Approach to Dyspnea

Question 1

mechanism by which CHF cause dyspnea

Answer 1

• increased interstitual fluid

- increase J receptor stimulation

Question 2

mechanism by which poor fitness contributes to dyspnea

Answer 2

increase anaerobic metabolism

acidosis

Question 3

mechanism by which anemia contributes to dyspnea

Answer 3

decreased oxygen delivery

acidosis

Question 4

initial investigations if someone presents with acute dyspnea

Answer 4

chest x ray
ECG
Blood work - cbc, Lytes, cardiac enzymes, d-dimer

Question 5

signs of respiratory distress

Answer 5

tachypneic 
indrawing, intercostal muscle use
cant lie down
cant speak in full sentences
agitated 
cyanotic, diaphoretic

Question 6

signs of impending respiratory failure

Answer 6

high CO2
LOC
acidosis

Question 7

chronic dyspnea - airway disease

Answer 7

COPD

Asthma

Question 8

chronic dyspnea - restrictive or pulmonary

Answer 8

ILD -

chronic thromboelmbolic - pulmonary HTN

Question 9

Chronic dyspnea - parenchymal disease

Answer 9

• TB ?

- lung cancer?

Question 10

obstructive + LOW DLCO

Answer 10

Emphysema

Question 11

Obstructive + normal DLCO

Answer 11

chronic bronchitis

asthma

Question 12

Normal + low Dlco

Answer 12

anemia

pulmonary vasculature