Differential diagnoses for severe asthma exacerbation

Question 1

What is heart failure?

Answer 1

The heart is unable to generate a cardiac output sufficient to meet the body’s demands without increasing diastolic pressure

Question 2

What is congestive heart failure?

Answer 2

HF with breathlessness, abnormal sodium and water retention resulting in oedema

Question 3

What are the symptoms of congestive HF?

Answer 3

• Dyspnoea
• Tachycardia
• Hepatomegaly
• Ankle oedema
• Night cough
• Pleural effusion
• JVP distention

Question 4

What are the risk factors for congestive HF?

Answer 4

• Past MI
• Diabetes
• Hypertension
• Cocaine abuse
• Increasing age
• Dyslipidaemia
• Renal insufficiency
• Increased C-reactive protein
• Left ventricular hypertrophy
• Positive family Hx
• Thyroid disorders
• Anaemia

Question 5

What is anaphylaxis?

Answer 5

Severe, generalised or systemic hypersensitivity reaction, characterised by rapidly developing life-threatening airway and/or breathing and/or circulation problems usually associated with skin and mucosal changes

Question 6

What are the symptoms of anaphylaxis?

Answer 6

• Acute onset
• Angio-oedema (airway swelling)
• Inspiratory stridor / hoarse voice
• Wheezing
• Chest hyperventilation
• Accessory muscle use
• Cyanosis
• Pale and clammy skin
• Bradycardia or tachycardia
• Hypotension
• Urticaria (hives)
• Pruritis

Question 7

What are the risk factors for anaphylaxis?

Answer 7

• Hx of atopy or asthma
• Previous anaphylaxis
• Exposure to:
  Food
  Medication
  Venoms
  Latex
  Exercise
  Hot/cold exposure

Question 8

What is a pneumothorax?

Answer 8

Air gains access to, or accumulated in pleural space

Question 9

What are the symptoms of a pneumothorax?

Answer 9

• Pleuritic chest pain
• Dyspnoea
• Hypoxia
• Sweating
• Quiet/reduced breath sounds

Question 10

What are the risk factors for a pneumothorax?

Answer 10

• Smoking
• Positive family Hx
• Tall and slender build
• Male gender
• Underlying lung disease
• Trauma