Dyspnea and Acute Cough Flashcards

1
Q

What are the two main mechanisms leading to the sensation of Dyspnea?

A

Impaired ventilators mechanics

Increased respiratory drive

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2
Q

3 common conditions falling under the category of impaired ventilators mechanics?

A

Airway obstruction, muscle weakness and chest wall is not very compliant.

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3
Q

5 common conditions falling under the increased respiratory drive category?

A

CHF, impaired alveolar exchange, chemoreceptors stimulus, pregnancy, and behavioral factors

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4
Q

What are the two types of dyspnea?

A

Acute and chronic

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5
Q

What are 4 CV causes of acute dyspnea?

A

Left heart failure, ACS, tamponade, and tachycardia

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6
Q

What are respiratory causes of dyspnea? What are the categories and give an example of each?

A

Airway obstruction (bronchospasm), has exchange sucks like pneumonia, vascular disease like PE, and jacking up the ventilatory pump like pleural effusion or pneumothorax.

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7
Q

What is the first step in approaching a patient with acute dyspnea?

A

Assess VS and stabilize. Might need oxygen or invasive/non invasive ventilation support.

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8
Q

What are 3 symptoms of acute dyspnea?

A

Tachypnea, accessory muscle use and conversational dyspnea.

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9
Q

Once we stabilize the patient, what do we do next?

A

History and PE.

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10
Q

Low sat of o2 suggest what cause of dyspnea and what 6 causes?

A

Gas exchange sucks.

Asthma, COPD flare up, ARDS, HF, pulmonary fibrosis, or PVD.

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11
Q

What is the primary initial diagnostic tool for dyspnea after PE and history?

A

CXR

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12
Q

Focal infiltrates, air in the pleural space, basal opacity with meniscus, and cardiomegaly suggest what?

A

Pneumonia
Pneumothorax
Pleural effusion
Heart failure

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13
Q

What test allows us to exclude heart failure in the setting of acute dyspnea?

A

BNP level less than 100

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14
Q

What does laryngoscopy and bronchoscopy allow us to detect?

A

Aspirated caused dyspnea

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15
Q

What does Bronchoscopy and Bronchoalveolar lavage help us detect?

A

Pneumonia caused dyspnea

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16
Q

When does dyspnea become chronic?

A

After 1 month

17
Q

What are the 4 most common causes of chronic dyspnea?

A

COPD, asthma, ILD, and heart failure.

18
Q

What is the key to working up chronic dyspnea?

A

Detailed history

19
Q

What are the 4 common causes of symptoms worsening with chronic dyspnea?

A

Natural disease progression, patient not compliant with meds, and exposure to environmental or dietary factors.

20
Q

What are esymptoms associated with cardiac caused chronic dyspnea?

A

Orthopnea and edema

21
Q

2 pulmonary associated symptoms with pulmonary caused chronic dyspnea?

A

Cough and wheezing

22
Q

What test do you do if history, exam and workup is not revealing of their dyspnea?

A

Cardiopulmonary exercise test.

23
Q

What is the length of weeks for acute, subacute, and chronic cough?

A

Less than 3 weeks, 3-8 weeks and more than 8 weeks

24
Q

What is the most common cause of acute cough?

A

Viral upper respiratory tract infection

25
Q

What are the 3 most common pathogens causing lower respiratory tract infections?

A

Flu a and b, parainfluenza, and RSV

26
Q

What are the 4 most common viruses causing upper RTI?

A

Rhinovirus, adenovirus, echovirus, and coronavirus

27
Q

3 clinical symptoms of rhinitis?

A

Sneezing, congestion and runny nose

28
Q

What is clinical criteria to diagnose influenza?

A

Temp over 37.7 or 100 and 1 of the following

Cough, pharyngitis, and rhinorrhea

29
Q

Two meds to treat flu a and B?

A

Neuraminidase inhibitors, oseltamivir and zanamivir

30
Q

What are you top 3 dogs causing uncomplicated acute bronchitis?

A

Pertussis, mycoplasma pneumonia, and C pneumonia.

31
Q

Which of the three is it recommended to use antibiotics?

A

Pertussis

32
Q

How do we clinically diagnose pertussis?

A

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

33
Q

What is the gold standard diagnostic tool for pertussis?

A

Recovery of bacteria by culture or PCR

34
Q

What is the third most common cause of acute cough?

A

Pneumonia

35
Q

What are 3 other causes of acute cough to be familiar with?

A

Asthma, flare ups of chronic bronchitis and bronchiectasis