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CDM II Fall Block > Dyspnea > Flashcards

Dyspnea Flashcards

1
Q

Dyspnea is subjective or objective?

A

Subjective

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2
Q

What is dyspnea?

A

A subjective sensation of shortness of breath or breathing discomfort

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3
Q

What is chronic dyspnea?

A

Sx greater than 1 month

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4
Q

T/F underlying cause of dyspnea is not directly related to duration or severity

A

True

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5
Q

How do pts describe dyspnea?

A

“I cant catch my breath”
“chest tightness”

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6
Q

What % accounts for FP visits for dyspnea?

A

4%

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7
Q

What age gets dyspnea?

A

Pediatrics and 55-69 years of age

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8
Q

T/F A large percentage of patients will have an already diagnosed cardiopulmonary disorder which accounts for the dyspnea

A

True

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9
Q

Dyspnea is approximately 2/3rds of cases are caused by _____?

A

Pulmonary or cardiac disorder

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10
Q

85% of dyspnea is caused by (detailed list)?

A

Asthma, CHF, COPD, PNA, cardiac ischemia, interstitial lung disease

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11
Q

What are the 1/3 (not caused by heart/lungs)?

A

Metabolic, deconditioning, anemia, or psychogenic

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12
Q

About what # of pt will have another complaint?

A

2/3

Mostly cough (17%)

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13
Q

T/F The diagnosis can be made in half of all patients with history alone (if a good history is taken!)

A

True

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14
Q

T/F Dyspnea is not multifactorial

A

False, it is multifactorial

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15
Q

Which (lung/cardiac) has slower onset?

A

Lung

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16
Q

Dyspnea at rest is most likely lung or cardiac?

A

Lungs

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17
Q

Cough that is more productive is more lungs or cardiac?

A

lungs

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18
Q

Which (lungs/cardiac) has more rapid onset?

A

Cardiac

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19
Q

Dyspnea with exertion is more likely (lung/cardiac)?

A

Cardiac

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20
Q

T/F Cough is common with cardiac dz

A

False, cough is rare

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21
Q

What are sx to send immediately to the ER?

A

Acute respiratory distress
- Labored (Wheezing, accessory muscle use, unable to speak in full sentence (two/word dsypnea).
- cyanotic, word dyspnea
(Chest pain)
(Hypoxic)

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22
Q

T/F 87% can be normal for pt with lung dz

A

True

23
Q

In addition to O2 %, what should you keep in mind?

A

vital signs

24
Q

COPD’s what is highest PE exam correlation

A

Wheezing

25
Q

what is most specific question for CHF?

A

DOE is the earliest symptom, but PND is more specific

26
Q

T/F S3 gallop is never normal

A

True

27
Q

What is S3 gallop associated with?

A

CHF

28
Q

New murmur is associated with?

A

CHF

29
Q

Which lung disease has slow progression of exertional dyspnea?

A

ILD

30
Q

What is present in 80% of pt with ILD?

A

Persistent inspiratory crackles

31
Q

25-50% will have what with ILD?

A

Clubbing

32
Q

What does normal O2 implies?

A

a mild disorder such as exercise-induced bronchospasm

33
Q

What does abnormal O2 with exertion implies?

A

mild to moderate cardiopulmonary disease

34
Q

What does abnormal O2 at rest implies?

A

moderate to severe cardiopulmonary disease

35
Q

Whats important to get with in lung dz pt?

A

Walking O2

36
Q

Whats the diagnostic approach for dyspnea?

A

If you get good H&P, you will prob have a diagnosis

37
Q

T/F Patients who present with dyspnea as a primary complaint are more likely to get an EKG than lung function testing

A

True but it needs to change

38
Q

What is your first choice of test for dyspnea?

A

PFT

39
Q

What is obstructive for FEV1 and FEV1/FVC?

A

FEV1 = <80%
FEV1/FVC? = <70%

40
Q

What are the obstructive lung dz?

A

COPD
Asthma
Bronchiectasis

41
Q

What is FEV1 and FEV1/FVC for restrictive?

A

FEV1 = <80%
FEV1/FVC? = >70%

42
Q

What are example of restrictive lung dz?

A

Interstitial lung disease
Pulmonary fibrosis
Obesity
Autoimmune diseases
Pleural effusion and heart failure

43
Q

How can EKG help in eval of dyspnea?

A

Cardiac ischemia or infarction
Ventricular hypertrophy
Pericardial disease

44
Q

Eval of dyspnea with CXR

A

Chest wall abnormalities, hyperinflation, CM or pleural effusions, Mass/Mets, PNA

  • good for dyspnea
45
Q

When would you order CT chest?

A

I have no idea what’s causing this patients dyspnea…
Interstitial lung disease, bronchiectasis, PE

You will see PE with this

46
Q

List the dx test

A
  • EKG
  • CXR
  • CTA PE
  • High res CT chest
  • CBC
  • BMP
47
Q

Why would you order CBC with dyspena?

A

Anemia
Infection
COPD

48
Q

Why would you order BMP with dyspena?

A

Acid-Base disturbance (bicard level)
Metabolic acidosis

49
Q

T/F BNP is good for CHF?

A

Yes, the higher it is, worse their CHF is

50
Q

T/F Echo is high yield for pt who we think have CHF

A

True

51
Q

Can paroxysmal afib cause dyspnea?

A

Yes, best with holter monitor

52
Q

If it doesn’t correlate with anything, sometimes at night, sometimes day etc what should you get?

A

Holter Monitor

53
Q

How will Lung bx help with eval of dyspnea- PANCE

A

Interstitial lung disease
Malignancy

54
Q

When should we refer dyspnea pt?

A
  • Underlying cause of dyspnea is unclear
  • Symptoms disproportionate to the apparent severity of the disease
  • For lung biopsy
  • Patient not adequately responding to treatment

CDM II Fall Block (9 decks)

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