Breathlesness

Question 1

What are the 10 questions to be asked again in history from a breathless patient

Answer 1

Chest pain. Long-standing breathing problem. Asthma. Heart failure. Degree of dyspnoea. Length of the DIB. Pain associated with breathing. Does position exacerbate breathing. Does the patient have a cough if yes is it productive. Has the patient increased medication recently

Question 2

Describe the physical assessment of a breathless patient 4.

Answer 2

Inspection. Palpation. Percussion. Auscultation.

Question 3

What key signs and symptoms would a physical assessment show? 6

Answer 3

RR, effort and effectiveness of ventilations. Pattern of breathing and depth of RR. Audible sounds. Breath Sounds. Neck veins/ankle swelling. Signs of anaphylaxis.

Question 4

List some major causes of breathlessness

Answer 4

Pulmonary. Acute exacerbation of asthma. Acute heart failure. Bronchiectasis. Acute exacerbation of COPD. Flail chest. Interstitial lung disease. Lung collapse. Massive Haemothorax. Pleural effusion. Pneumonia. Pneumothorax. PE. Upper airway obstruction.

Question 5

Cardiac causes of breathlessness

Answer 5

Cardiac arrhythmia. Tamponade. IHD. MI. Valvular dysfunction. Pericarditis.

Question 6

Other causes of breathlessness

Answer 6

Anaphylaxis. Chemicals. Poisons. DKA. Diaphragmatic splinting. Hyperventilating. Severe hypovaelemia. Metabolic causes. Obesity. Pain. Severe anaemia

Question 7

List three signs and symptoms of anaemia

Answer 7

Fatigue. Dizziness. Pallor

Question 8

Define epiglottitis

Answer 8

And acute information of the epiglottis potentially fatal

Question 9

What is the cause of epiglottitis

Answer 9

Bacterial infection.

Rare due to HIB vaccine

Question 10

What are the four symptoms of epiglottitis

Answer 10

Fever. Unwell/distressed. Stridor. Sitting up/drooling/chin out

Question 11

Define hyperventilation syndrome

Answer 11

A rate of ventilation exceeding metabolic needs and higher than that required to maintain the normal level of co2.

Question 12

What are the four symptoms of lung cancer

Answer 12

Persistent cough. Bloody sputum. Chest pain. Weight loss. Frequent and LRTI

Question 13

What are the three causes of Pleurisy

Answer 13

Pneumonia. Pneumothorax. PE, TB CA

Question 14

Define Pleurisy

Answer 14

Inflammation of the parietal pleura

Question 15

What are the five symptoms of pleurisy

Answer 15

Pleuritic pain. Splinting and spasm. Fever. Cough. Tachypnoea

Question 16

Define TB

Answer 16

Chronic bacterial infection normally of the lungs

Question 17

LIST two courses of TB

Answer 17

Poor living conditions. Compromised immune system.

Question 18

List for symptoms of TB

Answer 18

Chronic productive cough. Fever. Weight loss. Generally unwell

Question 19

Define pneumonia

Answer 19

And acute infective inflammation of the lungs

Question 20

What are the two courses of pneumonia

Answer 20

Bacterial infection. Community acquired, aspiration.

Question 21

What are the four symptoms of pneumonia

Answer 21

Generally unwell and confusion. Fever. Tachypnoea over 25 bpm. Cough yellow green

Question 22

Define pneumothorax

Answer 22

There in the plural cavity collapsing the lung

Question 23

List two causes of pneumothorax

Answer 23

Spontaneous. Traumatic or medical

Question 24

List for symptoms of pneumothorax

Answer 24

Pleuritic chest pain. Hyperresonant percussion. Assymetric chest wall. Tachypnoea

Question 25

What seven reasons would make your breathless patient time critical

Answer 25

Extreme DIB. Major ABCD. Cyanosis. Hypoxia or not responding to o2. Life threatening asthma. Tension pneumothorax. Acute MI. Anaphylaxis

Question 26

What would your general management of a breathless patient include 4

Answer 26

Ensure ABCs. O2. Position for comfort. Consider 12 lead

Question 27

List the 6 elements of obtaining a patient history

Answer 27

Presenting complaint. History of presenting complaint. Questioning. Past medical history. Family history. Social history