Dyspnea Er

Front 1

Dyspnea

Back 1

Difficulty breathing or shortness of breath

Front 2

Etiologies

Back 2

2/3 are cardiac or pulmonary. Many causes though

Front 3

DDx of Dyspnea

Back 3

Cardiac. Pulmonary. Mixed Cardiac and Pumonary. Non-cardiac and non-pulmonary.

Front 4

Pulmonary Eitologies

Back 4

COPD. Asthma. Restrictive lung disease. Hereditary lung disease. Pneumothorax. Pneumonia.

Front 5

Cardiac Eitologies

Back 5

CHF. CAD.
MI. Cardiomyopathy. Valvular dysfunction.
LVH. Pericarditis. Arrythmias.

Front 6

Mixed Cardiac and Pulmonary Causes

Back 6

COPD with cor pulmonale. Deconditioning. Chronic pulmonary emboli. Pleural effusion.

Front 7

Other Causes of Dyspnea

Back 7

Metabollic conditions. Pain. trauma. Neuromuscular. Functional (anxiety panic). Chemical exposure.

Front 8

Dx Approach

Back 8

Hx and Physical.
Chest radiograph.
ECG.
Screening spirometry.

Front 9

ABG

Back 9

Evaluates pH, CO2, and O2. May not change in acute dyspnea.

Front 10

Hyperventilation Syndrome

Back 10

Occurs when patient has anxiety and is panic. Decrease in CO2 causes constriction of blood vessels in brain results in anxiety, dizziness, and lightheadness. Parathesias in fingers and toes and carpopedal spasm of hands and feet.

Front 11

Treatment of Hyperventilation

Back 11

Talking patient down. Rebreath CO2 from the face mask with oxygen flowing 1 to 2 liters.

Front 12

Upper Airway and Dyspnea

Back 12

Foreign Body obstruction.
Pharyngeal Edema.
Croup.
Epiglotitis.

Front 13

Suspicion of Foreign Body

Back 13

Child who becomes acutely dyspenic and LOC.
Adult who has dyspnea and LOC while eating.

Front 14

Pharyngeal Edema

Back 14

Swelling of soft tissues in throat. Caused by allergic reactions and upperairway burns. Present with hoarsness, stridor, and drooling.

Front 15

Management of Pharyngeal Edema

Back 15

Postion. Oxygen. Epinephrine, benidryl, and steroids. Assist breathing.

Front 16

Stridor

Back 16

Is high pitched nose produced by narrowed airway in upper respiratory tract.

Front 17

Epiglotitis

Back 17

Is a bacterial infection of the epiglotitis resulting in edema. Typically occurs in 4 to 7 year olds and present with rapid onset fever, stridor, soar throat, and drooling. DO NOT LOOK INTO THROAT. INTUBATE IN OR.

Front 18

Croup

Back 18

Is a viral infection of the upper respiratory tract resulting occluding airway producing a barking cough.

Front 19

Management of Croup/Epiglotitis

Back 19

Oxygen. Racemic Epi nebs. Assist ventilations as needed.

Front 20

Lower Airway and Dyspnea

Back 20

Asthma. COPD.

Front 21

DDx of Wheezes

Back 21

Asthma. Pulmonary edema. PE. Anaphylaxisis. Foreign body aspiration. Pneumonia.

Front 22

Obstructive Lung Disease

Back 22

Chronic Bronchitis. Emphysema.

Front 23

Population of Chronic Bronchitis

Back 23

Urban male smokeres above the age of 30.

Front 24

Population of Emphysema

Back 24

Urban male smokers gerater than 40 to 50 years old.

Front 25

Management of COPD Excerbation

Back 25

Provide oxygen. Monitor carefully, ABG. Assist ventilators.

Nebulized bronchodilators. Steroids. Antibiotics.

Front 26

Epidemology of Pneumonia

Back 26

6th leading cause of death in US. Respiratory viruses and mycoplasma responsible for greater than 1/3 of cases.

Front 27

Presentation of RSV

Back 27

Fever. Chest pain. Dyspnea.

Prodrome phase include mailase, URT infection and GI symptoms.

Physical exam reveals wheezing sometimes.

Imaging patchy densities or interstitial involvement.

Front 28

Management of Viral Pneumonia

Back 28

Supportive treatment. Bed rest. Analgesics. Expectorants. Patient with airway obstruction treat with broncodilators.

Front 29

Causes of Atypical Pneumonia

Back 29

Mycoplasa. Chlamydia. Legionella.

Front 30

Treatment of Atypical Pneumonia

Back 30

Macrolides. Flouroquilones. Doxycyline.

Front 31

Typical Pneumonia Presentation

Back 31

Chills. Tremors. Tachypnea. Tachycardia. Malaise. Anorexia. Myalgias.

Front 32

Causes of Pneumothorax

Back 32

Pleural blebs. Bullae. Emphysema. Interstial lung disease. Alpha 1 antitrypsin deficiency.

Front 33

Traumatic and Iatrogenic Causes

Back 33

Penetrating wounds. Line placements. Lung biopsies. Mechanical ventilation.

Front 34

Clinical Presentation of Pneumothorax

Back 34

Dyspnea. Chest Pain.

Physical examination decreased breath sounds, hyperresonance. decreased tactile fremitus.

Front 35

Work up of Pneumothorax

Back 35

Chest x-ray characterized with hyperlucency and lack of lung markings at the periphery.

Front 36

Treatment Options Pneumothorax

Back 36

Observation is asymptomatic and is less than 15 to 20%. Tube thoracostomy. Simple Aspiration.

Front 37

Causes of Pulmonary Edema

Back 37

CHF. Toxic inhalants. Aspiration. Drowning. Trauma.

Front 38

Work up in Pulonary Edema

Back 38

Hx and Physical.
EKG. Echo. BNP
CXR
ABG. Pulse ox.

Front 39

Treatment of Pulmonary Edema

Back 39

Diuretics. Ionotropic agents. ACE inhibitors. Oxygen. MSO4

Front 40

Clinical Presentation of PE

Back 40

Dyspnea. Chest Pain. Tachycardia. Tachypnea. Hemoptysis.

Front 41

PAO2

Back 41

Is equal to (FIO2x713) - PACO2/0.8

Front 42

Managment of PE

Back 42

Oxygen. Assisted ventilation. Anticoagulation. Vena caval interruption. Thrombolytics.