7.8.2013(dyspnea)

Question 0

Cause of chest tightness or constriction

Answer 0

Bronchoconstriction

Interstitial Edema due to heart failure

Question 1

Metaboceptors are located in

Answer 1

Skeletal muscles

Question 2

Cannot get a deep breath,causes

Answer 2

Hyperinflation

Decreased tidal volume(fibrosis,chest wall restriction)

Question 3

Increased work or effort of breathing,causes

Answer 3

Obstruction

Neuromuscular causes

Question 4

Air hunger,causes

Answer 4

CHF
Pulmonary embolism
Obstruction

Question 5

Mechanism of Dyspnea in COPD

Answer 5

Increased work of breathing
Hypoxemia
Acute Hypercapnia

Question 6

Mechanism of Dyspnea in cardiogenic pulmonary Edema

Answer 6

Increased work of breathing
Air hunger
Hypoxemia
Stimulation of pulmonary receptors
Stimulation of vascular receptors
Metaboceptors

Question 7

Mechanism of Dyspnea in non cardiogenic pulmonary Edema

Answer 7

Similar to CPE except that metaboceptors and stimulation of vascular receptors donot play a role

Question 8

Mechanism of Dyspnea in asthma

Answer 8

Increased work of breathing
Air hunger
Hypoxemia
Acute Hypercapnia 
Stimulation of pulmonary receptors

Similar mechanisms in ILD

Question 9

Cause of Dyspnea in pulmonary vascular disease

Answer 9

Air hunger
Hypoxemia
Stimulation of pulmonary vascular receptors

Question 10

Mechanism of Dyspnea in Anemia

Answer 10

Stimulation of metaboceptors

Question 11

Causes of Dyspnea in pleural effusion

Answer 11

Increased work of breathing

Atelectasis stimulating pulmonary receptors

Question 12

Cause of Dyspnea in obesity

Answer 12

Impaired ventilatory function due to reduced chest wall compliance

Question 13

Orthopnea,causes

Answer 13

CCF
obesity
GERD induced asthma

Question 14

Nocturnal Dyspnea

Answer 14

Asthma

CCF

Question 15

Acute intermittent Dyspnea

Answer 15

Myocardial ischemia
Pulmonary embolism
Bronchospasm

Question 16

Chronic persistent Dyspnea

Answer 16

COPD
ILD
chronic thromboembolic disease

Question 17

Causes of platypnea

Answer 17

Left atrial myxoma

Hepatopulmonary syndrome

Question 18

History taking in Dyspnea

Answer 18

Quality
Timing
Positional variation
Persistent Vs intermittent

Question 19

Signs of increased work of breathing

Answer 19

Supraclavicular retraction
Use of accessory muscles of ventilation
Tripod position

Question 20

Paradoxical movement of abdomen during respiration is a sign of

Answer 20

Diaphragmatic weakness

Question 21

Prominent pulmonary vasculature in upper zones

Answer 21

Pulmonary venous hypertension

Question 22

Enlarged central pulmonary arteries

Answer 22

Pulmonary artery hypertension

Question 23

Distinguishing cardiovascular and respiratory cause of Dyspnea

Answer 23

Exercise cardiopulmonary testing

Question 24

Experimental interventions in Dyspnea

Answer 24

Cold air on face Chest wall vibration Inhaled frusemide

Question 25

Findings pointing to respiratory cause in cardiopulmonary exercise test

Answer 25

Pts achieves predicted maximal ventilation Increase in dead space Hypoxemia Bronchospasm

Question 26

Findings pointing to CVS cause in cardiopulmonary exercise test

Answer 26

HR is more than 85% of max Ischemic changes in ECG increased or decreased blood pressure Fall in O2 pulse

Question 27

O2 pulse

Answer 27

Oxygen consumption/HR | indicator of stroke volume

Question 28

Chest X ray in pulmonary Edema

Answer 28

Peribronchial thickening Prominent vascular markings in upper lung zones Kerley B lines

Question 29

Non cardiogenic pulmonary Edema due to direct lung injury

Answer 29

``` Chest trauma Aspiration Smoking Pneumonia Oxygen toxicity Pulmonary embolism,reperfusion ```

Question 30

Hematogenous causes of Noncardiogenic pulmonary Edema

Answer 30

``` Sepsis Pancreatitis Non thoracic trauma Leukoagglutination reactions Multiple transfusions IV drug use(heroin) Cardiopulmonary bypass ```

Question 31

Noncardiogenic pulmonary Edema due to lung injury and elevated hydrostatic pressures

Answer 31

High altitude pulmonary Edema Neurogenic pulmonary Edema Reexpansion pulmonary Edema

Question 32

Diff btw cardiogenic and Noncardiogenic pulmonary Edema

Answer 32

Pleural effusions are not common Normal heart size Uniform pulmonary infiltrates Doesnot respond to supplemental oxygen as it is due to intra pulmonary shunting

Question 33

Cause of Dyspnea in DKA,renal insufficiency

Answer 33

Increase in H+ conc

Question 34

Cause of sensation of air hunger

Answer 34

Chemoreceptor stimulation

Question 35

Cause of sensation of increased respiratory effort

Answer 35

Central respiratory motor command

Question 36

In which type Dyspnea is more? | Restrictive or obstructive

Answer 36

No such difference

Question 37

Scales for measuring Dyspnea

Answer 37

MRC | OCD(oxygen cost diagram)

Question 38

Rx that relives Dyspnea by reducing metabolic load

Answer 38

Exercise training | Supplemental oxygen

Question 39

How oxygen relieves Dyspnea ?

Answer 39

Reduces metabolic load | Decreases central drive