Scenario 8 - breathlessness

Question 1

Recall one important risk factor for pneumothorax

Answer 1

COPD

Question 2

What is the drug symbicort?

Answer 2

Steroid and LABA

Question 3

What is the drug tiotropium?

Answer 3

muscarinic acetylcholine receptor antagonist

Question 4

What are the 2 most likely differentials in sudden-onset SOB?

Answer 4

Pneumothorax

Pulmonary embolism

Question 5

Recall the management of pneumothorax, depending on type and size

Answer 5

<2cm: primary = discharge and repeat CXR, secondary = aspirate
>2cm: primary = aspirate + drain if unsuccessful, secondary = chest drain

Question 6

Recall 3 possible differentials for SOB that has a minutes to hours onset

Answer 6

1. Airway inflammation
2. Chest infection (produces pus in lungs)
3. Acute heart failure (produces fluid in lungs)

Question 7

Recall 6 possible differentials for SOB that has a days to weeks onset

Answer 7

Interstitial lung disease
Malignancy
Large pleural effusion
Neuromuscular aetiology
Unresolving chest infection
Anaemia