EXAM #1: PULMONARY HISTORY AND EXAM Flashcards
What causes the perception of dyspnea?
1) High level of ventilation perceived centrally i.e. “I’m working hard”
2) Length-tension dissociation of respiratory muscles
*Both modified by psychology
What is one of the most important questions to ask the patient with a chief complaint of dyspnea?
Onset (determine rapid vs. gradual)
In the chronic management of dyspnea, what do you want to know about his/her dyspnea?
Activity level that elicits dyspnea
In a patient with a new onset dyspnea, what do you want to be sure to ask about?
Did they start any new meds
What is the best indicator of the severity of dyspnea?
Activity level
What is the differential for rapid onset dyspnea?
1) Asthma exacerbation
2) LV HF–pulmonary edema
3) PE
4) Pneumothorax
5) FB
6) Hyperventilation
7) Pneumonia
What are the etiologies of hyperventilation syndrome?
1) Anxiety
2) Acidosis
3) Poisoning
What is the difference between hyperventilation and tachypnea?
Tachypnea= increased RR
Hyperventilation= ABG with low PaCO2
What is the differential diagnosis for gradual onset dyspnea?
1) COPD
2) Intersitial lung disease
3) Pneumoconiosis–work related exposure
4) Chornic/ recurrent PE
5) Deconditioning
6) NM disease
7) Chronic CHF
What suggests upper airway obstruction?
Inspiratory wheezing and stridor
What is expiratory wheezing most associated with?
Intrathoracic airway narrowing
What do you need to keep in mind about wheezing?
Severity of wheezing does NOT always correlate with disease severity
*Decompensation of acute asthma can present without wheezing b/c of a lack of air movement
What is pleuritic pain?
Pain that is sharp and stabbing/localized, associated with inspiration
What causes pleuritic pain?
Inflammation or irritation of the parietal pleura
What is an acute cough?
Less than 3 weeks
*Viral URI
