PC: breathlessness Flashcards
when exploring symptoms what do you want to ask in regards to timing
timing: when it started acute/gradual onset duration progression intermittent or continuous
when exploring symptoms what do you want to ask in regards to the breathlessness
exertion tolerance, what makes them stop
orthopnoea
PND
diurnal/seasonal variation
what relevant system review questions do you want to ask
general: fever or night sweats
Cadioresp: chest pain, palpitations, cough, sputum, leg swelling
what are the main differentials for breathlessness
MI CCF LRTI/pneumonia asthma COPD pneumothorax PE pulmonary fibrosis
others:
anemia, hyperventilation, pleural effusion, DKA, lobar collapse, bronchiectasis, AS, neuromuscular, sarcoidosis/TB
extrinsic allergic alveolitis
What clues/symptoms help you differentiate:
MI
acute onset SOB, often wakes them
associated nausea and vomitting
may be crushing central chest pain
cardiovascular risk factors
What clues/symptoms help you differentiate:
CCF
SOB, orthopnoea, PND
pink frothy sputum if acute LVF
peripheral odema
cardiac history
What clues/symptoms help you differentiate:
LRTI/pneumonia
acute SOB, cough and sputum
systemic symptoms ie fever
What clues/symptoms help you differentiate:
Asthma
intermittent wheeze
diurnal variation
nocturnal cough
exacerbating factor ie exercise and pets
What clues/symptoms help you differentiate:
COPD
chronic SOB
significant smoking history
chronic sputum production
What clues/symptoms help you differentiate:
pneumothorax
sudden onset pleuritic chest pain
risk factors eg COPD/asthma marfans appearance
What clues/symptoms help you differentiate:
pulmonary embolism
pleuritic chest pain
Haemoptysis
risk factors (long haul flights, recent surgery, immobilisation)
What clues/symptoms help you differentiate:
pulmonary fibrosis
progressive SOB over long period
dry cough
based on the following symptoms, what is the most likely disease:
acute onset SOB, often wakes them
associated nausea and vomitting
may be crushing central chest pain
cardiovascular risk factors
MI
based on the following symptoms, what is the most likely disease:
SOB, orthopnoea, PND
pink frothy sputum if acute LVF
peripheral odema
cardiac history
CCF
based on the following symptoms, what is the most likely disease:
acute SOB, cough and sputum
systemic symptoms ie fever
LRTI/pneumonia
