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Harrison- Approach to Symptoms > 7.8.2013(dyspnea) > Flashcards

7.8.2013(dyspnea) Flashcards

0
Q

Cause of chest tightness or constriction

A

Bronchoconstriction

Interstitial Edema due to heart failure

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1
Q

Metaboceptors are located in

A

Skeletal muscles

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2
Q

Cannot get a deep breath,causes

A

Hyperinflation

Decreased tidal volume(fibrosis,chest wall restriction)

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3
Q

Increased work or effort of breathing,causes

A

Obstruction

Neuromuscular causes

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4
Q

Air hunger,causes

A

CHF
Pulmonary embolism
Obstruction

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5
Q

Mechanism of Dyspnea in COPD

A

Increased work of breathing
Hypoxemia
Acute Hypercapnia

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6
Q

Mechanism of Dyspnea in cardiogenic pulmonary Edema

A 
Increased work of breathing
Air hunger
Hypoxemia
Stimulation of pulmonary receptors
Stimulation of vascular receptors
Metaboceptors
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7
Q

Mechanism of Dyspnea in non cardiogenic pulmonary Edema

A

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

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8
Q

Mechanism of Dyspnea in asthma

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

Similar mechanisms in ILD

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9
Q

Cause of Dyspnea in pulmonary vascular disease

A

Air hunger
Hypoxemia
Stimulation of pulmonary vascular receptors

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10
Q

Mechanism of Dyspnea in Anemia

A

Stimulation of metaboceptors

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11
Q

Causes of Dyspnea in pleural effusion

A

Increased work of breathing

Atelectasis stimulating pulmonary receptors

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12
Q

Cause of Dyspnea in obesity

A

Impaired ventilatory function due to reduced chest wall compliance

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13
Q

Orthopnea,causes

A

CCF
obesity
GERD induced asthma

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14
Q

Nocturnal Dyspnea

A

Asthma

CCF

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15
Q

Acute intermittent Dyspnea

A

Myocardial ischemia
Pulmonary embolism
Bronchospasm

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16
Q

Chronic persistent Dyspnea

A

COPD
ILD
chronic thromboembolic disease

17
Q

Causes of platypnea

A

Left atrial myxoma

Hepatopulmonary syndrome

18
Q

History taking in Dyspnea

A

Quality
Timing
Positional variation
Persistent Vs intermittent

19
Q

Signs of increased work of breathing

A

Supraclavicular retraction
Use of accessory muscles of ventilation
Tripod position

20
Q

Paradoxical movement of abdomen during respiration is a sign of

A

Diaphragmatic weakness

21
Q

Prominent pulmonary vasculature in upper zones

A

Pulmonary venous hypertension

22
Q

Enlarged central pulmonary arteries

A

Pulmonary artery hypertension

23
Q

Distinguishing cardiovascular and respiratory cause of Dyspnea

A

Exercise cardiopulmonary testing

24
Q

Experimental interventions in Dyspnea

A

Cold air on face
Chest wall vibration
Inhaled frusemide

25
Q

Findings pointing to respiratory cause in cardiopulmonary exercise test

A

Pts achieves predicted maximal ventilation
Increase in dead space
Hypoxemia
Bronchospasm

26
Q

Findings pointing to CVS cause in cardiopulmonary exercise test

A

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

27
Q

O2 pulse

A

Oxygen consumption/HR

indicator of stroke volume

28
Q

Chest X ray in pulmonary Edema

A

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

29
Q

Non cardiogenic pulmonary Edema due to direct lung injury

A 
Chest trauma
Aspiration
Smoking
Pneumonia
Oxygen toxicity
Pulmonary embolism,reperfusion
30
Q

Hematogenous causes of Noncardiogenic pulmonary Edema

A 
Sepsis
Pancreatitis
Non thoracic trauma
Leukoagglutination reactions
Multiple transfusions
IV drug use(heroin)
Cardiopulmonary bypass
31
Q

Noncardiogenic pulmonary Edema due to lung injury and elevated hydrostatic pressures

A

High altitude pulmonary Edema
Neurogenic pulmonary Edema
Reexpansion pulmonary Edema

32
Q

Diff btw cardiogenic and Noncardiogenic pulmonary Edema

A

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

33
Q

Cause of Dyspnea in DKA,renal insufficiency

A

Increase in H+ conc

34
Q

Cause of sensation of air hunger

A

Chemoreceptor stimulation

35
Q

Cause of sensation of increased respiratory effort

A

Central respiratory motor command

36
Q

In which type Dyspnea is more?

Restrictive or obstructive

A

No such difference

37
Q

Scales for measuring Dyspnea

A

MRC

OCD(oxygen cost diagram)

38
Q

Rx that relives Dyspnea by reducing metabolic load

A

Exercise training

Supplemental oxygen

39
Q

How oxygen relieves Dyspnea ?

A

Reduces metabolic load

Decreases central drive

Harrison- Approach to Symptoms (11 decks)

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