1. 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

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

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

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

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

6. 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)

7. 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

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

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

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

11. 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

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

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

14. 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

15. 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

16. 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)

17. 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

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

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

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

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

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

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

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

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

26. Signs and Symptoms of Respiratory Diseases
Chest examination
Shape
Kyphoscoliosis

27. Signs and Symptoms of Respiratory Diseases
Chest examination
Shape
Pectus excavatum

28. Signs and Symptoms of Respiratory Diseases
Head and Neck
Fundi
Papilledema

29. Signs and Symptoms of Respiratory Diseases
Lymph nodes

30. 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

31. 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

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

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

34. 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

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

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

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

38. 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

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

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

41. Signs and Symptoms of Respiratory Diseases
Thank you

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