Dyspnoea

Question 1

What are 6 broad causes of dyspnoea?

Answer 1

Respiratory
Cardiac
Muscle weakness
Metabolic
Anaemia
Psychogenic

Question 2

List 5 respiratory causes of dyspnoea in terms of the anatomical site affected, and give examples of each

Answer 2

Airways disease (e.g. tumour, asthma, COPD)
Alveolar disease (e.g. pneumonia, pulmonary oedema)
Pulmonary vascular disease (e.g. PE)
Pleural and chest wall disease (e.g. pleural effusion, pneumothorax)
Respiratory muscle disease (e.g. respiratory muscle weakness, phrenic nerve palsy)

Question 3

What symptoms are distinctive of airway disease causing dyspnoea?

Answer 3

Cough +/- sputum

Wheeze, squeaks or stridor

Question 4

What symptoms are distinctive of alveolar disease causing dyspnoea?

Answer 4

Cough

Crepitations +/- orthopnoea

Question 5

What is the impact of airway disease on lung function tests?

Answer 5

Obstructive ventilatory defect

Question 6

What is the impact of alveolar disease on lung function?

Answer 6

Restrictive ventilatory defect

Question 7

What symptoms are distinctive of pulmonary vascular disease causing dyspnoea?

Answer 7

Pain
+/- haemoptysis
Risk factors (e.g. tachycardia, recent immobilisation)
Symptoms and factors are added to get a Wells score, which provides an estimate of the likelihood of PE

Question 8

What is used to rule out PE?

Answer 8

D dimer

Question 9

What is used to rule in PE?

Answer 9

CTPA

V/Q

Question 10

What is CTPA?

Answer 10

CT pulmonary angiogram