×
MedSchool: Ace Your OSCEsThe Medical Company
 
 
 
 
 
GET - On the App Store
View
Resp History
 
 

Wheeze

February 15th, 2021
 
 
 
Bookmark

Overview

Wheezing is an unpleasant symptom that often occurs in patients with exacerbations of asthma, COPD, heart failure or allergies. Ask about possible precipitants for the patient's wheeze, and if in doubt consider rarer causes such as Churg-Strauss or carcinoid syndrome.

Aetiology

  • Causes of Wheeze

  • Obstructive lung disease - asthma, COPD
  • Left ventricular failure (pulmonary oedema)
  • Allergy (angioedema)
  • Aspiration
  • Bronchial / tracheal obstruction - foreign body, tumour, stenosis
  • Carcinoid syndrome
  • Churg-Strauss syndrome
  • Allergic bronchopulmonary aspergillosis (ABPA)
  • Asthma Triggers

  • Environmental - pollen, tobacco smoke, pollutants
  • Medications - beta blockers, ACE inhibitors, NSAIDs
  • Exercise
  • Stress
  • Respiratory infections
  • Gastroesophageal reflux

History of Presenting Complaint

  • Onset

    When the wheeze started, and under what circumstances.
  • Onset post eatingAllergy, aspiration or reflux (asthmatics)
  • Onset post new medicationPotential allergic drug reaction
  • Associated Symptoms

    Whether the wheeze is associated with any other symptoms.
  • Associated with shortness of breathNonspecific symptom of cardiorespiratory disease
  • Associated with paroxysmal nocturnal dyspnoeaSuggestive of heart failure
  • Fevers and coryzal symptoms / cough in an asthmaticSuggestive of infective exacerbation
  • Associated with haemoptysisConcerning for lung cancer
  • Exacerbating Factors

    Whether there is anything that triggered the wheeze or makes it worse.
  • Worse on lying downSuggestive of heart failure or reflux (asthmatics)
  • Exacerbated by environmental triggersSuggestive of asthma / allergies
  • Alleviating Factors

    Whether there is anything that relieves the wheeze.
  • Relieved with bronchodilatorSuggestive of asthma / COPD
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
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
Sign Up Now
   
 
 

Snapshot: Initialising...