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PCM III Test 1 > High Yield Handout Dyspnea > Flashcards

High Yield Handout Dyspnea Flashcards

1
Q

ATS definition of dyspnea

A

subjective experience of breathing discomfort that consists of quantitatively distinct sensations that vary in intensity.

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2
Q

Dyspnea is

A

a self reported symptom

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3
Q

Tachypnea is

A

a sign that is characterized by accessory uscle use and intercostal retractions due to the increased work of breathing

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4
Q

85% of SoB is caused by

A

cardiac and pulmonary

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5
Q

COPD

A

strongly associated with smoking, occupational lung disease, or medication.

Progressive symptoms over a long period of time leading to the feeling that one is unable to take a breath

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6
Q

stable angina

A

typically described as heavy, squeezing, pressure, tightness or choking but rarely as pain

angina equivalents include dyspnea, nausea, and fatigue

typically relieved with rest in 1-5 minutes

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7
Q

compare side to side in lung exam in a what pattern?

A

ladder

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8
Q

when listening to the lungs patient should breathe

A

with mouth open

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9
Q

common findings with COPD

A

barrel chest
limited rib motion
percussion yielding generalized hyperresonance
decreased breath sounds

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10
Q

rib motion is what for pulmonary complaints

A

a ‘special test’

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11
Q

1st step of dyspnea diagnostics

A

walking oximetry

peak flow assessment

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12
Q

2nd step of dyspnea diagnostics ‘phase 1’

A

chest x-ray
spirometry
EKG
CBC/BMP

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13
Q

3rd step of dyspnea diagnostics ‘phase 2’

A

Chest CT
Lung volumes/DLCO/tests
Echocardiogram
Cardiac stress Test

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14
Q

4th step of dyspnea diagnostic ‘phase 3’

A

consider cardiopulmonary exercise testing (and referral)

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15
Q

COPD diagnostic requirement

A

FEV/eFEV <70%

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16
Q

Typical X-ray findings of COPD

A

flattening of the diaphragm

increased AP diameter

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17
Q

sympathetic to heart

A

T1-6

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18
Q

sympathetic to lungs

A

T1-7

19
Q

parasympathetic to heart and lungs

A

vagus

20
Q

lungs chapmans’ points

A

anterior 2, 3, 4 ICS along sternum

posterior lateral T2 spinous process
intertransverse space between T2-3, T3-4, and T4-5

21
Q

Beta Agonist side effects

A

tremor

tachycardia

22
Q

anticholinergic muscarinic antagonist side effcts

A

dry mouth

23
Q

biomechanical OMT COPD goals

A

improve thoracic cage compliance and skeletal motion

24
Q

neurological OMT COPD goals

A

normalize autonomic tone

25
Q

resp-circ OMT COPD goals

A

maximize efficiency of the diaphragm and enhance lymphatic tone

26
Q

metabolic-energetic-immune OMT COPD goals

A

enhance self-regulatory and self-healing mechanisms

27
Q

behavioural OMT COPD goals

A

improve psychosocial components of health

28
Q

Complications of COPD

A

progressive hypoxia
Eaxerbations
Respiratory Failure

29
Q

progressive hypoxia complication of COPD

A

requires oxygen supplementation

30
Q

exacerbations of COPD

A

increased in frequency as FEV1<50% of predicted

driven by airway inflammation and >50% are related to bacterial infection

1/3 to viral

31
Q

repiratory failure of COPD

A

during exacerbation, patients may need support with oxygen

BIPAP or intubation with mechanical ventilation may be required

32
Q

Primary prevention of COPD

A

annual flu vaccine
pneumococcal vaccine followed by pneumovax 1 year later
TDAP to protect against bordetella pertussis

33
Q

Seconday prevention of COPD

A

avoidance of other dust and fumes

34
Q

tertiary prevention of COPD

A

Smoking Cessation/abstinence.
Pulmonary Rehab is a comprehensive treatment program
that incorporates exercise, education, psychosocial and
nutritional counseling. Proven to improve health-related
quality of life, dyspnea and exercise capacity as well as
reduce rates of hospitalization.

35
Q

Will a patient express the sensation of pain with stable angina

A

no, discomfort including tight, squeezing, heavy, pressure, etc but NO pain

36
Q

anginal equivalents

A

dyspnea
nausea
fatigue

37
Q

CAD in men

A

> 50

38
Q

CAD in women

A

> 60

39
Q

physical examination for stable angina

A

Pulomary evaluation

ascultation over all 4 cardiac listening posts.

palpate for PMI

auscultate for carotid bruits

peripheral pulses

assess for edema

40
Q

stable angina in stress echo

A

wall motion abnormalities

41
Q

cardiac stress test in stable angina

A

ST depressions identified during increased cardiac workload

may cause dyspnea

42
Q

with stable angina who is at high risk for coronary events

A

inability to exercise <6min

43
Q

secondary prevention for stable angina

A

asses pt for other CV symptoms (claudication for example)

screening for thyroid dysfunction, anemia, that can increase cardiac workload and cause symptoms to reoccur

44
Q

tertiary prevention for stable angina

A

cardiac rehab

smoking cessation/abstinence

treatment of lipid disorders and other comorbidities that increase risk of atherosclerosis or increase cardiac workload, such as anemia and thyroid dysfunction

PCM III Test 1 (13 decks)

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