Sunday, November 30, 2025

SERIES 2 - RESPIRATORY DISEASES

 



🌬️  COMMON RESPIRATORY DISEASES 


1. Acute Bronchitis

Stage 1: Early Viral Phase

  • Sore throat, runny nose
  • Dry cough
  • Mild fever
  • Chest discomfort

Stage 2: Progressive Bronchial Inflammation

  • Harsh barking cough
  • Burning sensation behind sternum
  • Mild wheeze

Stage 3: Productive Phase

  • Cough with mucoid sputum
  • Diffuse wheeze + rhonchi

Classical Features

  • Cough > 5 days
  • Normal chest X-ray

2. Community-Acquired Pneumonia (CAP)

Stage 1: Infection Onset

  • Sudden fever
  • Shaking chills
  • Malaise

Stage 2: Consolidation

  • Productive cough → rust-colored sputum (classical for pneumococcal)
  • Pleuritic chest pain
  • Breathlessness

Stage 3: Severe CAP

  • High fever
  • Confusion (elderly)
  • Hypoxia

Classical Signs

  • Bronchial breathing
  • Dull percussion
  • Increased vocal fremitus / resonance

3. Tuberculosis (Pulmonary TB)

Stage 1: Early Infection (Subclinical)

  • No symptoms or mild dry cough
  • Fatigue

Stage 2: Active Disease

  • Chronic cough (>2–3 weeks)
  • Evening rise of temperature
  • Night sweats (classical)
  • Weight loss
  • Hemoptysis

Stage 3: Advanced TB

  • Chest pain
  • Breathlessness
  • Loss of appetite

Peculiar Features

  • Cavitary lesions (upper lobe)
  • Post-tussive crepitations

4. COPD (Chronic Bronchitis + Emphysema)

Stage 1: Early COPD

  • Chronic productive cough
  • Morning “smoker’s cough”

Stage 2: Moderate

  • Breathlessness on exertion
  • Wheezing
  • Frequent infections

Stage 3: Severe

  • Dyspnea at rest
  • Barrel-shaped chest
  • Pursed-lip breathing

Classical Phenotypes

  • Blue Bloater (Chronic Bronchitis): cyanosis + edema
  • Pink Puffer (Emphysema): breathless, thin, no cyanosis

5. Asthma

Stage 1: Prodrome

  • Itchy throat
  • Chest tightness
  • Mild wheeze

Stage 2: Exacerbation

  • Cough (worse night/early morning)
  • Wheezing
  • Dyspnea

Stage 3: Severe Asthma Attack

  • Silent chest
  • Tachypnea
  • Accessory muscle use

Special Features

  • Reversible airway obstruction
  • Wheezing + episodic pattern
  • Cough variant asthma – cough only

6. Pleural Effusion

Stage 1: Small Effusion

  • Mild dyspnea
  • Chest pressure

Stage 2: Moderate

  • Stony dull percussion
  • Decreased breath sounds
  • Reduced chest expansion

Stage 3: Large Effusion

  • Orthopnea
  • Tracheal shift (away from side)

Classical Sign

  • Pleural rub (early stage)

7. Pneumothorax

Stage 1: Small Pneumothorax

  • Mild chest pain
  • Slight dyspnea

Stage 2: Moderate

  • Sudden sharp unilateral chest pain
  • Hyperresonant percussion
  • Decreased breath sounds

Stage 3: Tension Pneumothorax

  • Severe dyspnea
  • Tracheal shift (opposite side)
  • Distended neck veins
  • Hypotension → shock

Classical Feature

  • Hyperresonant percussion

8. Pulmonary Embolism (PE)

Stage 1: Early

  • Sudden chest pain
  • Tachypnea
  • Anxiety

Stage 2: Progressive

  • Dyspnea
  • Palpitations
  • Non-productive cough
  • Hemoptysis (in infarction)

Stage 3: Massive PE

  • Hypotension
  • Syncope
  • Right heart failure

Classical Feature

  • Sudden unexplained dyspnea + clear lungs

9. Interstitial Lung Disease (ILD)

Stage 1: Early

  • Dry cough
  • Progressive breathlessness

Stage 2: Moderate

  • Velcro-like fine inspiratory crackles
  • Fatigue
  • Clubbing

Stage 3: Advanced ILD

  • Severe dyspnea at rest
  • Cyanosis
  • Pulmonary hypertension

Classical Feature

  • Velcro crackles

10. Bronchiectasis

Stage 1: Early

  • Chronic productive cough
  • Foul-smelling sputum

Stage 2: Progressive

  • Recurrent infections
  • Fever
  • Wheezing
  • Hemoptysis

Stage 3: Advanced

  • Clubbing
  • Coarse crepitations
  • Large-volume purulent sputum

Classical Feature

  • Copious purulent sputum in 3 layers

11. Pneumoconiosis (Silicosis / Asbestosis / Coal worker’s)

Stage 1: Early

  • Chronic dry cough
  • Fatigue

Stage 2: Progressive Fibrosis

  • Breathlessness
  • Chest tightness

Stage 3: Late

  • Clubbing (asbestosis)
  • Recurrent infections
  • Cor pulmonale

Classical Features

  • Silicosis – Eggshell calcification of lymph nodes
  • Asbestosis – Pleural plaques

12. Lung Cancer

Stage 1: Early

  • Persistent cough
  • Chest pain
  • Hoarseness

Stage 2: Progressive

  • Hemoptysis
  • Weight loss
  • Fatigue
  • Recurrent pneumonia

Stage 3: Metastatic / Locally Advanced

  • Bone pain
  • Neurological deficits
  • Superior vena cava obstruction → face swelling, dilated chest veins

Peculiar Signs

  • Pancoast tumor → shoulder/arm pain + Horner syndrome
  • Clubbing

13. Acute Respiratory Distress Syndrome (ARDS)

Stage 1: Early

  • Acute dyspnea
  • Tachypnea
  • Hypoxia

Stage 2: Progressive

  • Pink frothy sputum
  • Severe breathlessness
  • Cyanosis

Stage 3: Severe ARDS

  • Diffuse crackles
  • Respiratory failure
  • Multiorgan dysfunction

Classical Feature

  • Refractory hypoxemia

14. Obstructive Sleep Apnea (OSA)

Stage 1: Early

  • Loud snoring
  • Daytime fatigue

Stage 2: Progressive

  • Morning headaches
  • Non-restorative sleep
  • Choking at night

Stage 3: Advanced

  • Hypertension
  • Personality changes
  • Poor concentration

Classical Feature

  • Witnessed apneic episodes

15. Cystic Fibrosis (in children/young adults)

Stage 1: Early

  • Persistent cough
  • Salty sweat (peculiar finding)
  • Poor weight gain

Stage 2: Moderate

  • Recurrent chest infections
  • Large-volume sputum
  • Nasal polyps

Stage 3: Advanced

  • Clubbing
  • Bronchiectasis
  • Respiratory failure

Special Feature

  • Salty skin test (sweat chloride ↑)


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