- Sputum, hemoptysis
- Chest pain
- Apnea, hoarseness, sinus symptoms
- Fever, night sweats
- Past medical, surgical history
- Family, social, drug history
- Duration of having cough.
- Productive vs. non-productive.
- Chest tightness (acute bronchitis).
- Onset: environment (allergy, asthma).
Whoop (whooping cough).
Dry, with post-nasal drip (pharynx).
- Exacerbating: night (CHF, asthma).
Yellow-green [purulent] (bronchiectasis, lobar pneumonia).
Grey [mucoid] (chronic bronchitis).
Pink froth secretion (pulmonary edema).
Red jelly (Klebsiella).
- Viscosity (mucoid more viscous than purulent).
- Foul smell (lung abscess, bronchiectasis).
- 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).
- Heard louder on expiration.
- Prolonged expiration.
- Precipitating factors.
- Pt. could use term wheeze, when it's an inspiratory stridor, etc.
- Character: stabbing.
- Exacerbating: deep inspiration (pleurisy, rib fracture), anxiety.
- Do you snore?
- Loudness of snoring.
- Interruption of activity next day.
- Laryngitis attacks.
- Voice hoarseness (CA, nerve palsy).
- Blocked sinuses sensation.
- Number of times draining sinuses in day.
- Post nasal drip.
- Fever (RTI, TB).
- Timing: day or night.
- Temperature reached, if known.
- Sweating at night (TB).
- RTIs: pneumonia, TB, bronchitis.
- Measles, pertussis during childhood.
- Lung CA.
- HIV (PCP).
- Surgery: for TB, tumor.
- Condition in a relative, what age.
- Emphysema, other COPDs.
- MI, angina.
- Smoking: ever smoked, how many per day, for how long, type [cigarette, pipe, chew].
- Passive smoking in the home, workplace.
- Alcohol (aspiration).
- Occupation type:
Farmer (farmer's lung).
Construction, shipyard (asbestos).
Miner, factory worker, stonemason (toxins).
Animal worker (M. psitacci).
Air conditioners (Legionella).
- Occupation details:
Tasks done at work.
How long of exposure.
Illness in fellow workers.
- Describe your home: stairs, etc.
- Pets at home (allergy, M. psittaci).
- Who is with you there at home.
- Drugs currently on, including delivery method.
Steroids (TB risk).
ACE inhibitors (cough).
OCP (PE risk).
- OTCs, including antihistamines.
- Recreational drugs:
IV users (pulmonary edema, abscess).
- Allergies, especially to inhaled substances.
- Allergies to drugs, dyes.
- Cardiovascular: (chest pain, dsypnoea).
- Alimentary: GERD (chest pain cause, cough worse after eating).
- Alimentary: fistula (cough worse after eating).
- Nervous (respiratory depression).
Pulmonary Exam »