OnlineMedEd: Intern Content - "Dyspnea"

Question 1

Review the dyspnea pyramid.

Answer 1

• Botton layer:

• Lungs
• Ps: PE, PNA, Pleural effusion, Pulmonary cancer
• Obstructive lung disease
• Intrinsic lung disease
• Diffuse alveolar hemorrhage

•Second layer:

• Heart
• MI, CHF (caused by tamponade, valvular problems, or systolic/diastolic heart failure), or arrhythmia

• Third layer:

• Blood
• Low levels of RBCs (anemia) or bad RBCs (methemoglobinemia or carboxyhemoglobinemia)

•Top:

• Acid-base
• Either metabolic acidosis (long differential) causing tachypnea or tachypnea causing respiratory alkalosis

Question 2

What labs should you order to evaluate for dyspnea?

Answer 2

• ABG: can show metabolic acidosis or respiratory alkalosis
• EKG: can show arrhythmia and MI
• CXR: can show PNA, pleural effusion, cancer, ILD, DAH, CHF effects