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Year 3 Histories/Conditions > Breathlessness > Flashcards

Flashcards in Breathlessness Deck (19)
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1
Q

How do you classify breathlessness?

A

New York classification

Stage 1 - no symptoms during physical Stage 2
Stage 3

2
Q

What is paroxysmal nocturnal dyspnea?

A

Waking up at night to gasp for air

3
Q

What is orthopnoea? What would you ask to confirm this?

A

SOB when lying flat

How many pillows do they have at night?

4
Q

Breathlessness, chest pain plus syncope, what are you thinking?

A

Aortic stenosis

5
Q

Other things you’d ask about

A

Palpitations
Chest pain
Do legs feel more heavy than usual? Pain in legs when walking?

6
Q

What does pink frothy sputum suggest?

A

HEART FAILURE as they’re trying to cough up the excess fluid in their lungs

7
Q

What might you ask to rule our asthma

A

Wheeze

Asthma pumps

8
Q

What might you ask in terms of previous medical history?

A
Previous stroke
Previous MI
Diabetes 
High cholesterol 
High BP
9
Q

What might you ask about the drugs?

A

Do you have any SE with these meds?

10
Q

Which drug should be stopped in heart failure?

A

CCB because they’re negative inotropes - decrease cardiac contractility which would mean the heart would struggle more

11
Q

Which drugs should be stopped in heart failure?

A

CCB because they’re negative inotropes - decrease cardiac contractility which would mean the heart would struggle more

NSAIDS - it interferes with COX and prostaglandin synthesis, thereby causing renal artery vasoconstriction and

Anaesthetics

12
Q

What causes heart failure?

A

Left ventricular dilation

Left ventricular hypertrophy

13
Q

Immediate management of acute heart failure

A

Hx failure
Sit them upright
High flow oxygen

14
Q

What would you order on bloods?

A

BNP over ?100 (heart failure)

Trops (heart attack)

15
Q

What tests would you order?

A

Bloods
ECG
CXR

16
Q

What would you see on a CXR in someone with heart failure?

A
Alveoli batwings 
Kurley B lines (interstitital oedema)
Cardiomegaly 
Dilated upper blood vessels 
Effusion
17
Q

What’s the definitive test to diagnose HF?

A

Echo cardiogram

18
Q

Treatment of HF

A

Diamorphine
Frusemide
GTN spray or nitrate infusion

19
Q

Long term management of HF

A

Stop smoking
Cut salt
Lose weight