Ebook Hutchison’s clinical methods (24/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Hutchison’s clinical methods (24/E): Part 2
Ebook Hutchison’s clinical methods (24/E): Part 2
https://khothuvien.cori!SECTION 3Basic systemsSECTION THREEBASIC SYSTEMSRespiratory system12Veronica L.c. WhiteIntroductionDiseases of the respiratory Ebook Hutchison’s clinical methods (24/E): Part 2y system account for tip to a third of deaths in most countries and for a major proportion of visits to the doctor and time away from work or school. As with ever)' aspect of diagnosis in medicine, the key to success is a clear and carefully recorded history; symptoms may be trivial or extremely dis Ebook Hutchison’s clinical methods (24/E): Part 2tressing, but either may indicate serious and lifethreatening disease.Most patients with respiratory disease will present With breathlessness, cough,Ebook Hutchison’s clinical methods (24/E): Part 2
excess sputum, haemop-tysis, wheeze or chest pain.BreathlessnessEveryone becomes breathless on strenuous exertion. Breathlessness inappropriate to thehttps://khothuvien.cori!SECTION 3Basic systemsSECTION THREEBASIC SYSTEMSRespiratory system12Veronica L.c. WhiteIntroductionDiseases of the respiratory Ebook Hutchison’s clinical methods (24/E): Part 2to a lowered blood oxygen tension (hypoxia) or to a raised blood carbon dioxide tension (hypercapnia), although these may play a significant part. People with cardiac disease (see Ch. 13) and even non-cardiorespiratory conditions such as anaemia, thyrotoxicosis or metabolic acidosis may become dyspn Ebook Hutchison’s clinical methods (24/E): Part 2oeic as well as those with primarily respiratory problems (Box 12.1).An important assessment is whether the dyspnoea is related only to exertion and hEbook Hutchison’s clinical methods (24/E): Part 2
ow far the patient can walk at a normal pace on the level (exercise tolerance). This may take some skill to elicit, as fewpeople note their symptoms ihttps://khothuvien.cori!SECTION 3Basic systemsSECTION THREEBASIC SYSTEMSRespiratory system12Veronica L.c. WhiteIntroductionDiseases of the respiratory Ebook Hutchison’s clinical methods (24/E): Part 2fications will include whether there is variability in the symptoms, whether there are good days and bad days and, very importantly, whether there are any times of day or night that are usually worse than others. Variable airways obstruction dueto asthma is very often worse at night and in the early Ebook Hutchison’s clinical methods (24/E): Part 2 morning. By contrast, people with predominantly irreversible airways obstruction due to chronic obstructive pulmonary disease (COPD) will often say tEbook Hutchison’s clinical methods (24/E): Part 2
hat as long as they are sitting in bed, they feel quite normal; it is exercise that troubles them.CoughThe symptom of cough can be short lived or lasthttps://khothuvien.cori!SECTION 3Basic systemsSECTION THREEBASIC SYSTEMSRespiratory system12Veronica L.c. WhiteIntroductionDiseases of the respiratory Ebook Hutchison’s clinical methods (24/E): Part 2roductive with sputum Acute cough is most commonly caused by recent infection, either viral or bacterial; however, any cough that is associated with haemoptysis should be a cause for concern, prompt appropriate assessment and a baseline chest X-ray (CXR) at the very least. Any patient with a chronic Ebook Hutchison’s clinical methods (24/E): Part 2 cough, i.e. one that lasts more than 8 weeks, should be sent for a CXR and spirometry as baseline investigations (Box 12.4). Discussion about cough sEbook Hutchison’s clinical methods (24/E): Part 2
hould include:■How long has the cough been present? A cough lasting a few days following a cold has less significance than one lasting several weeks ihttps://khothuvien.cori!SECTION 3Basic systemsSECTION THREEBASIC SYSTEMSRespiratory system12Veronica L.c. WhiteIntroductionDiseases of the respiratory Ebook Hutchison’s clinical methods (24/E): Part 2rly symptom of asthma, as may a cough that comes in spasms lasting several minutes.■Is the cough aggravated by anything, for example allergic triggers such as dust, animals or pollen, or non-specific triggers such as exercise or cold air? The increased reactivity of the airways seen in asthma and in Ebook Hutchison’s clinical methods (24/E): Part 2 some normal people for several weeks after viral respiratory infections may present in this way. Severe coughing, whatever its cause, may be followedEbook Hutchison’s clinical methods (24/E): Part 2
by vomiting (Box 12.5).Sputum■Is sputum produced?■What does it look like? Children and some adults swallow sputum, but it is always worth16812Respirahttps://khothuvien.cori!SECTION 3Basic systemsSECTION THREEBASIC SYSTEMSRespiratory system12Veronica L.c. WhiteIntroductionDiseases of the respiratory Ebook Hutchison’s clinical methods (24/E): Part 2MalignancyPneumothoraxCardiac tamponadeChronic pulmonary emboliPulmonary embolusMetabolic acidosisRestrictive lung disorders, including interstitial lung diseaseMyocardial infarctionPainCongestive cardiac failurePulmonary oedemaPontine haemorrhageValvular dysfunctionArrhythmiasCardiomyopathy Ebook Hutchison’s clinical methods (24/E): Part 2https://khothuvien.cori!SECTION 3Basic systemsSECTION THREEBASIC SYSTEMSRespiratory system12Veronica L.c. WhiteIntroductionDiseases of the respiratoryGọi ngay
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