Breathlessness

Question 1

How does central information processing in the brain result in breathlessness

Answer 1

Central information processing in the brain compares the afferent and efferent pathways. Dyspnoea occurs when mismatch occurs between 2

Question 2

Define breathlessness

Answer 2

Need for ventilation (afferent signal) is not met by breathing (efferent signal)

Question 3

Which receptors are involved in breathlessness experienced in type 1 resp failure

Answer 3

Peripheral chemoreceptors

Question 4

Are most cases of type 2 respiratory failure related to breathlessness

Answer 4

No (hypoventilation)

Question 5

How does metabolic acidosis lead to breathlessness

Answer 5

All causes of metabolikc acidosis cause breathlessness due to effect on peripheral chemoreceptor

Question 6

How can hypotension lead to breathlessness

Answer 6

Leads to stagnant hypoxia resulting in decreased p02 in peripheral chemoreceptor

Question 7

How does exercise lead to breathlessness

Answer 7

Inreased pC02 and via afferents from skeletal muscles stimulating resp centre

Question 8

How does pregnancy lead to breathlessness

Answer 8

Due to direct effect on respiratory centre from progesterone

Also, increased CO2 production

Question 9

How does anxiety and pain lead to breathlessness

Answer 9

Impulses passing from hypothalamus to the resp centre

Question 10

How can pulmonary oedema lead to breathlessness

Answer 10

Stimulates J receptors in lung

Question 11

Does anaemia cause breathlessness

Answer 11

Yes

Question 12

What receptor are affected when breathign CO2

Answer 12

Central chemoreceptors

Question 13

2 ways of classifying breathlessness

Answer 13

Surgical sieve

Systems based

Question 14

What pneumonic can be used to classify breathlessness via surgical sieve

Answer 14

Very
Early 
Man
Did
Not 
Talk
I
I
I
I
I

Question 15

What does the breathlessness pneumonic stand for

Answer 15

Vascular
Endocrine
Metabolic
Degenerative
Neoplastic
Truamatic
Infective
Inflammatory
Immunological
Iatrogenic
Idiopathic

Question 16

Name some vascular causes of breathlessness

Answer 16

Pulmonary hypertension
Pulmonary embolism
Pleural effusion
CAD
Congestive heart failure
Arrythmia
Acquired vascular heart disease
Congenital heart disease

Question 17

Name some endocrine causes of breathlessness

Answer 17

DKA
Cushings syndrome
Phageo-chromocytoma

Question 18

Name some metabolic causes of breathlessness

Answer 18

Pericardial effusion
Cardiac drugs
Uraemia
Ascites
CO poisoning
Anaemia

Question 19

Name some degenerative causes of breathlessness

Answer 19

COPD
GORD
Interstitial lung disease
Aortic dissection
Kyphoscoliosis

Question 20

Name some neoplastic causes of breathlessness

Answer 20

Tumours
Pleural effusion
Phrenic nerve paralysis

Question 21

Name some traumatic causes of breathlessness

Answer 21

Foreign body aspiration
Anxiety
Aortic dissection

Question 22

Name some infective causes of breathlessness

Answer 22

Septic shock
Epiglottis 
Laryngitis
Diptheria
Bronchitis
Pneumothorax

Question 23

Name some inflammatory causes of breathlessness

Answer 23

Cardiomyopathy

Myocarditis

Question 24

Name some iatrogenic causes of breathlessness

Answer 24

phrenic nerve paralysis

Question 25

What are the systems involved in the systems approach

Answer 25

Airway
Breathing
Cardiovasc
Endocrine
Haematological
Neurological
Allergic

Question 26

What some MET stand of

Answer 26

Metabolic equivelent

Question 27

What is sitting down in terms of METs

Answer 27

1

Question 28

How many METS are used climbing a flight of stairs

Answer 28

4

Question 29

How many METS are used walking at 2mph

Answer 29

2

Question 30

7 things tested for in primary investigation for breathlessness

Answer 30

• FBC
• U&E
• pulse oximetry
• PEFK
• PFT
• ABG
• Cardiac enzymes

Question 31

5 things tested for in secondary investigation for breathlessness

Answer 31

• ECG
• CXR
• Echo
• Shuttle walk
• VQ scan