Signs and Symptoms of

Respiratory Dis

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
thromboembolis
m

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
Tietz 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=142)
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
Flapping

B2 agonist
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

Hepatosplenomegal
y

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