General Examination

Dyspnoea: 

• it is an undue awareness of respiratory effort or of the need to increase this effort .

Causes of acute or sudden dyspnoea:

•  Acute severe asthma.
•  Pulmonary oedema (acute LVF).
•  Pulmonary embolism.
•  Spontaneous pneumothorax.
•  Adult respiratory distress syndrome.
•  Hysterical conversion reaction or panic attack.

Cough : 

1. Dry or Non- productive Cough :

• a. worse in morning - Bronchitis
• b. worse at night - Asthma
• c. Dry initially ,productive later- Pneumonia .

2. Productive cough 

• a. Bronchiectasis 
• b. pulmonary edema 

3. Persistent cough 

• a. Bronchial carcinom
• b.Chronic bronchitis 
• c.Bronchial asthma 
• d.postnasal drip

Sputum :

A.Character of sputum :

• 1. Serous (clear,watery,frothy )--Acute pulmonary edema 
• 2. Mucoid ( clear, white,grey, jelly like strick,)-Chronic bronchitis , Bronchial asthma 
• 3. Mucopurulent or purulent (yellow,green,brown,not sticky)--Bronchiectasis , Lung Abscess, Acute bronchitis , last stage of TB .
• 4. Rusty (Rusty,golden yellow) -- Pneumococcal pneumonia .
  

B. Odour : foul smell 

• lung abscess, Bronchiectasis , Advantage of last stage of TB

Haemoptysis: 

• 1. Frunk Haemoptysis : TB , Bronchiectasis , Bronchial carcinoma , pulmonary infarction.
• 2.Scanty Haemoptysis : chronic bronchitis ,bronchial carcinoma.
• 3.Haemoptysis with purulent sputum ; Bronchiectasis ,chronic bronchitis ,suppurative pneumonia 
• 4. Recurrent Haemoptysis : pulmonary thromboembolism ,Bronchial carcinoma , Bronchiectasis, chronic bronchitis .