Cough, Cough, Wheeze, Wheeze
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Chest Pain and Non-Respiratory Symptoms in Acute Asthma
Postgrad Med J 2000;76:413–414 413 Chest pain and non-respiratory symptoms in Postgrad Med J: first published as 10.1136/pmj.76.897.413 on 1 July 2000. Downloaded from acute asthma W M Edmondstone Abstract textbooks. Occasionally the combination of The frequency and characteristics of chest dyspnoea and chest pain results in diagnostic pain and non-respiratory symptoms were confusion. This study was prompted by the investigated in patients admitted with observation that a number of patients admitted acute asthma. One hundred patients with with asthmatic chest pain had been suspected a mean admission peak flow rate of 38% of having cardiac ischaemia, pleurisy, pericardi- normal or predicted were interviewed tis, or pulmonary embolism. It had also been using a questionnaire. Chest pain oc- observed that many patients admitted with curred in 76% and was characteristically a asthma complained of a range of non- dull ache or sharp, stabbing pain in the respiratory symptoms, something which has sternal/parasternal or subcostal areas, been noted previously in children1 and in adult worsened by coughing, deep inspiration, asthmatics in outpatients.2 The aim of this or movement and improved by sitting study was to examine the frequency and char- upright. It was rated at or greater than acteristics of chest pain and other symptoms in 5/10 in severity by 67% of the patients. A patients admitted with acute asthma. wide variety of upper respiratory and sys- temic symptoms were described both Patients and methods before and during the attack. One hundred patients (66 females, mean (SD) Non-respiratory symptoms occur com- age 45.0 (19.7) years) admitted with acute monly in the prodrome before asthma asthma were studied. -
Factors Associated with Pleurisy in Pigs: a Case-Control Analysis of Slaughter Pig Data for England and Wales
Aus dem Zentrum für Klinische Tiermedizin der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München Arbeit angefertigt unter der Leitung von Prof. Dr. Mathias Ritzmann Angefertigt am Cambridge Infectious Diseases Consortium, University of Cambridge, Department of Veterinary Medicine, Cambridge, UK (Dr. A W (Dan) Tucker) Factors associated with pleurisy in pigs: A case-control analysis of slaughter pig data for England and Wales Inaugural-Dissertation zur Erlangung der tiermedizinischen Doktorwürde der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München Von Henrike Caroline Jäger aus Wiesbaden München 2012 Gedruckt mit der Genehmigung der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München Dekan: Univ.-Prof. Dr. Joachim Braun Berichterstatter: Univ.-Prof. Dr. Mathias Ritzmann Korreferent: Univ.-Prof. Dr. Dr. habil. Manfred Gareis Tag der Promotion: 9. Februar 2013 Meinem Vater Dr. med Sepp-Dietrich Jäger Table of Contents 4 TABLE OF CONTENTS I. INTRODUCTION ...................................................................................... 7 II. LITERATURE OVERVIEW .................................................................... 8 1. Anatomy and Physiology of the Pleura ....................................................8 2. Pleurisy ........................................................................................................9 2.1. Morphology ..................................................................................................9 2.2. Prevalence ..................................................................................................11 -
Management of Wheeze and Cough in Infants and Pre-Schoo L Children In
nPersonal opinio lManagement of wheeze and cough in infants and pre-schoo echildren in primary car Pauln Stephenso nIntroductio is, well established in adults 2thoughs there remain somer controversy about its diagnosis in children eve Managementa of wheeze and cough in children is sinceh Spelman's uncontrolled study of children wit commonm problem in primary care. In this paper I ai nchronic cough successfully treated according to a tod provide a few useful management tools with regar .asthma protocol 3gWithout the ability to perform lun toe diagnosis, the role of a trial of treatment, and th functione tests in pre-school children, care must b rationalee for referral. For an in-depth review see th takent to exclude other diagnoses. A persisten article. in this journal two years ago by Bush 1 eproductiv coughc may be due solely to chroni catarrhe with postnasal drip, but early referral may b sPresentation of Symptom needed. A persistent dry cough,n worse at night and o exercise,s and without evidence of other diagnose Ity is always worth asking parents what they mean b warrants. a trial of asthma treatment thed term 'wheeze' or 'cough'. The high-pitche musicaln noise of a wheeze usually on expiratio Thef younger the child, the longer the list o shouldy not be confused with the sound of inspirator differentialo diagnoses and the more one has t sstridor. The sound of airflow through secretions i econsider possibilities other than 'asthma'. Thes ddifferent again, and parents may describe their chil linclude upper airways disease, congenital structura 'vomiting'g when, in fact, the child has been coughin diseasel of the bronchi, bronchial or trachea severely and bringing up phlegm or mucus. -
What Is Pertussis (Whooping Cough)?
