Dyspnea and Acute Cough Flashcards
What are the two main mechanisms leading to the sensation of Dyspnea?
Impaired ventilators mechanics
Increased respiratory drive
3 common conditions falling under the category of impaired ventilators mechanics?
Airway obstruction, muscle weakness and chest wall is not very compliant.
5 common conditions falling under the increased respiratory drive category?
CHF, impaired alveolar exchange, chemoreceptors stimulus, pregnancy, and behavioral factors
What are the two types of dyspnea?
Acute and chronic
What are 4 CV causes of acute dyspnea?
Left heart failure, ACS, tamponade, and tachycardia
What are respiratory causes of dyspnea? What are the categories and give an example of each?
Airway obstruction (bronchospasm), has exchange sucks like pneumonia, vascular disease like PE, and jacking up the ventilatory pump like pleural effusion or pneumothorax.
What is the first step in approaching a patient with acute dyspnea?
Assess VS and stabilize. Might need oxygen or invasive/non invasive ventilation support.
What are 3 symptoms of acute dyspnea?
Tachypnea, accessory muscle use and conversational dyspnea.
Once we stabilize the patient, what do we do next?
History and PE.
Low sat of o2 suggest what cause of dyspnea and what 6 causes?
Gas exchange sucks.
Asthma, COPD flare up, ARDS, HF, pulmonary fibrosis, or PVD.
What is the primary initial diagnostic tool for dyspnea after PE and history?
CXR
Focal infiltrates, air in the pleural space, basal opacity with meniscus, and cardiomegaly suggest what?
Pneumonia
Pneumothorax
Pleural effusion
Heart failure
What test allows us to exclude heart failure in the setting of acute dyspnea?
BNP level less than 100
What does laryngoscopy and bronchoscopy allow us to detect?
Aspirated caused dyspnea
What does Bronchoscopy and Bronchoalveolar lavage help us detect?
Pneumonia caused dyspnea
When does dyspnea become chronic?
After 1 month
What are the 4 most common causes of chronic dyspnea?
COPD, asthma, ILD, and heart failure.
What is the key to working up chronic dyspnea?
Detailed history
What are the 4 common causes of symptoms worsening with chronic dyspnea?
Natural disease progression, patient not compliant with meds, and exposure to environmental or dietary factors.
What are esymptoms associated with cardiac caused chronic dyspnea?
Orthopnea and edema
2 pulmonary associated symptoms with pulmonary caused chronic dyspnea?
Cough and wheezing
What test do you do if history, exam and workup is not revealing of their dyspnea?
Cardiopulmonary exercise test.
What is the length of weeks for acute, subacute, and chronic cough?
Less than 3 weeks, 3-8 weeks and more than 8 weeks
What is the most common cause of acute cough?
Viral upper respiratory tract infection
What are the 3 most common pathogens causing lower respiratory tract infections?
Flu a and b, parainfluenza, and RSV
What are the 4 most common viruses causing upper RTI?
Rhinovirus, adenovirus, echovirus, and coronavirus
3 clinical symptoms of rhinitis?
Sneezing, congestion and runny nose
What is clinical criteria to diagnose influenza?
Temp over 37.7 or 100 and 1 of the following
Cough, pharyngitis, and rhinorrhea
Two meds to treat flu a and B?
Neuraminidase inhibitors, oseltamivir and zanamivir
What are you top 3 dogs causing uncomplicated acute bronchitis?
Pertussis, mycoplasma pneumonia, and C pneumonia.
Which of the three is it recommended to use antibiotics?
Pertussis
How do we clinically diagnose pertussis?
Cough greater than 2 weeks and one of the following:
Paroxysm of cough, inspiratory whoop or post tussive vomiting
OR
Cough greater than 2 weeks with a documented outbreak of pertussis
What is the gold standard diagnostic tool for pertussis?
Recovery of bacteria by culture or PCR
What is the third most common cause of acute cough?
Pneumonia
What are 3 other causes of acute cough to be familiar with?
Asthma, flare ups of chronic bronchitis and bronchiectasis
