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Acute Medicine > Breathlessness > Flashcards

Breathlessness Flashcards

1
Q

Main system differentials for breathlessness

A 
Thyrotoxicosis
Anaemia
Anxiety
MSK
Cardio 
Resp
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2
Q

What is the big question to ask with breathlessness?

A

How quickly it came on (onset)

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3
Q

Examples of causes of SOB with sudden onset

A

Pneumothorax

PE

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4
Q

Examples of causes of SOB with acute onset

A

Exacerbation of asthma

Exacerbation of COPD

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5
Q

Examples of SOB caused by chronic condition

A

Carcinoma
Chronic asthma
Chronic COPD

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6
Q

What is atypical angina

A

Dont need to have chest pain etc (2/3 criteria for stable angina)

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7
Q

Who gets silent MIs?

A

DM

Elderly

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8
Q

ECG in stable angina

A

Normal but changes with stress test

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9
Q

Gold standard diagnostic test for stable angina

A

CTCA

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10
Q

What is aspirin usually prescribed with?

A

Omeprazole

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11
Q

What is an adverse effect of statins and how is this usually managed?

A

Renal problems

Creatinine can go up to 10x normal limit if no symptoms until you change the statin

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12
Q

What drug is protective against diabetic nephropathy?

A

ACEI

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13
Q

Pneumonic to remember the pharmacological drugs for stable angina

A

BASAC

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14
Q

Features of pain with PE

A

Sharp

On inspiration

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15
Q

ECG features in PE

A 
Sinus tachycardia
S1O2T3
V1-V4 T wave insertion 
ST depression 
RBBB
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16
Q

What must be checked when someone has a PE?

A

Whether it was provoked or unprovoked

17
Q

If you have an unprovoked PE, what must someone be investigated for?

A

Cancer

18
Q

What is used to assess PE?

A

Wells score

19
Q

Outcomes of wells score if low risk

A

D dimer

20
Q

Outcomes of wells score if high risk

A

CTPA

21
Q

Pneumonic to analyse a chest x ray and what it stands for….

A 
A - Appearance
B - Bone and soft tissue 
C - cardiac
D - diaphragm 
E - effusions 
F - foreign bodies, air fields, fissures
G - great vessels
H - hilum and mediastinum, perihilar lymphadenopathy
22
Q

What is perihilar lymphadenopathy a sign of?

A

Sarcoidosis

23
Q

What is looked at when looking at appearance of CXR?

A

PA or AP
Quality
Penetrance (spinal processes visible?)
Rotation (clavicles equidistant from spinal processes / are they symmetrical?)

24
Q

What is the usual position of a CXR?

A

PA

25
Q

If a patient has a CXR AP, what does this usually indicate?

A

Patient not able to stand

26
Q

What is looked at when assessing the cardiac section of a CXR?

A

Size of heart - diameter of heart should be less than 1/2 the diameter of the whole chest

27
Q

What is looked at when assessing for effusions on a chest xray/

A

Blunting of the costophrenic angle

Acute Medicine (4 decks)

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