DOORWAY-SHORTNESS OF BREATH (SOB)

Question 1

SOB-DIFFERENTIALS

Answer 1

ACUTE-

CHF, ASTHMA, GERD, BRONCHITIS, PNEUMONITIS, FOREIGN BODY

CHRONIC-COPD, BRONCHIECTASIS, LUNG CANCER, TB, INTERSTITIAL LUNG DISEASE/FIBROSIS

OTHER: PNEUMONIA, PE

Question 2

RULE OUT CHF

Answer 2

(Night time awakening for asthma is after few hours of Sleep)

a. Do you have to use more pillows than usual?
b. Do you have to wake up at night to catch breath? (If yes, timing at night)
c. Have you noticed any swelling of your feet?

Question 3

CHF WORKUP

Question 4

RULE OUT ASTHMA

Answer 4

a. Is there any relationship with exercise or weather?
b. Do you have any pets at home?
c. Do you have to wake up at night to catch breath? (If yes, timing at night)

Question 5

ASTHMA WORKUP

Question 6

RULE OUT GERD

Answer 6

a. Have you noticed any burning sensation in your chest or change in taste of your mouth?

Question 7

GERD WORKUP

Question 8

RULE OUT BRONCHITIS

Answer 8

Do you get your flu shot regularly?

OTHER

CAUSED BY VIRUSES

Cough

> 5 days

Resolves in 2–3 weeks

Sputum (∼ 50% of cases), especially as infection progresses

Runny nose and sore throat (likely symptoms of the preceding or simultaneous URI)

Chest pain and dyspnea

Headache

Malaise

Myalgias

Fever (uncommon

Question 9

BRONCHITIS WORKUP

Answer 9

CLINICAL

Question 10

RULE OUT PNEUMONITIS

Answer 10

LOOK FOR ALLERGIES

OTHER

Inflammation of lung tissue that may be idiopathic (acute interstitial pneumonitis) or due to environmental allergens (hypersensitivity pneumonitis), radiation (radiation-induced lung injury), or aspiration (chemical pneumonitis).

Question 11

PNEUMONITIS WORKUP

Question 12

RULE OUT FOREIGN BODY ASPIRATION

Answer 12

(Alcoholic person is a risk factor)

a. Have you experienced any loss of consciousness recently?
b. Have you noticed any difficulty swallowing (Stroke)?

Question 13

FOREIGN BODY WORKUP

Question 14

RULE OUT COPD

Answer 14

a. Have you noticed any Shortness of breath?
b. Have you noticed any abnormal sound while breathing?

Question 15

COPD WORKUP

Question 16

RULE OUT BRONCHIECTASIS

Answer 16

OTHER

Bronchiectasis requires the combination of two important processes taking place in the bronchi: local infection or inflammation and either inadequate clearance of secretions, airway obstruction, or impaired host defenses.

Question 17

RULE OUT LUNG CANCER

Question 18

LUNG CANCER WORKUP

Question 19

RULE OUT TB

Answer 19

For T.B:

a. When was your last PPD/Monteux? If yes, then result.
b. Have you ever been Exposed to anybody with similar complaints?
c. Have you experienced Night sweats?
d. Have you Travelled recently (to endemic areas)?

Question 20

TB WORKUP

Question 21

RULE OUT INTERSTITIAL LUNG DISEASE

Answer 21

d. What do you do for living? (Occupation)
e. Have you ever been exposed to radiation or chemotherapeutic drugs?

Question 22

INTERSTITIAL LUNG DISEASE WORKUP

Question 23

BRONCHIECTASIS WORKUP

Question 24

SOB WORKUP