Exam 2 - SOB

Question 1

23 y/o female, with no PMH, presents with SOB, perioral paresthesia, palpitations, and lightheadedness, exam found normal PFTs

Answer 1

Provisional dx: hyperventilation/anxiety

Question 2

A 30 y/o male, with unknown PMH, presents with SOB associated with platypnea

Answer 2

provisional dx: intracardiac shunt/vascular lung shunts/parenchymal lung shunts

Question 3

SOB associated with CV

Answer 3

1) paroxysmal nocturnal dyspnea
2) intensified by recumbency
3) Slow recovery period

Question 4

SOB associated with pulmonary

Answer 4

1) Postural changes have little or no effect
2) Intensified by effort
3) Fast recovery period
4) Daily productive cough
5) Don’t usually have dyspnea at rest

Question 5

35 y/o male, with PMH of obesity, presents with recurrent SOB upon minimal exertion, physical exam, labs, cxr were unremarkable

Answer 5

provisional dx: poor physical conditioning

Question 6

66 y/o female, with history of smoking, HTN, DM, COPD, presents with severe SOB upon exertion and is alleviated by leaning forward. exam found rapid/shallow respirations

Answer 6

provisional dx: COPD exacerbation

Question 7

50 y/o male, with history of smoking and HTN, presents worsening SOB, exam found increase AP chest diameter, decreased breath sounds and cxr shows hyperventilation

Answer 7

provisional dx: emphysema

Question 8

55 y/o male, with PMH of smoking and multiple CV risk factors, presents with chronic productive cough, exam found diffuse ronchi

Answer 8

provisional dx: chronic bronchitis