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Flashcards in Respiratory (differentials) Deck (22):
1

What is dypnoea? 

The sensation of shortness of breath

2

What is orthopnoea?

Shortness of breath that occurs when lying flat and is due to the abdominal contents pressing on the diaphgragm and displacing blood from bases of lungs

3

What is paroxysmal nocturnal dyspnoea?

  • Manifestation of left heart failure
  • Patient wakes up gasping for breath
  • Often sleeps with several pillows
  • Severe interstitial pulmonary oedema can accumulate
  • Because sensory awareness id depressed during sleep

4

What investigations can be done for acute breathlessness?

  • CXR
  • Pulse oximetry
  • ECG
  • ABG
  • FBC
  • U&E
  • Glucose and troponin (& D-dimers)

5

What investigations can be done for chronic breathlessness?

  • Lung function tests
  • Pulse oximetry
  • FBC
  • CXR

6

Give differential diagnoses for acute breathlessness

  • Acute asthma
  • Exacerbation of COPD
  • Pneumothorax
  • Pulmonary embolism
  • Pneumonia
  • Hypersensitivity pneumonitis
  • Upper airway obstruction: foreign body or anaphylaxis
  • Left heart failure
  • Cardiac tamponade
  • Panic w/ hyperventilation

7

Give differential diagnoses for chronic breathlessness

  • Asthma
  • COPD
  • Diffuse parenchymal lung disease
  • Pleural effusion
  • Cancer of the bronchus/trachea
  • Heart failure
  • Severe anaemia

8

What is the mechanism of a cough?

  • Cough initiated by a mechnical or chemical stimulation
  • Of specialised epithelium of resp tract
  • Afferents signal to the cough centre in medulla
  • Efferents signal via the phrenic and vagus nerves 
  • To expiratory musculature
  • To generate cough

9

Give common causes (differentials) for persistant cough

  • Asthma
  • GORD aspirations
  • Postnasal drip (rhinitis, acute nasopharyngitis, sinusitis)
  • Chronic cough w/ sputum is common in smokers

10

What are some less common causes for persistent cough?

  • Lung airway disease: COPD, bronchiectasis, tumour/foreign body
  • Lung parenchymal disease: interstitial lung disease, lung absess, ACE Inhibitors
  • Worsening cough may be presenting symptom of bronchial carcinoma

11

What is a wheeze?

Wheeze is the result of airflow limitation due to localised or generalised obstruction of airways. It is commonly caused by obstructive/restrictive airway diseases asthma, COPD and bronchiolitis. 

12

What is stridor, how is it different to a normal wheeze?

A harsh inspiratory wheeze caused by obstruction of the trachea or main bronchi

13

Give differential diagnoses for wheezing

  • Asthma
  • COPD
  • Emphysema
  • GORD
  • Heart failure
  • Lung cancer
  • Sleep apnoea
  • Anaphylaxis
  • Resp tract infection
  • Pneumonia
  • Bronchitis

14

What is haemoptysis?

Haemoptysis is the coughing of blood from a source below the glottis. 

15

Give differential diagnoses for haemoptysis

  • Bronchiectasis
  • Bronchial carcinoma
  • Pulmonary embolism
  • Bronchitis
  • Pneumonia (rust coloured sputum)
  • TB and abscesses
  • Pulmonary oedema (pink frothy sputum)
  • Wegener's granulomatosis and Goodpasture's Syndrome

16

What is pleuritic chest pain?

Localised, sharp pain made worse by breathing or coughing

17

Give differential diagnoses for pleuritic chest pain

  • Pulmonary embolism
  • Pneumothorax 
  • Pneumonia
  • Pericarditis
  • MI
  • Aortic dissection
  • Infection

18

Give respiratory causes for finger clubbing

  • Bronchial carcinoma, especially squamous cell
  • Bronchiectasis
  • Lung abscess
  • Empyema
  • Pulmonary fibrosis
  • Pleural and mediastinal tumours
  • Cryptogenic organising pneumonia

19

Give cardiovascular and miscellaneous causes for finger clubbing

  • Cyanotic heart disease
  • Subacute infective endocarditis
  • Atrial myxoma
  • Congenital (ie no disease)
  • IBD
  • Cirrhosis

20

Give a differential diagnosis for cough productive of sputum

  • Infections
  • Bronchitis
  • Pneumonia
  • Smoking
  • COPD
  • Bronchiectasis
  • Cystic Fibrosis

21

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