13. shortness of breath

Question 1

Causes of Chronic Cough

Answer 1

upper airway cough syndrome (UACS - previously called postnasal drip)
vocal cord dysfunction
asthma
gastroesophageal reflux disease (GERD)
cough due to medications such as angiotensin-converting enzyme inhibitors (ACE-inhibitors)
tobacco-related cough
post-infectious cough
chronic obstructive pulmonary disease (especially the chronic bronchitis type)
non-asthmatic eosinophilic bronchitis.

Question 2

Causes of Wheezing

Answer 2

asthma
    chronic obstructive pulmonary disease 
    congestive heart failure 
    foreign body aspiration 
    persistent bronchitis 
    upper airway cough syndrome 
    vocal cord dysfunction 
    pulmonary embolism

Question 3

Pneumonia (E) may present with

Answer 3

rales

Question 4

Epiglottitis (H) may present with

Answer 4

stridor

Question 5

Obstructive sleep apnea (J) may present with

Answer 5

daytime sleepiness, nocturnal snoring and irregular breathing when asleep

Question 6

Conditions which may require treatment to improve the control of asthma such as:

Answer 6

gastroesophageal reflux disease (GERD)
    obesity or overweight
    obstructive sleep apnea
    rhinitis or sinusitis
    stress and depression

Question 7

It is more likely to be a viral rhinosinusitis if the duration of symptoms is less than ten days and they are not worsening. In this case, you can continue to observe the patient and reassure him that antibiotics are not necessary at this time.

Answer 7

…

Question 8

Symptoms of Chronic Sinusitis

Answer 8

nasal obstruction or congestion
mucopurulent drainage (anterior, posterior or both)
facial pain, pressure or fullness
decreased sense of smell

Question 9

Allergic Rhinitis Management

Answer 9

Oral antihistamine (cetirizine)
    Inhaled nasal corticosteriod  (fluticasone)

Question 10

Suspected Asthma Management

Answer 10

The American College of Chest Physicians (ACCP) recommends offering standard asthma medication including an inhaled bronchodilator and an inhaled corticosteroid.

Question 11

Moderate persistent asthma requires

Answer 11

low-dose inhaled corticosteroid and long-acting beta2-agonist inhaler OR a medium-dose inhaled corticosteroid alone for maintenance medications.

Question 12

Pharmaceutical Therapy for Allergic Rhinitis

Answer 12

Nasal corticosteroids are the most effective medications for patients with allergic rhinitis

Question 13

Treatment for Chronic Sinusitis

Answer 13

regular use of nasal corticosteroids and, if indicated, allergen immunotherapy.

regular nasal saline irrigation is a useful adjunct

no compelling evidence to support the use of antibiotics in patients with chronic sinusitis