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Y4 Extra teaching notes > SOB patient > Flashcards

SOB patient Flashcards

1
Q

History in a patient presenting with an exacerbation of asthma

A
  • dyspnoea
  • cough
  • audible wheeze
  • PMH: asthmatic
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2
Q

History in a patient presenting with an exacerbation of COPD

A
  • dyspnoea
  • cough
  • change in sputum colour
  • PMH: COPD
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3
Q

History in a patient presenting with pneumonia

A
  • dyspnoea
  • fever
  • cough
  • confusion
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4
Q

History in a patient presenting with pneumothorax

A
  • dyspnoea
  • chest pain
  • possible PMH of: COPD, Marfan’s
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5
Q

History in a patient presenting with PE

A
  • dyspnoea
  • chest pain
  • hemoptysis
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6
Q

History in a patient presenting with ACS

A
  • central crushing chest pain
  • radiating to the jaw and left arm
  • lasting >30 minutes
  • not relieved by nitrates or rest
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7
Q

History in a patient presenting with Pulmonary oedema

A
  • dyspnoea
  • pink frothy sputum
  • peripheral oedema
  • PMH: cardiac history
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8
Q

What can be found on the examination of a patient with Asthma Exacerbation?

A
  • tachypnea
  • polyphonic wheeze
  • reduced air entry
  • reduced PEFR
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9
Q

What can be found on the examination of a patient with COPD exacerbation?

A
  • tachypnea
  • polyphonic wheeze
  • reduced air entry
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10
Q

What can be found on the examination of a patient with Pneumonia?

A
  • tachypnea
  • cyanosis
  • febrile
  • crepitation and bronchial breathing
  • dullness to percussion
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11
Q

What can be found on the examination of a patient with a pneumothorax?

A

Ipsilateral findings of:

  • reduced chest expansion
  • no breath sounds
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12
Q

What can be found on the examination of a patient with Tension Pneumothorax?

A
  • tracheal deviation
  • raised JVP
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13
Q

What can be found on the examination of a patient with Pulmonary embolism?

A
  • tachycardia
  • low BP
  • pleural rub
  • loud P2
  • signs of DVT
  • clear lung auscultation
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14
Q

What can be found on the examination of a patient with ACS?

A
  • no murmurs
  • no temperature
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15
Q

What can be found on the examination of a patient with Pulmonary oedema?

A
  • tachypnoea
  • tachycardia
  • bilateral crepitation
  • raised JVP
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16
Q

What can be found on the examination of a patient with Anaphylaxis?

A
  • facial swelling
  • stridor
  • wheezing
  • hives
  • hypotensive
17
Q

What can be found on the examination of a patient with Anxiety?

A
  • hyperventilation
18
Q

Investigations done in exacerbation of asthma

A
  • CXR → exclude consolidation
  • ABG → to exclude ‘tiring’ patient
  • blood and sputum culture
19
Q

Investigations done in exacerbation of COPD

A
  • clinical diagnosis
  • CXR → exclude consolidation
  • ABG → exclude hypercapnia
20
Q

Investigations done in Pneumonia

A
  • raised inflammatory markers
  • CXR → consolidation
  • sputum culture
  • blood culture
  • urine legionella and pneumococcal screen
21
Q

Investigation done in pneumothorax

A
  • CXR → will show air in pleural space
22
Q

Investigation done in PE

A

Confirmed by CTPA

23
Q

Investigations done in ACS

A
  • ECG → ST elevation in 2 anatomically contiguous leads
  • Troponins high
24
Q

Investigations done in Pulmonary Oedema

A

CXR findings:

A - alveolar oedema

B - Kerley B-lines

C - Cardiomegaly

D- dilated prominent upper lobe vessels

E - pleural effusion

25
Q

Management of ACS

A
  • oxygen
  • high dose nitrates
  • ACS protocol
  • PCI
26
Q

Management of Pulmonary oedema

A
  • L - loop diuretic
  • M- morphine
  • N- nitrates
  • O- oxygen
  • P- position
27
Q

Management of Asthma exacerbation

A
  • salbutamol nebs
  • Ipratropium nebs
  • steroids (40 mg)
  • Magnessium
  • Antibiotics
28
Q

Management of COPD exacerbation

A
  • salbutamol nebs
  • ipratropium nebs
  • steroids - 30 mg
  • Abx if bacterial
  • Non-invasive ventilation if hypercapnia
29
Q

Management of Pneumonia

A
  • antibiotics
  • supportive treatment
30
Q

Management of ipsilateral pneumothorax:

- primary

- secondary

A
  • Primary ipsilateral pneumothorax:

<2 cm → CXR monitoring

>2 cm → aspirate

  • Secondary ipsilateral pneumothorax:

<1 cm → observe

1-2 cm → aspirate

>2 cm → chest drain

31
Q

Management of tension pneumothorax

A

Aspiration

32
Q

Management of PE

A
  • thrombolysis
  • treatment dose of dalteparin
33
Q

Management of anaphylaxis

A
  • adrenaline (1:1000)
  • IV fluid challenge
  • Chlorphenamine
  • Hydrocortisone
34
Q

Management of anxiety

A
  • Reassurance
  • CBT

Y4 Extra teaching notes (5 decks)

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