Dyspnea

Question 1

Dyspnoea

Answer 1

Abnormally increased awareness of breathing or sensation of
difficulty breathing

Question 2

Orthopnoea

Answer 2

Dyspnoea when lying flat. Typically described in terms of
the number of pillows the patient uses to breathe comfortably to sleep.

Question 3

Paroxysmal nocturnal dyspnoea (PND)

Answer 3

Dyspnoea that wakes the patient
from sleep. The patient may report waking up gasping for air, and
classically finds relief by sitting by an open window.

Question 4

Platypnoea

Answer 4

Dyspnoea that improves when the patient lies down

Question 5

Trepopnoea

Answer 5

Dyspnoea that occurs in the lateral decubitus position on one
side, but not the other

Question 6

Hyperpnoea

Answer 6

denotes increased volume of ventilation.

Question 7

Respiratory System Dyspnea

Answer 7

Airway disease

Chest wall disorders

Lung parenchymal disorders

Question 8

Airway disease

Answer 8

Asthma and chronic obstructive pulmonary
disorder (COPD) are common causes of dyspnea associated
with increased work of breathing. Bronchospasm can cause
chest tightness and hyperventilation. Hypoxemia and
hypercapnia can result from ventilation-perfusion mismatch.

Question 9

Bronchospasm

Answer 9

can cause
chest tightness and hyperventilation

Question 10

ventilation-perfusion mismatch

Answer 10

Hypoxemia and
hypercapnia

Question 11

Chest wall disorders:

Answer 11

Chest wall stiffness (e.g., kyphoscoliosis)
and neuromuscular weakness (e.g., myasthenia gravis) cause
increased work of breathing.

Question 12

Lung parenchymal disorders

Answer 12

pulmonary fibrosis

Question 13

Cardiovascular System Dyspnea

Answer 13

Left heart disorders

Pulmonary vascular disorders

Pericardial diseases

Question 14

Left heart disorders

Answer 14

Elevations of left-ventricular
end-diastolic and pulmonary capillary wedge
pressures lead to dyspnea related to stimulation of
pulmonary receptors and hypoxemia from
ventilation-perfusion mismatch. Coronary artery
disease and cardiomyopathy are examples of
diseases affecting left heart function

Question 15

Pulmonary vascular disorders

Answer 15

Pulmonary emboli

primary pulmonary arterial hypertension

pulmonary vasculitis

Question 16

Pericardial diseases

Answer 16

Constrictive pericarditis

pericardial tamponade

Question 17

Dyspnea with Normal Respiratory and
Cardiovascular Systems

Answer 17

Anemia

Obesity

Deconditioning and anxiety

Question 18

Obesity is associated with dyspnea

Answer 18

due to high
cardiac output and impaired ventilatory function

Question 19

Initial Approach

Answer 19

Airway, Breathing, and Circulation

Look for features of respiratory distress & whether the
patient is toxic

Decide if the patient need immediate respiratory distress
(Intubation), ABG analysis & quick evaluation before
taking further action

Provide supplemental O2 therapy

Question 20

Clinical Features

Answer 20

Directed History.
Focused chest Examination.
Bedside investigation (ECG & ABG).
CXR.

Question 21

Assess increased work of breathing indicated by

Answer 21

accessory ventilatory
muscle use or supraclavicular retractions

Question 22

Chest examination

Answer 22

Determine if chest movement is symmetric, Use
percussion (dullness or hyperresonance), & Auscultation (decreased or
adventitious breath sounds) to assess the lungs.

Question 23

Cardiac examination

Answer 23

Should note
jugular venous distention,
heart murmurs,
and S3 or S4 gallops.