7.8.2013(dyspnea) Flashcards Preview

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Flashcards in 7.8.2013(dyspnea) Deck (40):
0

Metaboceptors are located in

Skeletal muscles

1

Cause of chest tightness or constriction

Bronchoconstriction
Interstitial Edema due to heart failure

2

Cannot get a deep breath,causes

Hyperinflation
Decreased tidal volume(fibrosis,chest wall restriction)

3

Increased work or effort of breathing,causes

Obstruction
Neuromuscular causes

4

Air hunger,causes

CHF
Pulmonary embolism
Obstruction

5

Mechanism of Dyspnea in COPD

Increased work of breathing
Hypoxemia
Acute Hypercapnia

6

Mechanism of Dyspnea in cardiogenic pulmonary Edema

Increased work of breathing
Air hunger
Hypoxemia
Stimulation of pulmonary receptors
Stimulation of vascular receptors
Metaboceptors

7

Mechanism of Dyspnea in non cardiogenic pulmonary Edema

Similar to CPE except that metaboceptors and stimulation of vascular receptors donot play a role

8

Mechanism of Dyspnea in asthma

Increased work of breathing
Air hunger
Hypoxemia
Acute Hypercapnia
Stimulation of pulmonary receptors

Similar mechanisms in ILD

9

Cause of Dyspnea in pulmonary vascular disease

Air hunger
Hypoxemia
Stimulation of pulmonary vascular receptors

10

Mechanism of Dyspnea in Anemia

Stimulation of metaboceptors

11

Causes of Dyspnea in pleural effusion

Increased work of breathing
Atelectasis stimulating pulmonary receptors

12

Cause of Dyspnea in obesity

Impaired ventilatory function due to reduced chest wall compliance

13

Orthopnea,causes

CCF
obesity
GERD induced asthma

14

Nocturnal Dyspnea

Asthma
CCF

15

Acute intermittent Dyspnea

Myocardial ischemia
Pulmonary embolism
Bronchospasm

16

Chronic persistent Dyspnea

COPD
ILD
chronic thromboembolic disease

17

Causes of platypnea

Left atrial myxoma
Hepatopulmonary syndrome

18

History taking in Dyspnea

Quality
Timing
Positional variation
Persistent Vs intermittent

19

Signs of increased work of breathing

Supraclavicular retraction
Use of accessory muscles of ventilation
Tripod position

20

Paradoxical movement of abdomen during respiration is a sign of

Diaphragmatic weakness

21

Prominent pulmonary vasculature in upper zones

Pulmonary venous hypertension

22

Enlarged central pulmonary arteries

Pulmonary artery hypertension

23

Distinguishing cardiovascular and respiratory cause of Dyspnea

Exercise cardiopulmonary testing

24

Experimental interventions in Dyspnea

Cold air on face
Chest wall vibration
Inhaled frusemide

25

Findings pointing to respiratory cause in cardiopulmonary exercise test

Pts achieves predicted maximal ventilation
Increase in dead space
Hypoxemia
Bronchospasm

26

Findings pointing to CVS cause in cardiopulmonary exercise test

HR is more than 85% of max
Ischemic changes in ECG
increased or decreased blood pressure
Fall in O2 pulse

27

O2 pulse

Oxygen consumption/HR
indicator of stroke volume

28

Chest X ray in pulmonary Edema

Peribronchial thickening
Prominent vascular markings in upper lung zones
Kerley B lines

29

Non cardiogenic pulmonary Edema due to direct lung injury

Chest trauma
Aspiration
Smoking
Pneumonia
Oxygen toxicity
Pulmonary embolism,reperfusion

30

Hematogenous causes of Noncardiogenic pulmonary Edema

Sepsis
Pancreatitis
Non thoracic trauma
Leukoagglutination reactions
Multiple transfusions
IV drug use(heroin)
Cardiopulmonary bypass

31

Noncardiogenic pulmonary Edema due to lung injury and elevated hydrostatic pressures

High altitude pulmonary Edema
Neurogenic pulmonary Edema
Reexpansion pulmonary Edema

32

Diff btw cardiogenic and Noncardiogenic pulmonary Edema

Pleural effusions are not common
Normal heart size
Uniform pulmonary infiltrates
Doesnot respond to supplemental oxygen as it is due to intra pulmonary shunting

33

Cause of Dyspnea in DKA,renal insufficiency

Increase in H+ conc

34

Cause of sensation of air hunger

Chemoreceptor stimulation

35

Cause of sensation of increased respiratory effort

Central respiratory motor command

36

In which type Dyspnea is more?
Restrictive or obstructive

No such difference

37

Scales for measuring Dyspnea

MRC
OCD(oxygen cost diagram)

38

Rx that relives Dyspnea by reducing metabolic load

Exercise training
Supplemental oxygen

39

How oxygen relieves Dyspnea ?

Reduces metabolic load
Decreases central drive