Shortness of breath

Question 1

Some differential for SOB

Answer 1

COPD, Pneumonia, TB, heart failure, MI, sarcoidosis, Wet disease (pleural effusions, ascites, pericardial effusion-cancer, infection, pericardial effusion)
Pneumothorax, primary lung cancer, metastatic disease, superior vena cava obstruction

Question 2

Investigations for SOB?

Answer 2

CXR,
bloods (d-dimer), Arterial blood gas, CTPA
ECG-for pericardial effusion-tachycardia, los voltage, Electrical alternanes (most old people have bad PR)

Question 3

What cant you miss in a cancer patient?

Answer 3

cancer and chemo–Greatly increase chances of Pulm Embolism-

So any new SOB in known cancer patient should be queried as PE

Question 4

If a patient has pneumonia, why would do you need a 6week X-ray after?

Answer 4

Consolidation can hide important other disease-like cancer/malignancies