Differentials for acute presentations - SOB Flashcards

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1
Q

What are life threatening differentials for SOB that need to be initially excluded?

A
  • PE
  • Penumothorax
  • Asthma/COPD exacerbation
  • Pneumonia
  • Acute LVF
  • Anaphylaxis
  • ACS
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2
Q

How would you explore SOB as a symptoms?

A
  • When didi it start?
  • Anything triggered it?
  • Exercise tolerance (current vs normal)
  • Orthopnoea
  • PND
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3
Q

What would you want to ask about on systems review in someone with SOB?

A
  • How patient feels
  • Fever
  • Chest pain
  • Wheeze
  • Cough
  • Sputum
  • Leg swelling
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4
Q

What would you sepcifically want to ask about in the PMH in someone with SOB?

A
  • Other medical conditions
  • Happened before
  • Asthma/COPD - baseline, severity, exacerbation history, normal PEFR
  • Recent surgery
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5
Q

What would you want to ask about in the drug history in someone with SOB?

A
  • Medications they are on
  • Inhaler compliance/usage
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6
Q

What is important to ask about in social history in someone with SOB?

A
  • SMoking
  • Alcohol
  • Long-haul travel - DVT
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7
Q

What would you specifically want ot examine in someone with SOB?

A

Cardiorespiratory

  • Tracheal deviation and JVP
  • Inspect chest
  • Expansion
  • Heaves/apex
  • Auscultate heart and lungs
  • Leg swelling/tenderness/odema
  • PEFR
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8
Q

What bloods would you consider doing in someone with SOB?

A
  • FBC
  • U+E’s
  • CRP
  • Consider D-dimer
  • BNP
  • BC if pyrexial
  • ABG
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9
Q

What imaging would you consider doing in someone with SOB?

A
  • CXR
  • CTPA
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10
Q

What Bedside tests would you consider doing in someone with SOB?

A
  • NEWs
  • ECG
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11
Q

What cultures would you consider doing in someone with SOB?

A
  • Blood Cultures
  • Sputum cultures
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12
Q

What structured approach would you take to determining what investigations wo consider doing for someone with SOB?

A
  • Bloods/Bedside tests
  • Orifices - cultures etc.
  • Xrays/imaging
  • ECG
  • Specific tests
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13
Q

What are respiratory causes of acute SOB?

A
  • PE
  • Pneumonia
  • Pneumothorax
  • Asthma exacerbation
  • COPD exacerbation
  • Laryngitis
  • Bronchitis
  • Pneumonitis
  • Bronchiectasis
  • LRTI
  • Pleural effusion
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14
Q

What are cardiac causes of acute SOB?

A
  • ACS
  • Acute LVF
  • Cardiomyopathy
  • Myocarditis
  • Acute valvular disease
  • Pericardial effusion
  • Pulmonary hypertension
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15
Q

What are non-cardiorespiratory causes of acute SOB?

A
  • Hyperventilation in axiety
  • DKA
  • Overdose
  • Metabolic acidosis
  • Sepsis/SIRS
  • Foreign body
  • Anaphylaxis
  • Anaemia
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16
Q
A