Dyspnoea Flashcards
Main symptom of interstitial lung disease
Dry irritating cough
SOB/dyspnoea
What are the Red Flags for a patient presenting with dyspnoea (10)
- Wheezing
- confused or agitated
- RR>30
- BP <90/60
- Breathlessness at rest or while talking
- O2 Sats <94
- Coughs blood (1 tablespoon)
- swelling in 1 calf
- Difficulty breathing worse when lying flat and leg swelling (HF)
- sudden breathlessness, ,more resonant/ decreased breath sounds/ pain on one side, deviated trachea, BP <90/60 (tension pneumothorax likely)
Outline the management of urgent signs of dyspnoea
Give 40% O2
If pneumo inset large bore cannula in 3rd rib MCL
If BP<90/60 give sodium chloride 0,9% 500ml over 30min until systolic PB>90
If rapid deep breathing check glucose likely low, DKA
Check temp if >38 likely pneumonia, give ceftriaxone 1mg IV/IM
Is interstitial lung disease obstructive or restrictive
Restrictive
List the metabolic causes of dyspnoea
MUDPILES
Methyl glycol
Uraemia
DKA
Pancreatitis
Infection
Lactic acidosis
Exogenous:metformin, INH
Salicylate
Is trachea pushed or pulled in a pleural effusion
Pushed
Is trachea pushed or pulled or central in consolidation
Central
Is trachea pushed or pulled in in mass
Pushed if large
Is trachea pushed or pulled in lung collapse
Pulled
Is vocal resonance increased or reduced in pleural effusion
Reduced
Is vocal resonance increased or reduced in lung mass
Increased
Is vocal resonance increased or reduced in lung collapse
Increased
Is vocal resonance increased or reduced in lung consolidation
Increased
Outline your approach to different causes of pleural effusion
Exudate
Transudate
Empyema
Haemorrhage- haemothorax (malignancy, PE, trauma)
Chylous (milky due to thoracic duct lymph leakage or carcinoma or lymphoma in thoracic duct)
Outline main causes of pleural effusion in SA
TB
HF
Renal failure or nephrotic syndrome
Malignancy
Parapneumonic
Difference in albumin in Exudate and Transudate pleural effusion
<12 in Exudate
>12 in Transudate
Which pleural effusion between Exudate and Transudate has more Total protein
Exudate
Exudate >30 total protein and Transudate<30
Which pleural effusion between Exudate and Transudate has more LDH (fluid LDH: serum LDH)
Exudate
Exudate >0.6, Transudate<0.6
