Breathlessness: Emergency Presentations

Question 1

Wheezing - Diff Dx:

Answer 1

1. Asthma
2. COPD
3. Heart failure
4. Anaphylaxis

Question 2

Stridor - Diff Dx:

Answer 2

1. Foreign body or tumour
2. Acute epiglottitis (younger patients)
3. Anaphylaxis
4. Trauma, eg laryngeal fracture

Question 3

Crepitations - Diff Dx:

Answer 3

1. Heart failure
2. Pneumonia
3. Bronchiectasis
4. Fibrosis

Question 4

Chest clear but breathless - Diff Dx:

Answer 4

1. Pulmonary embolism
2. Hyperventilation
3. Metabolic acidosis - DKA
4. Anaemia
5. Drugs - salicylates
6. Shock - may cause ‘air hunger’
7. Pneumocystis jirovecii pneumonia
8. CNS causes

Question 5

Key investigations in breathless pt:

Answer 5

1. Baseline observations - O2 sats, pulse, temperature, peak flow
2. ABG if saturations <94% or concern about acidosis/drugs/sepsis
3. ECG (signs of PE, LVH, MI?)
4. CXR
5. Baseline bloods: glucose, FBC, U&E, consider drug screen