Shortness of Breathe - History Taking Flashcards
What are the acute causes of SOB?
Pulmonary Embolism Pneumothorax Inhalation of foreign body Anaphylaxis Acute asthma attack Laryngeal oedema secondary to burns Tension pneumothorax
What position is heart failure SOB worse in?
Lying flat
Questions to ask regarding Asthma?
Any particular times during the day?
Certain times of the year?
Certain locations?
Pets?
Which drugs can cause pulmonary fibrosis?
Amiodarone, methotrexate, cyclophosphamide, bleomycin, hydralazine, busulphan
How do you calculate pack year?
N. per day/20 x years
Cough questions
Productive? Colour of sputum? Blood/haemopytsis? When does the cough occur? Volume? Sound- wheeze?
Cause of acute persistent productive cough?
Pneumonia
Cause of chronic productive cough?
Chronic bronchitis
What are the cause of a dry cough?
Cancer
Asthma
Left ventricular failure
Atypical pneumonia
Causes of haemoptysis?
Pulmonary embolism
Lung cancer - FLAWs
TB
Cavitating pneumonia
What can cause a bovine cough?
Lung cancer - compression - recurrent laryngeal nerve palsy
Causes of pleuritic chest pain?
PE,
Pneumothorax,
Pericarditis,
Pleural effusion
Causes of muscle weakness and fatigue
Neuromuscular disease-GBS Myasthenia gravis Lambert-eaton syndrome Polymyositis Motor neurone disease
Red flag signs for lung cancer
Weight loss
Night sweats
Loss of appetite
Lethargy/fatigue
Causes of chronic SOB?
COPD Chronic asthma Heart failure Pulmonary fibrosis Anaemia Bronchiectasis
What is the presentation of chronic COPD?
Cough productive of sputum
Irreversible shortness of breath
What are causes of COPD?
− Smoking (usually more than 20 pack years)
− Occupational exposure to lung irritants, e.g. in coal miners, tunnel workers
− α1-Antitrypsin defi ciency (liver failure, family history).
What are the signs of COPD?
Hyperexpanded chest − Breathing through pursed lips − Reduced air entry/chest expansion − Hyper-resonant percussion note (particularly resonance over the heart and liver).
Presentation of chronic asthma?
History of transient, reversible cough, wheeze and shortness of breath –
often worse at night, during exercise, or when exposed to allergens or cold
− Presence of associated atopic conditions personally or in family members
(eczema, hayfever, allergies, nasal polyps)
− Symptoms may be exacerbated by drugs such as non-steroidal antiinfl
ammatory drugs (NSAIDs), aspirin, β-blockers (including those in eye
drops used for glaucoma)
− Wheeze on auscultation of the lungs.
Signs of pulmonary fibrosis?
Clubbing
Reduced air entry/chest expansion
End-inspiratory bibasal crepitatins
What are the risk factors for pulmonary fibrosis?
History of exposure to asbestos, silica, or coal (pneumoconioses causing
fi brosis), exposure to drugs (e.g. methotrexate)
What are the signs of heart failure?
Displaced apex beat − Th ird and fourth heart sounds − Crackles in both lung bases − Raised jugular venous pressure (JVP), hepatomegaly, peripheral oedema (ankles, sacrum).
