4Pneumothora4( Male, COPD, or( Male, COPD, or 1all, thin 1all, thin
PulmonaryPulmonaryem%olism ( Female,em%olism ( Female,PillsPills
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
DyspneaDyspnea
– Acute dyspneaAcute dyspnea
(hours to days(hours to days
-ronchial-ronchial
asthmaasthma
PneumoniaPneumonia
Massi"e pleuralMassi"e pleural
e5usione5usion
PulmonaryPulmonary
edema ('3F, MSedema ('3F, MS
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Chronic dyspneaChronic dyspnea
(months to 6ears(months to 6ears
– Chronic %ronchitisChronic %ronchitis– &mphysema&mphysema
– PulmonaryPulmonary
.%rosis.%rosis
– ChronicChronicthrom%oem%olisthrom%oem%olis
mm
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
1ypes of dyspnea 1ypes of dyspnea
– Paro4ysmal dyspneaParo4ysmal dyspnea
-ronchial asthma-ronchial asthma ($hee!es, no crac+les($hee!es, no crac+les 'eft "entricular failure (crac+les,'eft "entricular failure (crac+les,
cardiomegalycardiomegaly
– #octurnal dyspnea#octurnal dyspnea
-ronchial asthma-ronchial asthma 7&RD7&RD
'3F'3F
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
hee!es (Rhonchihee!es (Rhonchi
– -ronchial asthma-ronchial asthma
– COPDCOPD
– Pulmonary em%olismPulmonary em%olism
– 'ung cancer'ung cancer
– -ronchiectasis-ronchiectasis– '3F'3F
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Chest painChest pain
– Pulmonary infarctionPulmonary infarction
– PneumoniaPneumonia
– Acute pleurisyAcute pleurisy
– 1iet8! syndrome 1iet8! syndrome
– Angina pectorisAngina pectoris
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
7eneral e4amination7eneral e4amination
– SputumSputum
hite mucoidhite mucoid Chronic %ronchitisChronic %ronchitis Purulent, yello$, greenPurulent, yello$, green Suppurati"eSuppurati"e
lunglung syndromesyndrome
RedRed 1-, Ca lung, P& 1-, Ca lung, P&
Frothy pin+Frothy pin+ Pulmonary edemaPulmonary edema
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
General examinationGeneral examination– SputumSputum
hite mucoidhite mucoid– Chronic %ronchitisChronic %ronchitis
Purulent, yello$, greenPurulent, yello$, green– Suppurati"e lungSuppurati"e lung
syndromesyndrome RedRed
– 1-, Ca lung, P& 1-, Ca lung, P& Frothy pin+Frothy pin+
– Pulmonary edemaPulmonary edema
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
7eneral e4amination7eneral e4amination
– Respiratory rate (n9:; of H%deo4ygenateddeo4ygenated Central (%lue hands 2 tongueCentral (%lue hands 2 tongue
Peripheral (%lue hands 2 red tonguePeripheral (%lue hands 2 red tongue
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Hands examinationHands examination Central CyanosisCentral Cyanosis
– COPD, AsthmaCOPD, Asthma
– Pulmonary .%rosisPulmonary .%rosis– Pneumonia, P&Pneumonia, P&
– A03 malformationA03 malformation
– Cardiac Rt to 'tCardiac Rt to 't
shuntsshunts Peripheral cyanosisPeripheral cyanosis
– Cold $eatherCold $eather
– 'o$ COP'o$ COP
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Clubbing of theClubbing of the
ngers and toesngers and toes
– -ronchiectasis-ronchiectasis– Ca lungCa lung
– 'ung a%scess'ung a%scess
– Pulmonary .%rosisPulmonary .%rosis
– As%estosisAs%estosis– Cystic .%rosisCystic .%rosis
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
HandsHands
examinationexamination
HypertrophicHypertrophicpulmonarypulmonary
osteoarthropathyosteoarthropathy
– Ca lungCa lung
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Hands e4aminationHands e4amination
1remors 1remors
– FineFine -* agonist-* agonist
– FlappingFlapping CO* retentionCO* retention
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Head & neck Head & neck
Horner?sHorner?s
syndromesyndrome– PtosisPtosis
– &nophthalmos&nophthalmos
– MiosisMiosis
– AnhydrousisAnhydrousis
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Head and neck Head and neck
FaceFace
– S'&S'& (-utter@y(-utter@yrashrash
– SarcoidosisSarcoidosis
('upus('upus
perniopernio
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Head and #ec+Head and #ec+
3P 3P
– CHFCHF (Pulsatile(Pulsatile– S3OS3O (#on(#on
pulsatilepulsatile
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
ChestChest
e4aminatione4amination
– S+in (scarS+in (scar– 1horacotomy 1horacotomy
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
