1. Cough
2. Sputumhemoptysis
3. Dyspnoea
4. Wheeze
5. Chest pain
6. Apneahoarsenesssinus symptoms
7. Fevernight sweats
8. Past medicalsurgical history
9. Familysocialdrug history
10. Systems

Cough

• Duration of having cough.
• Productive vs. non-productive.
• Chest tightness (acute bronchitis).
• Onset: environment (allergyasthma).
• Character:
  • Bark-like (larynx).
  • Whoop (whooping cough).
  • Drywith post-nasal drip (pharynx).
• Exacerbating: night (CHFasthma).

Sputumhemoptysis

• Volume.
• Color:
  • Yellow-green [purulent] (bronchiectasislobar pneumonia).
  • Clear [serous].
  • Grey [mucoid] (chronic bronchitis).
  • Pink froth secretion (pulmonary edema).
  • Red jelly (Klebsiella).
• Viscosity (mucoid more viscous than purulent).
• Foul smell (lung abscessbronchiectasis).

Dyspnoea

• Exertional: how far can you walk?
• Orthopnoea: sleep with pillows?
• Paroxysmal nocturnal dyspnoea: gasp at night?
• Timing: worsened over the years (pulmonary fibrosis) vs. rapid onset (RTI).

Wheeze

• Heard louder on expiration.
• Prolonged expiration.
• Precipitating factors.
• Pt. could use term wheezewhen it's an inspiratory stridoretc.

Chest pain

• SOCRATES.
• Character: stabbing. 
• Exacerbating: deep inspiration (pleurisyrib fracture)anxiety.

Apnea

• Do you snore?
• Loudness of snoring.
• Interruption of activity next day.

Hoarseness

• Laryngitis attacks.
• Voice hoarseness (CAnerve palsy).

Sinus symptoms

• Blocked sinuses sensation.
• Number of times draining sinuses in day.
• Post nasal drip.

Fevernight sweats

• Fever (RTITB).
• Timing: day or night.
• Temperature reachedif known.
• Sweating at night (TB).

Past medicalsurgical history

• RTIs: pneumoniaTBbronchitis.
• Asthma.
• Measlespertussis during childhood.
• Laryngitis.
• Lung CA.
• HIV (PCP).
• Surgery: for TBtumor.

Family history

• Condition in a relativewhat age.
• Asthma.
• Emphysemaother COPDs.
• CF.
• TB.
• MIangina.

Social history

• Smoking: ever smokedhow many per dayfor how longtype [cigarettepipechew].
• Passive smoking in the homeworkplace.
• Alcohol (aspiration).
• Occupation type:
  • Farmer (farmer's lung).
  • Constructionshipyard (asbestos).
  • Minerfactory workerstonemason (toxins).
  • Animal worker (M. psitacci).
  • Air conditioners (Legionella).
• Occupation details:
  • Tasks done at work.
  • How long of exposure.
  • Protection used.
  • Illness in fellow workers. 
• Describe your home: stairsetc.
• Pets at home (allergyM. psittaci).
• Who is with you there at home.

Drug history

• Drugs currently onincluding delivery method.
  • Steroids (TB risk).
  • ACE inhibitors (cough).
  • OCP (PE risk).
  • Beta-blockers (bronchospasm).
• OTCsincluding antihistamines.
• Ventilators.
• Recreational drugs:
  • Marijuana (cigarette-like).
  • Cocaine (fibrosis).
  • IV users (pulmonary edemaabscess).
• Allergiesespecially to inhaled substances.
• Allergies to drugsdyes.

Systems

• Cardiovascular: (chest paindsypnoea).
• Alimentary: GERD (chest pain causecough worse after eating).
• Alimentary: fistula (cough worse after eating).
• Nervous (respiratory depression).

Pulmonary Exam »

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