GRADING

Dyspnoea


Dyspnoea is define as an abnormally uncomfortable awareness of breathing

Grading of dyspnoea



Medical research council classification

Grade I----- shortness of breath when hurrying on a level ground or walking up a small hill Grade II---- shortness of breath when walking with people of same age group on level ground Grade III ----- shortness of breath when walking at own pace on level ground, having to stop for breath in between




New york heart association

Grade I---- no symptoms with ordinary physical activity Grade II----- symptoms with ordinary activity, slight limitation of physical activity Grade III----- symptoms with less than ordinary activity. Marked limitation of activity Grade IV----- symptoms with any physical activity or even at rest

Type of cough
   

Dry cough; pleural disorders, interstitial lung disease Productive cough; chronic bronchitis, pulmonary TB Short cough; it is seen in upper respiratory infections (common cold) Brassy cough; cough with metallic sound produced by compression of the trachea by intrathoracic space occupying lesions

Brovine cough; cough with loss of its explosive nature, Eg. Tumours pressing on recurrent laryngeal nerve Prolonged and paroxysmal cough; it is present in chronic bronchitis Barking cough; it is found in epiglottal involvement as well as hysterical and nervous individual

Type of Sputum
Type


Appearance Clear, watery frothy, pink

Cause Acute pulmonary oedema

Serous Mucoid

Purulent or mucopurulent Rusty

Clear, grey white, Chronic viscid bronchitis/COPD asthma Yellow, green Pneumonia, lung abscess, bronchiectasis Rusty, golden Pneumococcal yellow pneumonia

Grade sputum types

      

M1= pure mucoid M2 = mainly mucoid with a trace of pus P1 = purulent 1/3 pus P2 = purulent 1/3 2/3 pus P3 = purulent 2/3 pus H1 = fresh blood H2 = old blood

Hemoptysis


    

It is defined as expectoration of blood or bloody sputum Severity of hemoptysis ; ----Mild ---- <100 ml blood loss per day Moderate ----- 100- 150 ml blood loss per day Severe ----- upto 200 ml blood loss per day Massive ----- > 500 ml blood loss per day