American Thoracic Society PATIENT EDUCATION | INFORMATION SERIES What Is Pertussis (Whooping Cough)? Pertussis is a very contagious respiratory infection commonly known as ‘whooping cough’. It is caused by a bacterium called Bordetella pertussis. The infection became much less common after a successful vaccine was developed and given to children to help prevent infection. However, in recent years, the number of people infected with pertussis has increased and now is at the highest rate seen since the 1950’s. There is concern that this is due mainly to people not taking the pertussis (whooping cough) vaccination and adults who have not had a booster and their immune protection has weakened with age. Whooping cough usually starts as a mild cold-like illness get in the air. If you are close enough, you can breathe in these (upper respiratory infection). The pertussis bacteria enter the droplets or they can land on your mouth, nose, or eye. You lungs and cause swelling and irritation in the airways leading can also get the infection if you kiss the face of a person with to severe coughing fits. At times, people with whooping pertussis or get infected nose or mouth secretions on your cough can have a secondary pneumonia from other bacteria hands and then touch your own face to rub your eyes or nose. while they are ill. Whooping cough can cause very serious A person with pertussis can remain contagious for many weeks illness. It is most dangerous in young babies and can result unless treated with an antibiotic. in death. It spreads very easily and people who have the infection can still spread it to others for weeks after they What are the symptoms of Pertussis infection? become sick. -
Gas Exchange and Respiratory Function
LWBK330-4183G-c21_p484-516.qxd 23/07/2009 02:09 PM Page 484 Aptara Gas Exchange and 5 Respiratory Function Applying Concepts From NANDA, NIC, • Case Study and NOC A Patient With Impaired Cough Reflex Mrs. Lewis, age 77 years, is admitted to the hospital for left lower lobe pneumonia. Her vital signs are: Temp 100.6°F; HR 90 and regular; B/P: 142/74; Resp. 28. She has a weak cough, diminished breath sounds over the lower left lung field, and coarse rhonchi over the midtracheal area. She can expectorate some sputum, which is thick and grayish green. She has a history of stroke. Secondary to the stroke she has impaired gag and cough reflexes and mild weakness of her left side. She is allowed food and fluids because she can swallow safely if she uses the chin-tuck maneuver. Visit thePoint to view a concept map that illustrates the relationships that exist between the nursing diagnoses, interventions, and outcomes for the patient’s clinical problems. LWBK330-4183G-c21_p484-516.qxd 23/07/2009 02:09 PM Page 485 Aptara Nursing Classifications and Languages NANDA NIC NOC NURSING DIAGNOSES NURSING INTERVENTIONS NURSING OUTCOMES INEFFECTIVE AIRWAY CLEARANCE— RESPIRATORY MONITORING— Return to functional baseline sta- Inability to clear secretions or ob- Collection and analysis of patient tus, stabilization of, or structions from the respiratory data to ensure airway patency improvement in: tract to maintain a clear airway and adequate gas exchange RESPIRATORY STATUS: AIRWAY PATENCY—Extent to which the tracheobronchial passages remain open IMPAIRED GAS -
Chief Compaint/HPI History
PULMONOLOGY ASSOCIATES OF TEXAS 6860 North Dallas Pkwy, Ste 200, Plano, TX 75024 Tel: 469-305-7171 Fax: 469-212-1548 Patient Name: Thomas Cromwell Patient DOB: 02-09-1960 Patient Sex: Male Visit Date: 03-06-2016 Chief Compaint/HPI Chief Complaint: Shortness of Breath History of Present Illness: he patient is an 56-year-old male. From the last few days, he is not feeling well. Complains of fatigue, tiredness, weakness, nausea, no vomiting, no hematemesis or melena. The patient relates to have some low-grade fever. The patient came to the emergency room. Initially showed atrial fibrillation with rapid ventricular response. It appears that the patient has chronic atrial fibrillation. As per the medications, they are not very clear. He denies any specific chest pain. Her main complaint is shortness of breath and symptoms as above Pulmonary symptoms: cough, sputum, no hemoptysis, dyspnea and wheezing. History Past Medical History: Pulmonary history includes pneumonia and sleep apnea. Cardiac history includes atrial fibrillation and congestive heart failure. Remainder of PMH is non-significant. Surgical History: appendectomy in 2007. Medications: Pulmonary medications are albuterol and Spiriva; Cardiac medications include: atenolol and digoxin; Family History: Father is deceased at age 80. Father PMH remarkable for CHF, hypertension and MI; Mother is alive. Mother PMH remarkable for alzheimers, diabetes and hypertension; Cancer history in family: No Lung disease in the family: No Social History: Current every day smoker - 1 pack / day Alcohol consumption: social Marital status: lives alone Exposure History: Occupation: farmer. Asbestos exposure: None. No exposure to Ground Zero. Immunization History: Patient has an immunization history of flu shot, H1N1shot and pneumococcal shot. -
