Internal Diseases · MU Sofia

Practical · 9 Main symptoms and syndromes of respiratory diseases

Covers the main respiratory symptoms, taking cough, sputum, dyspnoea, chest pain, haemoptysis, and wheeze or stridor in turn, with the features and likely causes of each. It notes the acute, subacute and chronic duration bands for cough, the grading of dyspnoea from grade I to IV, and a summary table of pneumonia, pleural effusion, COPD, asthma, pulmonary fibrosis and pneumothorax with their key features and causes.

Inside: 3 sections · 3 labelled pictures · 2 tables · 12 flashcards · 2 min

Topic 66 of 88 in the MU Sofia syllabus for Internal Diseases (Dental Medicine, Year 4). The free AceMed note covers it in 3 sections, about 207 words (2 min of reading), with 12 flashcards.

In this note

  1. Symptoms & Syndromes of Respiratory Diseases
  2. Main Symptoms (Always ask about onset, duration, progression, severity, and associated factors)
  3. Main Respiratory Syndromes

Main Symptoms (Always ask about onset, duration, progression, severity, and associated factors)

1. Cough

  • Dry: Often seen in viral infections, interstitial lung diseases, asthma.
  • Productive: Suggests infection (e.g., pneumonia, bronchitis), bronchiectasis, COPD.
  • Ask about duration: acute (<3 weeks), subacute (3–8 weeks), chronic (>8 weeks).
  • Timing: Nocturnal (asthma), postural (bronchiectasis), morning (COPD).

2. Sputum

  • Color:
  • Clear/white → viral infection or allergies.
  • Yellow/green → bacterial infection.
  • Rusty → pneumococcal pneumonia.
  • Pink frothy → pulmonary edema.
  • Bloody → hemoptysis.
  • Amount: Large volume → bronchiectasis or lung abscess.
  • Odor: Foul-smelling → anaerobic infections or abscess.

3. Dyspnea (Shortness of Breath)

  • On exertion: Early sign of many chronic respiratory diseases.
  • At rest: Seen in severe disease or acute conditions.
  • Orthopnea: Suggests cardiac origin (CHF).
  • Paroxysmal nocturnal dyspnea: CHF but can occur in severe asthma.
  • Grading:
  • Grade I: Only on strenuous exertion.
  • Grade II: On moderate exertion (e.g. walking uphill).
  • Grade III: On minimal exertion.
  • Grade IV: At rest.

4. Chest Pain

  • Pleuritic: Sharp, worse on inspiration or coughing → pleuritis, pneumonia, PE, pneumothorax.
  • Non-pleuritic: Dull, constant → malignancy, chest wall pain.
  • Localize and characterize!

5. Hemoptysis

  • Small streaks → bronchitis.
  • Frank blood → TB, bronchiectasis, cancer, PE.
  • Rule out GI (hematemesis).

6. Wheezing or Stridor

  • Wheezing: Expiratory musical sound → asthma, COPD.
  • Stridor: High-pitched inspiratory sound → upper airway obstruction (tumor, foreign body, croup).

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