Respiratory Patient Assessment

Background

Medical History

• Morbid background
• Chronic respiratory diseases (presence or absence)
• Thoracic surgery history
• Injuries

Reproductive History

• Relevant for therapeutic and diagnostic decisions
• Reproductive age
• Contraceptive methods
• Catamenial regimen

Habits

• Crucial for diagnosis
• Snuff: type, frequency, duration, mode, passive exposure
• Pack-years (e.g., 1 pack/day for 1 year = 1 pack-year)
• Alcohol consumption
• Animal breeding (mammals, birds)
• Biomass fuel use

Drug Use History

• Impact on diagnosis and treatment
• Effects on bronchial kinetics
• Effects on lung morphology
• Influence on respiratory comorbidities

• ACE inhibitors
• Beta-blockers (e.g., propranolol)
• Antineoplastics (e.g., bleomycin, doxorubicin)
• Antiarrhythmics (e.g., amiodarone)
• Nitrofurantoin, methotrexate
• Calcium, antiresorptive bone drugs, NSAIDs
• Anti-TNF agents

Allergies

• Medications
• Food
• Environmental

Social and Personal History

• Occupation
• Occupational diseases (e.g., pneumoconiosis, sensitivity pneumonitis, occupational asthma, COPD)
• Place of residence
• Epidemiology

Immunizations and Family History

• BCG
• Influenza
• Pneumonia
• Whooping cough

Anamnesis

Major Symptoms

• Cough: Acute or chronic, respiratory or extra-respiratory source
• Expectoration: Color, amount, odor, taste, consistency, timing (mucoid, mucopurulent, hemoptysis, pink, blackish, fetid, abundant and morning-dominant, bronchiectasis, cavities)
• Dyspnea: Acute or chronic, related to exertion level, respiratory or non-respiratory source
• Hemoptysis: Distinguish from epistaxis, gingival bleeding, hematemesis
• Cyanosis: Central (respiratory/cardiac causes) or peripheral (local causes)
• Vomica: Sudden expulsion of purulent fluid

Other Related Symptoms

• Voice disorders
• Chest Pain: Acute or chronic, type (pressure, stinging, burning), respiratory or non-respiratory origin (lung, pleura, heart, ribcage, other organs)

Wheezing and Stridor

Note: Onset, intensity, evolution, and frequency of cough and dyspnea are crucial for classification and detailed explanation.

Physical Examination

• Inspection

• Position and Attitude: Orthopnea, platypnea, trepopnea

• Auscultation
• Percussion
• Palpation