ChestChest
e4aminatione4amination
ShapeShape– -arrel shape-arrel shape
(COPD(COPD
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
ChestChest
e4aminatione4amination
ShapeShape– ByphoscoliosisByphoscoliosis
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
ChestChest
e4aminatione4amination
ShapeShape– PectusPectus
e4ca"atume4ca"atum
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Head and #ec+Head and #ec+
FundiFundi
– PapilledemaPapilledema
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
'ymph nodes'ymph nodes
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Chest e4aminationChest e4amination
– Position of thePosition of the
tracheatrachea Shifted to the sideShifted to the side
of the lesionof the lesion
– Fi%rosisFi%rosis
– CollapseCollapse
Shifted a$ayShifted a$ay– Pleural e5usionPleural e5usion
– 1ension 1ension
Pneumothora4Pneumothora4
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Chest e4aminationChest e4amination– Cardiac ape4Cardiac ape4
(de4trocardia(de4trocardia
– Chest e4pansionChest e4pansion(n9=cm(n9=cm
– 1actile 3ocal fremitus 1actile 3ocal fremitus EncreasedEncreased
– ConsolidationConsolidation DecreasedDecreased
– Pleural e5usionPleural e5usion
– CollapseCollapse
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Chest e4aminationChest e4amination
– PercussionPercussion DecreasedDecreased
– Pleural e5usionPleural e5usion(stony dull(stony dull
– ConsolidationConsolidation(dull(dull
– CollapseCollapse
– Fi%rosisFi%rosis EncreasedEncreased
– Pneumothora4Pneumothora42 emphysema2 emphysema
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
AuscultationAuscultation
– -reathing sounds-reathing sounds
3esicular3esicular -ronchial-ronchial
AegophonyAegophony
hispering pectrologyhispering pectrology
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
AuscultationAuscultation
– Decreased %reath soundDecreased %reath sound
Pleural e5usionPleural e5usion Collapse0AtelectasisCollapse0Atelectasis
Pneumothora4 2 O%esityPneumothora4 2 O%esity
– Encreased %reath soundEncreased %reath sound ConsolidationConsolidation Ca"ityCa"ity
1op of pleural e5usion 1op of pleural e5usion
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
AuscultationAuscultation
– hee!e (Rhonchihee!e (Rhonchi
– -ilateral-ilateral Asthma, COPD, '3FAsthma, COPD, '3F
– nilateralnilateral F-F-
'ung cancer'ung cancer
Mucous plugMucous plug
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
AuscultationAuscultation– Crac+lesCrac+les
(crepitations(crepitations
FineFine– Pulmonary .%rosisPulmonary .%rosis
CoarseCoarse
– -ronchiectasis-ronchiectasis
– PneumoniaPneumonia
– Pulmonary edemaPulmonary edema Friction ru%Friction ru%
– Enfection,Enfection,Enfarction, tumorEnfarction, tumor
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
xamination ofxamination of
systems related tosystems related to
respiratory diseaserespiratory disease
– C3SC3S P*, Corpulmonale,P*, Corpulmonale,
CHFCHF
– A%domenA%domen HepatosplenomegalHepatosplenomegal
yy– RenalRenal
7oodpastures7oodpastures
syndromesyndrome
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
xamination ofxamination ofsystems related tosystems related torespiratoryrespiratory
diseasedisease 'ocomotor'ocomotor RheumatoidRheumatoid
arthritis, S'&, PA#,arthritis, S'&, PA#,-one pain-one pain
– C#SC#S CO* retentionCO* retention &pilepsy&pilepsy Cranial ner"e palsyCranial ner"e palsy
Si d S t fSi d S t f
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
xamination ofxamination of
systems relatedsystems related
to respiratoryto respiratory
diseasedisease
Skin
erythema nodosum,
vasuclitisheliotropic rash
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Signs and Symptoms ofSigns and Symptoms of
Respiratory DiseasesRespiratory Diseases
Gui!!esGui!!es
– ::
– **–
– ;;
– ==
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Signs and SymptomsSigns and Symptoms
of Respiratoryof RespiratoryDiseasesDiseases
1han+ you 1han+ you
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Signs and SymptomsSigns and Symptoms
of Respiratoryof RespiratoryDiseasesDiseases Suggested 1e4t %oo+ to readSuggested 1e4t %oo+ to read
– Mc'eod?s sing and symptomsMc'eod?s sing and symptoms