SHORTNESS OF BREATH

Question 1

Case 1-
Your next patient is 51 year old lady with SOB. She works as a secretary.
Task-
*Take history for 5 minutes
*Ask for PEFE
*Explain the provisional dx and mx

PEFE
G/A-NL, BP-120/78/PULSE 78B/M,TEMP 37,SPO02-85%
CVS-NO MURMUR
RESP-SYMMETRICAL VESICULAR BREATH SOUND ,BILATERAL EXPIRATORY WHEEZES
BSL-4.6
SPIROMETRY -FEV1 60% OF PREDICTED AND FEV1/FVC IS 0.6

Question 2

Case 2
15 year old boy is brought by ambulance from school with chest pain and shortness of breath. Already your colleagues have checked him and put on oxygen , CXR pending
task
*take history for 5 minutes
*xray will be shown at 5mins
*explain the dx and mx

Question 3

54 years old patient with bad lung history and you have ordered spirometry
Task
*explain the purpose of spirometry
* explain the steps of spirometry

Question 4

Case4
A 71 yrs old man came to emergency department with SOB.On further history taking he also has orthopnoea,PMH of IHD,HYPERTENTION.He has CABG 13 years back..A medical student is observing you
TASK
Explain further physical examination and Relevant findings to the student

Question 5

CASE 5
You are an HMO in a surgical dept and have been called by nurse to see a post operatice patient who underwent laparoscopic cholecystectomy 24 hour ago.She has been breathless since morning Her temp is 39 ,HR 92.RR 22 SPO2 98%.Pt is receiving prophylactic enoxaparine .
TASK
*TAKE history for 4 min
*pefe at 4 min
*explain provisional dx and mx
*mention the ddx

PEFE
G/A-DISTRESS,NO PALLOR EDEMA DEHYDRATION,JAUNDICE,CYANOSIS,DEHYDRATION
JVP-2 CM NO TRACHEAL DEVIATION
NO LYMPHADENOPATHY
RESP-SYMMETRIC DIMINISHED BREATH SOUND,BASAL CRACKS ON LEFT LUNG
CVS-NO MURMUR
ABDOMEN-NO DISTENTION ,RIGIDITY OR DISCHARGE FROM WOULND SITE
EXTREMITIES-NO CALF EDEMA
COVID INFLUENZA RSV TEST NEGATIVE
LFT KFT THYROID BSL –NL
ABG PH-7.35 ,PO2 75 MM(HG),PCO2- 37 MM(HG)

Question 6

CASE 6
Your next patient is 27 year old lady with shortness of breath ,Her only medication is OCP
TASK
*Take history for 5 mins
*PEFE at 5 min
*Explain provisional dx and ddx with reasons

PEFE

G/A-PATNT IS DISTRESSED NO ODEMA PALLOR DEHYDRATION JAUNDICE LYMPHADENOPATHY
BP PULSE TEMP SPO2 -NL
CVS -NL
RESP-VESICUALR MURMUR
ABDOMEN-SOFT AND NONTENDER
EXTREMITIES- TENDERNESS ON THIGH AND SWELLING