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Questionnaire
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MEDICAL SEMIOLOGY GUIDE OF THE RESPIRATORY SYSTEM
C H A P T E R
1 Questionnaire If you want to know if a patient suffers from a respiratory disease, you must ask about the main symptoms of the respiratory disease. These are stabbing pain, dyspnea, cough, expectoration, and hemoptysis. In addition to these major symptoms, there could also be present a few minor symptoms such as chills (shivering), fever, and sweating. 1. Do you have stabbing pain (a sudden chest pain like a cut starting in your anterior chest wall with posterior irradiation accented in deep inspiration)? 2. Do you have difficulty breathing (dyspnea)? 3. Which is more difficult: to inhale or to exhale? Expiratory dyspnea is typically present in respiratory diseases. 4. Do you hear any sounds in your expiration, such as the caterwaul of a cat? This noise is called wheezing and signifies significant obstruction of the small bronchi and is typically present in the case of bronchial asthma. 5. Do you cough? 6. For how long have you been coughing? 7. Is it a dry cough or a productive cough? 8. If it is a productive cough, what color is your expectoration (sputum)? 9. Is your expectoration white? This is mucous expectoration. 10. Is your expectoration yellow? This is purulent expectoration. 11. Is your expectoration a combination of white and yellow? This is mucousepurulent expectoration. 12. Is your expectoration a combination of serous consistency (like water) with white (mucous) and yellow colors (purulent)? This is serousemucousepurulent expectoration. 13. Is your expectoration of greenish color? 14. When coughing, do you expectorate sputum in high quantities, more than 300 mL/24 h, which is stratified in three or four layers: serous, mucous, and purulent? This is a typical sign of bronchiectasis. 15. Do you expectorate (sometimes) a high quantity of pus after an episode of excessive cough? This is vomicadelimination of the pus contained in a pulmonary abscess! 16. Do you sometimes expectorate with streaks of blood? 17. How often? 18. Were the streaks of blood combined with sputum? 19. Were the streaks of blood combined with white or yellow sputum? 20. Do you expectorate only fresh blood? This is hemoptysis, specific for lung carcinoma or lung tuberculosis (TB). 21. In what quantity? 22. How many times? 23. Was the color of the blood fresh red? 24. Was the color of the blood dark? 25. Was the color of the blood black? Medical Semiology Guide of the Respiratory System https://doi.org/10.1016/B978-0-12-816113-5.00001-6
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© 2020 Elsevier Inc. All rights reserved.
3 26. Was the color of the expectoration like that of currant jelly? This is specific for lung carcinoma. 27. Do you have rust-like (rubiginosa) expectoration? This is specific for pneumonia. 28. Do you expectorate very viscous dark blood? This is specific for pulmonary embolism. 29. Did you have chills (shivering), fever, sweating, and stabbing pain? This is the sudden onset of pneumonia. 30. Do you smoke? 31. How many cigarettes per day? 32. For how long have you smoked? 33. What type of cigarettes you smoke, with filter or without filter? This is a risk factor for chronic bronchitis, chronic obstructive pulmonary disease (COPD), and lung carcinoma. 34. Do you smoke a pipe? This is a risk factor for carcinoma of the lips. 35. Do you work in a medium with dust? This is a risk factor for bronchitis and bronchial asthma. 36. Do you work now or have you worked in the past in a mine? This is a risk factor for silicosis. The patients with silicosis have a higher risk for TB and this is silicotuberculosis. 37. Do you work in a medium with asbestos? This is a risk factor for pleural mesothelioma. 38. Do you work under cold-temperature conditions? This is a risk factor for pneumonia. 39. Do you come in contact with parrots and canaries? This is a risk factor for psittacosis. 40. Have you had pulmonary TB for a short period? 41. Do you have any family members with active pulmonary TB? 42. Do you have any friends or persons with active pulmonary TB who have come in contact with you? 43. Do you have in your family history any members with lung cancer? 44. Do you have in your family history any members with bronchial asthma? 45. Have you ever had oraletracheal intubation during general anesthesia? This is a risk factor for aspiration pneumonia and abscess of the lung. 46. Have you had thoracic trauma with any fracture or fractures of the ribs? This is a risk factor for pneumothorax and hemothorax because a fractured rib can break the pleural cavity and let air pass into the pleural cavity (pneumothorax) or it can cause blood to appear inside the pleural cavity (hemothorax). 47. Do you live in a cold and overcrowded home? This is a risk factor for respiratory tract infections and pulmonary TB. 48. Do you live with a person who smokes? You are a passive smoker and you have a risk factor for juvenile chronic bronchitis.
