CC Resp-Differential Diagnosis Flashcards
Airway obstruction (Causes)
- Infections: Croup, epiglottis is
- Foreign bodies, trauma, cancer
- Anaphylaxis
- Chemical burns
Airway obstruction (Important History)
- Duration of problem, history of infection
- Quickness of decompensation
Airway obstruction (Exam findings)
- (S/S)Stridor, dyshphagia, drooling, wheezing, unable to speak, cyanosis, air hunger, anxiety, confusion, ALOC, HR up, RR up, TV down, fever
- PETCO2 up, SpO2 down
Airway obstruction (Treatment)
- Scene safety
- Patent airway
- Cool air, heimlich, laryngoscope, intubation, surg cric, Epi/Benadryl, glucagon (esophageal obstruction), manage problem
Asthma (Causes)
- Bronchoconstriction
- Bronchial edema
- Increased mucous production
Asthma (Important history)
- History of asthma
- It’s a TRIGGER DISEASE
- Find out trigger of cause
Asthma (Exam findings)
- Progressing wheezes
- Airtrapping
- ALOC, HR up, RR up, I:E up, PETCO2 up, TV down, diaphoresis
Asthma (Treatment)
- O2 NRB, Capnography
- Meds: -Albuterol, Ipratropium neb.
- Dexamethasone, Terbutaline/Epi Sq (if severe) - IV / Monitor
- Intubation if needed
COPD: Bronchitis / Emphysema (Causes)
- Inflammation, mucous in bronchial trees
- Alveolar destruction
- Most COPD has both of these
COPD: Bronchitis / Emphysema (Important history)
- COPD history
- Smoker (previous)
- Long term exposure to irritants
COPD: Bronchitis / Emphysema (Exam findings)
Chronic bronchitis: Productive cost, cyanosis, JVD, accessory muscles
Emphysema: Barrel chest, little cough, tripod, accessory muscle hypertrophy
Both: PETCO2 up, SpO2 down, H&H up
COPD: Bronchitis / Emphysema (Treatment)
- O2
- IV
- Airway (CPAP, Intubate)
- Monitor
- Meds: Epi or albuterol if bronchoconstricted
CHF (Causes)
- Impaired heart ability
- MI
- Cardiovascular disease (CAD, HTN, valvular malfunction)
- Drugs: sympathomimetic, alchohol
CHF (Important History)
- Altered vitals cause more s/s
- Gradual onset
- Dyspnea at rest, laying flat, at night or during normal activity
- Improvement when upright or at open window
CHF (Exam findings)
- Coarse/fine crackles, wheezes
- Dependent edema, enlarged liver, JVD, ascites, dyspnea on exertion
- BP down, RR up
- JVD while pressing on liver (Hepatojugular reflex), BUN up
- S1, S2, S3
- Increased WOB, alveolar collapse
CHF (Treatment)
- O2, IV
- CPAP w/ PEEP, Intubation
- Treat rhythm/rate problem
- Meds: Lasix, albuterol, morphine, nitro, dopamine, Mild fluid Bolus, dobutamine
Metabolic acidosis (Causes)
- Increased acid production/elimination
- Aspirin, ethylene, glycol, iron, TCA ingestion
Metabolic acidosis (Important history)
-It is a result of some other underlying disease/OD
Metabolic acidosis (Exam findings)
- Tinnitus, blurred vision, chest pain, head ache, abd pain, tahcyC, Arrythmia, low BP
- Hyperkalemia often present, BGL up (DKA), PETCO2 down
Metabolic acidosis (Treatment)
- Stabilize ABC’s, arrythmias, underlying cause
- Meds: Sodium bicarb .5-1 mEq/Kg, will decrease K level
Neurogenic: ALS/Guillain-Barre (Causes)
- Amyotrophic Lateral Sclerosis (ALS)- Unknown
- Guillain-Barre Syndrome (GBS)- Autoimmune
Neurogenic: ALS/GBS (Important History)
GBS- Symmetrical ascending wave of weakness/paralysis. Usually 2-4 weeks after GI or Resp infection. Weakness over several days, 1/3 of affected need ventilated. Range ~15-35 y/o
ALS- Progressive weakness, no sensation change. Disease = fatal
Neurogenic: ALS/GBS (Exam findings)
GBS- Weakness, pain of weakened areas, paraesthesia (tingling), respiratory distress, facial droop, alt BP & HR, unable to walk
ALS- Starts with limb weakness, difficulty speaking, dysphagia, fasciculations, stiffness, impaired resp muscles
Neurogenic: ALS/GBS (Treatment)
ALS- Supportive care: Ensure resp/Cardiac function, Check DNR
GBS- Supportive care: Ensure resp/Cardiac function, Pain management
Pneumonia (Causes)
- Viral
- Bacterial
- Aspiration
- Fungal
- Mixed
- Usually unilateral
Pneumonia (Important History)
- History of viral/bacterial infection
- History of aspiration
-Can present as separate disease or part of complex medical pt
Pneumonia (Exam findings)
- Productive cough (color and odor, viral = white), pleuritic chest pain, fever with chills, fatigue, diminished aeration, resp distress, TachyC, TachyP, tactile fremitus
- Check for dehydration
Pneumonia (Treatment)
- IV, O2, Monitor
- Support breathing
- Meds: Fluid if dehydrated
Psychogenic Hyperventilation (Causes)
- Anxiety
- Stress
Psychogenic Hyperventilation (Important history)
- Stressful event
- Rule out more serious conditions
Psychogenic Hyperventilation (Exam findings)
- TachyC, P, dyspnea
- Numbness, tingling in extremities, mouth, dizzy
- PETCO2 down, SpO2 up
Psychogenic Hyperventilation (Treatment)
- High flow O2
- Ensure not MI/PE
- Coach breathing
- IV, Monitor
Tuberculosis (Causes)
- Resp infection with M tuberculosis
- M tuberculosis becoming more resistant to therapy
Tuberculosis (Important history)
- May have history
- Associated with prisons, homeless, HIV, travel to areas of high TB
- Can effect GI, Neuro, Skeletal, GU
Tuberculosis (Exam findings)
-Productive cough, NIGHT SWEATS, recent weight loss, chest pain, fever
Tuberculosis (Treatment)
- Masks for all
- O2
- Supportive care
- IV, monitor
Acute Respiratory Distress Syndrome (ARDS) (Causes)
- Non-cardiac PE
- Sepsis, near drowning, burns, OD, pancreatitis, trauma, aspiration, pneumonia
- Generalized diagnosis
ARDS (Important history)
- Is a result of another condition
- Usually starts 12-48hrs after initial incident
- 40-70% mortality
ARDS (Exam findings)
-RR up, HR up, PETCO2 up, SPO2 down (even on O2), hemoptysis, fine/coarse crackles, wheezing, no JVD, fever, pulmonary edema
ARDS (Treatment)
- Critical patients
- CPAP w/ PEEP, capno, vent if needed
- Meds: Furosemide, Albuterol, Dopamine/Fluids
