Resp. Misc. 7 - Breathlessness is a multifactorial disease

Question 1

What conditions can cause a patient to become breathless? (6)

Answer 1

Heart failure
Asthma and lung diseases
PE
Angina equivalent
Hyper-ventilation syndrome
Anaemia

Question 2

Functional categorisations of causes of breathlessness?

Answer 2

Oxygen transport
Mechanical disadvantage
Respiratory drive
Perception of breathing

Question 3

What is VO2?

Answer 3

the maximum amount of oxygen in millilitres, one can use in one minute per kilogram of body weight.

Question 4

What does VO2=?

Answer 4

VO2 = CO X (CaO2 - CvO2) - Fick equation

Question 5

When is VO2 max reached?

Answer 5

when oxygen consumption remains at steady state despite an increase in workload

Question 6

What is the VO2 max of the average male?

Answer 6

45ml/kg/min

Question 7

What is the VO2 max of the average female?

Answer 7

38ml/kg/min

Question 8

What is the cause of ongoing SOB despite treatment for PE for 6 months with warfarin in a 56 year old female, limited to 100yd not he flat, mid swelling on ankles, O2 sats = 93% on room air dropping to 84% after short walk, normal spirometry but gas transfer reduced to 54%?

Answer 8

Chronic thromboembolic pulmonary hypertension

Question 9

What is a diagnosis of exclusion for SOB that can be seen on complex physiology testing during exercise and can be helped with breathing retraining techniques?

Answer 9

Dysfunctional breathing

Question 10

What time frame is acute?

Answer 10

Mins - hours

Question 11

What time frame is subacute?

Answer 11

Days

Question 12

What time frame is chronic?

Answer 12

Months - years