Breathing Difficulty

Question 1

SOB, chest tightness, cough (dry or clear sputum).

Answer 1

Asthma

Question 2

SOB, productive cough (may be chronic), may have recurrent chest infections.

Answer 2

COPD

Question 3

SOB, cough with blood-stained sputum, sharp chest pain, fever, nausea/vomiting, abdominal pain.

Answer 3

Pneumonia

Question 4

Fever, new continuous cough, loss or change to sense of smell or taste.

Answer 4

COVID

Question 5

Triggered onset, rapid breathing, chest tightness, pins and needles in limbs.
Symptoms revolve after coaching breathing.

Answer 5

Anxiety

Question 6

Sudden onset - SOB, hives/rash/erythema, angiodema (swelling), chest tightness, diarrhea, vomiting.

Answer 6

Anaphylaxis

Question 7

SOB, chest pain, deviated trachea, decreased air entry, surgical emphysema.

Answer 7

Pneumothorax

Question 8

Pale, clammy, sweaty. SOB, no chest pain.

Answer 8

Silent MI

Question 9

SOB, worse when lying flat. Fatigue/lethargy, may be chest pain, productive cough with blood-stained sputum, oedema in lower limbs/back or abdomen.

Answer 9

Heart failure

Question 10

Fatigue, pale, SOB, dizziness or lightheadedness, melaena (dark sticky faeces - contain blood) or haematemesis (consider GI bleed).

Answer 10

Anaemia

Question 11

SOB (may be sudden), sharp chest pain, productive cough with blood-stained sputum.

Answer 11

Pulmonary Embolism

Question 12

Risk factors for Pulmonary Embolism?

Answer 12

Lower limb pain/swelling (DVT), recent long haul flight, recent history of immobility, chemotherapy.

Question 13

Assessment findings for Asthma?

Answer 13

Wheeze, normal percussion.

Question 14

Assessment findings for COPD?

Answer 14

Wheeze, auscultation suggests consolidation. May be reduced air entry.

Question 15

Assessment findings for Pneumonia?

Answer 15

Basal crackles, dull percussion.

Question 16

Assessment findings for Pneumothorax?

Answer 16

One sided hyporesonance and reduced/absent air entry.
Reduced O2 saturation.

Question 17

ECG findings for Silent MI?

Answer 17

ECG may show ischaemia - ST elevation or depression, deep and wide Q waves, symmetrical T wave inversions.

Question 18

Assessment and ECG findings for Heart Failure?

Answer 18

Auscultation suggesting consolidation - basal crackles with dull percussion.
ECG findings - ventricular hypertrophy.

Question 19

Assessment and ECG findings for Pulmonary Embolism?

Answer 19

May be reduced air entry over area.
May be sinus tachy.
S1Q3T3. S wave in lead 1, Q wave in lead 3 in association with T inversion in lead 3.