Approach to Type 2 Respiratory Failure Changing Nature of NIV
Approach to type 2 Respiratory Failure Changing Nature of NIV • Not longer just the traditional COPD patients • Increasingly – Obesity – Neuromuscular – Pneumonias • 3 fold increase in patients with Ph 7.25 and below Impact • Changing guidelines • Increased complexity • Increased number of patients • Decreased threshold for initiation • Lower capacity for ITU to help • Higher demands on nursing staff Resp Failure • Type 1 Failure of Oxygenation • Type 2 Failure of Ventilation • Hypoventilation • Po2 <8 • Pco2 >6 • PH low or bicarbonate high Ventilation • Adequate Ventilation – Breathe in deeply enough to hit a certain volume – Breathe out leaving a reasonable residual volume – Breath quick enough – Tidal volume and minute ventilation Response to demand • Increase depth of respiration • Use Reserve volume • Increase rate of breathing • General increase in minute ventilation • More gas exchange Failure to match demand • Hypoventilation • Multifactorial • Can't breathe to a high enough volume • Can't breath quick enough • Pco2 rises • Po2 falls Those at risk • COPD • Thoracic restriction • Central • Neuromuscular • Acute aspects – Over oxygenation – Pulmonary oedema Exhaustion • Complicates all forms of resp failure • Type one will become type two • Needs urgent action • Excessive demand • Unable to keep up • Resp muscle hypoxia Exhaustion • Muscles weaken • Depth of inspiration drops • Residual volume drops • Work to breath becomes harder • Spiral of exhaustion • Pco2 rises, Po2 drops Type 2 Respiratory Failure Management Identifying Those -
Respiratory System Diseases & Disorders
Respiratory System Diseases & Disorders HS1, DHO8, 7.10, pg 206 Objectives Discuss the diseases and disorders of the respiratory system and related signs, symptoms, and treatment methods Identify diseases and disorders that affect the respiratory system, including the following: asthma, pleurisy, bronchitis, pneumonia, COPD, rhinitis, emphysema, sinusitis, epistaxis, sleep apnea, influenza, TB, laryngitis, URI, and lung cancer Day 1 Respiratory Diseases and Disorders Upper Respiratory Tract The major passages and structures of the upper respiratory tract include the nose, nasal cavity, pharynx, and larynx. Asthma Bronchospasms with increase in mucous, and edema in mucosal lining Caused by sensitivity to allergen such as dust, pollen, animal, medications, or food Stress, overexertion, and infection can cause asthma attack Prevent asthma attacks by eliminating or desensitizing to allergens Symptoms: dyspnea, wheezing, coughing, and chest tightness Treatment: bronchodilators, anti-inflammatory med, epinephrine, and O2 therapy Test Your Knowledge Barbara has asthma and uses an inhaler when she starts to wheeze. The purpose of the device is to: a) Dissolve mucus b) Contract blood vessels c) Liquify secretions in the lungs d) Enlarge the bronchioles Correct answer: D Acute Bronchitis Chronic Bronchitis ◦ Caused by infection ◦ Caused by frequent attacks of ◦ S/S: productive cough, acute bronchitis or long-term exposure to smoking dyspnea, rales (bubbly breath sounds), chest ◦ Has chronic inflammation, pain, and fever damaged cilia, & -
Laryngotracheitis Caused by COVID-19
Prepublication Release A Curious Case of Croup: Laryngotracheitis Caused by COVID-19 Claire E. Pitstick, DO, Katherine M. Rodriguez, MD, Ashley C. Smith, MD, Haley K. Herman, MD, James F. Hays, MD, Colleen B. Nash, MD, MPH DOI: 10.1542/peds.2020-012179 Journal: Pediatrics Article Type: Case Report Citation: Pitstick CE, Rodriguez KM, Smith AC, Herman HK, Hays JF, Nash CB. A curious case of croup: laryngotracheitis caused by COVID-19. Pediatrics. 2020; doi: 10.1542/peds.2020-012179 This is a prepublication version of an article that has undergone peer review and been accepted for publication but is not the final version of record. This paper may be cited using the DOI and date of access. This paper may contain information that has errors in facts, figures, and statements, and will be corrected in the final published version. The journal is providing an early version of this article to expedite access to this information. The American Academy of Pediatrics, the editors, and authors are not responsible for inaccurate information and data described in this version. Downloaded from©2020 www.aappublications.org/news American Academy by of guest Pediatrics on September 30, 2021 Prepublication Release A Curious Case of Croup: Laryngotracheitis Caused by COVID-19 Claire E. Pitstick, DO, Katherine M. Rodriguez, MD, Ashley C. Smith, MD, Haley K. Herman, MD, James F. Hays, MD, Colleen B. Nash, MD, MPH Affiliations: Rush University Medical Center, Division of Pediatrics, Chicago, Illinois Address Correspondence to: Claire E. Pitstick, Department of Pediatrics, Rush University Medical Center, 1645 W Jackson Blvd Ste 200, Chicago, IL 60612 [[email protected]], 312-942-2200. -
