Resp History




  • Haemoptysis is the coughing up of bloody or blood-tinged sputum. This may be due to disease of the airways, pulmonary parenchyma or pulmonary vasculature.


    • Causes of Haemoptysis

    • Tracheobronchial

    • Cancer
    • Acute bronchitis
    • Chronic bronchitis
    • Bronchiectasis
    • Foreign body aspiration
    • Parenchymal

    • Infection - pneumonia, lung abscess, tuberculosis
    • Inflammatory - Goodpasture’s, Wegener’s granulomatosis
    • Lung contusion
    • Vascular

    • Pulmonary embolism
    • Arteriovenous malformation
    • Not True Haemoptysis

    • Haematemesis (upper GI bleed)
    • Oral source of bleeding
    • Nasopharyngeal bleed

History of Presenting Complaint

    • Onset

    • Whether the sputum was red from the start or began with a cough with or without sputum production.
    • Sputum

      The colour, volume and consistency of the sputum.
    • Bright or dark red sputumHaemoptysis
    • Yellow / green sputum with red streaksSuggestive of infectious cause
    • Pink, frothy sputumCharacteristic of acute pulmonary oedema
    • Coffee groundsSuggestive of haematemesis
    • Associated Symptoms

      Whether the cough is associated with any other symptoms.
    • FeversSuggestive of upper / lower respiratory tract infection
    • Pleuritic chest painSuggestive of pneumonia or PE
    • Chest pain and shortness of breathConcerning for PE
    • Duration

    • Whether the has been coughing up blood for days, weeks, months or years.
    • Course

      The frequency & length of coughing episodes, and whether it varies throughout the day.
    • Worse in the morningCharacteristic of smoker’s cough (chronic bronchitis)
    • Exacerbating Factors

      Whether the cough is triggered by anything.
    • Exacerbated by environmental allergensSuggestive of asthma or chemical exposure
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge


Ainslie G. Assessment of cough. Continuing Medical Education. 2009 Mar 19;27(2):68.
 Antoniou KM, Margaritopoulos GA, Tomassetti S, Bonella F, Costabel U, Poletti V. Interstitial lung disease. European Respiratory Review. 2014 Mar 1;23(131):40-54. Badran M, Ayas N, Laher I. Cardiovascular complications of sleep apnea: role of oxidative stress. Oxidative medicine and cellular longevity. 2014;2014. Beasley R, Semprini A, Mitchell EA. Risk factors for asthma: is prevention possible?. The Lancet. 2015 Sep 12;386(9998):1075-85. Braman SS, Davis SM. Wheezing in the elderly. Asthma and other causes. Clinics in geriatric medicine. 1986 May;2(2):269-83. Cano-Jiménez E, Hernández González F, Peloche G. Comorbidities and Complications in Idiopathic Pulmonary Fibrosis. Medical Sciences. 2018 Sep;6(3):71. Committee on Rating of Mental and Physical Impairment. The Respiratory System. JAMA. 1965 Nov; 194(8): 919-932. Cushman M. Epidemiology and risk factors for venous thrombosis. InSeminars in hematology 2007 Apr 1 (Vol. 44, No. 2, pp. 62-69). WB Saunders. del Giudice MM, Allegorico A, Parisi G, Galdo F, Alterio E, Coronella A, Campana G, Indolfi C, Valenti N, Di Prisco S, Caggiano S. Risk factors for asthma. InItalian journal of pediatrics 2014 Dec (Vol. 40, No. 1, p. A77). BioMed Central. Feierabend R. Hoarseness in adults. Am Fam Physician. 2009;80:363. Gordon BR. Asthma History and Presentation. Otolaryngeal Clin N Am. 2008; 41: 375-385. Harding SM. Complications and consequences of obstructive sleep apnea. Current opinion in pulmonary medicine. 2000 Nov 1;6(6):485-9. Heit JA, Silverstein MD, Mohr DN, Petterson TM, O'fallon WM, Melton LJ. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Archives of internal medicine. 2000 Mar 27;160(6):809-15. Ho WK. Deep vein thrombosis: risks and diagnosis. Australian family physician. 2010 Jul;39(7):468. Holzinger F, Beck S, Dini L, Stöter C, Heintze C. The diagnosis and treatment of acute cough in adults. Deutsches Ärzteblatt international. 2014;111:356. Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest. 2006;129:1S-23S. Kilgore D, Najm W. Common Respiratory Diseases. Prim Care Clin Office Pract. 2010; 37: 297-324. Krieger BP. When wheezing may not mean asthma: other common and uncommon causes to consider. Postgraduate medicine. 2002 Aug 1;112(2):101-11. Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. The Lancet. 2007 Sep 1;370(9589):765-73. Mathews KP. Respiratory Atopic Disease. JAMA. 1982 Nov; 248(20): 2587-2610. Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. InMayo Clinic Proceedings 2008 May 1 (Vol. 83, No. 5, pp. 584-594). Elsevier. O'Donnell AE. Bronchiectasis. Chest. 2008 Oct 1;134(4):815-23. Osann KE. Lung Cancer in Women: The Importance of Smoking, Family History of Cancer, and Medical History of Respiratory Disease. Cancer Research. 1991 Sep; 51: 4893-4897. Papiris S, Kotanidou A, Malagari K, Roussos C. Clinical review: severe asthma. Critical Care. 2001 Feb;6(1):30. Prakash UBS. Uncommon Causes of Cough. Chest. 2006;129:206S. Pratter MR. Overview of common causes of chronic cough: ACCP evidence-based clinical practice guidelines. CHEST Journal. 2006 Jan 1;129(1_suppl):59S-62S. Samama MM. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Archives of internal medicine. 2000 Dec 11;160(22):3415-20. Sethi GR, Batra V. Bronchiectasis: causes and management. The Indian Journal of Pediatrics. 2000 Feb 1;67(2):133-9. Travis, W.D., Costabel, U., Hansell, D.M., King Jr, T.E., Lynch, D.A., Nicholson, A.G., Ryerson, C.J., Ryu, J.H., Selman, M., Wells, A.U. and Behr, J., 2013. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. American journal of respiratory and critical care medicine, 188(6), pp.733-748. Troy L, Corte T. Interstitial lung disease in 2015: where are we now?. Australian family physician. 2015 Aug;44(8):546. Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. Jama. 2004 Apr 28;291(16):2013-6.