MEDICAL SEMIOLOGY GUIDE OF THE RESPIRATORY SYSTEM
C H A P T E R
1 Questionnaire If you want to know if a patient suffers from a respiratory disease, you must ask about the main symptoms of the respiratory disease. These are stabbing pain, dyspnea, cough, expectoration, and hemoptysis. In addition to these major symptoms, there could also be present a few minor symptoms such as chills (shivering), fever, and sweating. 1. Do you have stabbing pain (a sudden chest pain like a cut starting in your anterior chest wall with posterior irradiation accented in deep inspiration)? 2. Do you have difficulty breathing (dyspnea)? 3. Which is more difficult: to inhale or to exhale? Expiratory dyspnea is typically present in respiratory diseases. 4. Do you hear any sounds in your expiration, such as the caterwaul of a cat? This noise is called wheezing and signifies significant obstruction of the small bronchi and is typically present in the case of bronchial asthma. 5. Do you cough? 6. For how long have you been coughing? 7. Is it a dry cough or a productive cough? 8. If it is a productive cough, what color is your expectoration (sputum)? 9. Is your expectoration white? This is mucous expectoration. 10. Is your expectoration yellow? This is purulent expectoration. 11. Is your expectoration a combination of white and yellow? This is mucousepurulent expectoration. 12. Is your expectoration a combination of serous consistency (like water) with white (mucous) and yellow colors (purulent)? This is serousemucousepurulent expectoration. 13. Is your expectoration of greenish color? 14. When coughing, do you expectorate sputum in high quantities, more than 300 mL/24 h, which is stratified in three or four layers: serous, mucous, and purulent? This is a typical sign of bronchiectasis. 15. Do you expectorate (sometimes) a high quantity of pus after an episode of excessive cough? This is vomicadelimination of the pus contained in a pulmonary abscess! 16. Do you sometimes expectorate with streaks of blood? 17. How often? 18. Were the streaks of blood combined with sputum? 19. Were the streaks of blood combined with white or yellow sputum? 20. Do you expectorate only fresh blood? This is hemoptysis, specific for lung carcinoma or lung tuberculosis (TB). 21. In what quantity? 22. How many times? 23. Was the color of the blood fresh red? 24. Was the color of the blood dark? 25. Was the color of the blood black? Medical Semiology Guide of the Respiratory System https://doi.org/10.1016/B978-0-12-816113-5.00001-6
2
© 2020 Elsevier Inc. All rights reserved.
3 26. Was the color of the expectoration like that of currant jelly? This is specific for lung carcinoma. 27. Do you have rust-like (rubiginosa) expectoration? This is specific for pneumonia. 28. Do you expectorate very viscous dark blood? This is specific for pulmonary embolism. 29. Did you have chills (shivering), fever, sweating, and stabbing pain? This is the sudden onset of pneumonia. 30. Do you smoke? 31. How many cigarettes per day? 32. For how long have you smoked? 33. What type of cigarettes you smoke, with filter or without filter? This is a risk factor for chronic bronchitis, chronic obstructive pulmonary disease (COPD), and lung carcinoma. 34. Do you smoke a pipe? This is a risk factor for carcinoma of the lips. 35. Do you work in a medium with dust? This is a risk factor for bronchitis and bronchial asthma. 36. Do you work now or have you worked in the past in a mine? This is a risk factor for silicosis. The patients with silicosis have a higher risk for TB and this is silicotuberculosis. 37. Do you work in a medium with asbestos? This is a risk factor for pleural mesothelioma. 38. Do you work under cold-temperature conditions? This is a risk factor for pneumonia. 39. Do you come in contact with parrots and canaries? This is a risk factor for psittacosis. 40. Have you had pulmonary TB for a short period? 41. Do you have any family members with active pulmonary TB? 42. Do you have any friends or persons with active pulmonary TB who have come in contact with you? 43. Do you have in your family history any members with lung cancer? 44. Do you have in your family history any members with bronchial asthma? 45. Have you ever had oraletracheal intubation during general anesthesia? This is a risk factor for aspiration pneumonia and abscess of the lung. 46. Have you had thoracic trauma with any fracture or fractures of the ribs? This is a risk factor for pneumothorax and hemothorax because a fractured rib can break the pleural cavity and let air pass into the pleural cavity (pneumothorax) or it can cause blood to appear inside the pleural cavity (hemothorax). 47. Do you live in a cold and overcrowded home? This is a risk factor for respiratory tract infections and pulmonary TB. 48. Do you live with a person who smokes? You are a passive smoker and you have a risk factor for juvenile chronic bronchitis.