Breathless Patient Week 1 Flashcards
Respiratory causes of breathlessness
Asthma
COPD
Pneumonia
Lung cancer
Cardiovascular causes of breathlessness
Heart failure
Pulmonary oedema
Pulmonary embolism - blood clot
Atrial fibrillation
Other causes of breathlessness
Functional - obesity
Anaemia
Pneumothorax - collapsed lung
Iatrogenic - caused by medicine (beta blockers)
Foreign bodies - peanut stuck
Panic attacks - anxiety, hyperventilation, psychogenic
What is orthopnoea?
Breathless by changing posture
Symptoms of heart failure
SoB
Swelling of ankles
Orthopnoea
What could digital clubbing be a sign of?
Lung cancer
Bronchiectasis
Pulmonary fibrosis
Cardiac eg. Fallot’s tetralogy
Types of cyanosis
Central: reduced O2 sat, blue tongue and lips, cardiac/resp. with shunting of blood
Peripheral: hand, feet due to poor blood flow
Physical examination
Palpation and percussion - dull sound = pneumonia
Auscultation: wheeze - expiration, limitations of flow in asthma and COPD
crackles - opening of closed bronchiole, early inspiration = diffuse airflow limitation; late inspiration = pulmonary oedema, fibrosis, bronchiectasis
pleural rub - inflammation of pleural surfaces
Sats of hypoxia
<92%
Why would you do a full blood count for a SoB patient?
Check for anaemia
What would you see on a chest x-ray with pneumonia?
Parts of lungs v white
What would you see on a chest x-ray with lung oedema or heart failure
Accumulation of fluid on the lungs
How to find the ventilation/perfusion
V - pulmonary 99mTc scintigraphy: underperformed areas, Technetium 99mTc albumin macro aggregated
Q - inhalation of Xenon-133 gas to detect underventilated areas
What would cause a striking perfusion/ventilation mismatch?
Pulmonary embolism
Symptoms of chronic heart failure
Left ventricular failure Pulmonary oedema Dyspnoea - sensation of drowning Chest cough Orthopnoea - breathless on lying down Inspiratory crepitations - crackling noises
