Dyspnoea

Question 1

Quality

Answer 1

Could you describe what the shortness of breath feels like?

Do you ever have a wheezing noise when you breathe?

Question 2

Severity

Answer 2

How far can you walk before you become short of breath?
Are you short of breath when you are at rest?
Do you ever find yourself short of breath when you lie down at night?
How many pillows do you sleep with?

Question 3

Time course

Answer 3

Does the shortness of breath come on suddenly?
How long have you experienced shortness of breath for?
Is the shortness of breath getting worse?
Has this ever happened before?

Question 4

Context

Answer 4

When do you get short of breath?

Is the shortness of breath worse when you lie down?

Question 5

Relieving

Answer 5

Normal

Question 6

Aggreavating

Answer 6

Normal

Question 7

Assocaited

Answer 7

Normal

Question 8

Past medical history

Answer 8

Normal

Question 9

Fam history

Answer 9

Normal

Question 10

Smoking

Answer 10

Normal

Question 11

What are we looking for in associated features?

Answer 11

Chest  pain
Cough
Wheeze
Peripheral oedema 
Orthopnoea 
Fever 
Anxiety

Question 12

Differential diagnosis

Answer 12

Pulmonary Embolus – sudden onset, chest pain radiating to jaw, shoulder, back, recent immobility, history of clotting disorder, syncope

Cardiac Failure – oedema, fatigue, past medical and family history, chest pain

Asthma – Context, past history, allergies

COPD – smoking history Lung Cancer – smoking history, past and family history, haemoptysis, fever

Respiratory Infection – fever, productive cough, context, travel + duration (TB?)

Reflux – chest pain, past history, worse with eating

Anxiety – context

Pneumothorax – Young, male, sudden onset, asthma