Cough and Acute Bronchitis
Symptoms of Cough / Acute Bronchitis Symptoms of a cough / acute bronchitis may include: Cough which develops over a day or so and may become quite irritating. Fever, headache, aches and pains. Cold symptoms. Symptoms typically peak after 2-3 days, and then gradually clear. However, the cough may persist for up to three weeks after the infection has gone. This is because the inflammation in the airways, caused by the infection, can take a while to clear. Do I need an antibiotic? Most coughs / acute bronchitis are caused by a viral infection. Antibiotics DO NOT kill viruses. So you DO NOT need an antibiotic for most coughs / acute bronchitis. In people who are normally well, your own immune system will usually clear the infection. Most bouts of cough / acute bronchitis clear without complications. Antibiotics may cause side-effects such as thrush, diarrhoea, rash and stomach upsets, so they should not be taken unnecessarily. Unnecessary use of some antibiotics has caused them to become less effective. You may be prescribed antibiotics if you already have ongoing chronic lung disease. This is to prevent you developing a ‘secondary’ bacterial infection, rather than to clear a viral infection. Treatment for Cough / Acute Bronchitis Treatment options to relieve symptoms whilst waiting for your immune system to clear the infection. No treatment Many bouts of cough / acute bronchitis are mild and will usually get better soon without any treatment. Pain & fever relief Take paracetamol or ibuprofen regularly. Do not take any more than the recommended dose. Fluids Drink plenty of fluids such as water and fruit-juices to avoid dehydration. -
Asthma Symptoms
Asthma Symptoms Title: Asthma Center Source: WebMD Link: http://www.webmd.com/asthma/guide/asthma-symptoms People with asthma experience symptoms when the airways tighten, inflame, or fill with mucus. Common asthma symptoms include: • Coughing, especially at night • Wheezing • Shortness of breath • Chest tightness, pain, or pressure Still, not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms of asthma at different times. Your symptoms may also vary from one asthma attack to the next, being mild during one and severe during another. Some people with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks. Others might have asthma symptoms every day. In addition, some people may only have asthma during exercise or asthma with viral infections like colds. Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild symptoms to help you prevent severe episodes and keep asthma under better control. Signs of a Pending Asthma Attack Know the Early Symptoms of Asthma Early warning signs are changes that happen just before or at the very beginning of an asthma attack. These signs may start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening. In general, these signs are not severe enough to stop you from going about your daily activities. -
THE DIFFERENTIAL DIAGNOSIS of HEMOPTYSIS. by W
56 POST-GRADUATE MEDICAL JOURNAL February, 1938 Postgrad Med J: first published as 10.1136/pgmj.14.148.56 on 1 February 1938. Downloaded from THE DIFFERENTIAL DIAGNOSIS OF HEMOPTYSIS. By W. ERNEST LLOYD, M.D., F.R.C.P. (Assistant Physician, Westminster Hospital and Brompton Hospital for Consumption and Diseases of the Chest.) Haemoptysis or blood-spitting is a symptom of many different diseases and it should always lead to a complete investigation of the patient so as to try and determine its cause. The amount of blood expectorated varies greatly from a few streaks of blood in the phlegm or blood-stained sputum to a free hemorrhage of many ounces. When it occurs for the first time it is rarely copious but it is a symptom which always causes great anxiety and rarely does a patient ignore it. This is in striking contrast to other symptoms of chest disease for a patient may have had a cough for months before seeking medical advice. When a patient goes to a doctor with the history of having coughed up blood, a re-assuring attitude should be adopted and a history of the circumstances accompanying the haemoptysis should be obtained. If possible, the actual blood should be observed especially if the history is not clear whether the blood was actually coughed up or vomited. Occasionally, a history of epistaxis precedes that of the haemoptysis and blood may be seen to be coming from the naso- pharynx. Protected by copyright. The past history of the patient may offer a clue to the vetiology.