Breathlessness

Question 1

What signs would you look for in a patient with breathlessness?

Answer 1

Wheezing
Stridor
Crepitations
Chest clear?
Inflation
Breath sounds
Vocal resonance

Question 2

Differentials for a patient with breathlessness and wheeze?

Answer 2

Asthma
COPD
Heart Failure
Anaphylaxis

Question 3

Differentials for a patient with breathlessness and stridor?

Answer 3

Foreign body aspiration
Tumour
Acute epiglottitis
Anaphylaxis
Trauma - laryngeal fracture

Question 4

Differentials for a patient with breathlessness and crepitations?

Answer 4

Heart failure
Pneumonia
Bronchiectasis
Fibrosis - fine inspiratory crackles

Question 5

Differentials for a patient with breathlessness and a clear chest?

Answer 5

PE
Hyperventilation
Metabolic acidosis - DKA
Anaemia
Drugs - Salicylate poisoning
Shock
Pneumocystis Jirovecii poisoning
CNS causes

Question 6

How would a pneumothorax present?

Answer 6

Pleuritic pain
Hyperresonant to percussion
Breathlessness
Tracheal deviation if tension

Question 7

How would a pleural effusion present?

Answer 7

Breathlessness

Stony dull to percuss

Question 8

What investigations would you request for breathlessness?

Answer 8

Baseline obs - O2 sats, pulse, temp, peak flow
ABG - if sats <94% or concern of acidosis/drugs/sepsis
ECG - PE/LVH/MI
CXR
Baseline bloods - glucose, FBC, U&E, tox screen?