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42 Cards in this Set
- Front
- Back
Dyspnea
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Difficulty breathing or shortness of breath
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Etiologies
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2/3 are cardiac or pulmonary. Many causes though
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DDx of Dyspnea
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Cardiac. Pulmonary. Mixed Cardiac and Pumonary. Non-cardiac and non-pulmonary.
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Pulmonary Eitologies
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COPD. Asthma. Restrictive lung disease. Hereditary lung disease. Pneumothorax. Pneumonia.
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Cardiac Eitologies
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CHF. CAD.
MI. Cardiomyopathy. Valvular dysfunction. LVH. Pericarditis. Arrythmias. |
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Mixed Cardiac and Pulmonary Causes
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COPD with cor pulmonale. Deconditioning. Chronic pulmonary emboli. Pleural effusion.
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Other Causes of Dyspnea
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Metabollic conditions. Pain. trauma. Neuromuscular. Functional (anxiety panic). Chemical exposure.
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Dx Approach
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Hx and Physical.
Chest radiograph. ECG. Screening spirometry. |
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ABG
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Evaluates pH, CO2, and O2. May not change in acute dyspnea.
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Hyperventilation Syndrome
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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.
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Treatment of Hyperventilation
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Talking patient down. Rebreath CO2 from the face mask with oxygen flowing 1 to 2 liters.
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Upper Airway and Dyspnea
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Foreign Body obstruction.
Pharyngeal Edema. Croup. Epiglotitis. |
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Suspicion of Foreign Body
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Child who becomes acutely dyspenic and LOC.
Adult who has dyspnea and LOC while eating. |
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Pharyngeal Edema
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Swelling of soft tissues in throat. Caused by allergic reactions and upperairway burns. Present with hoarsness, stridor, and drooling.
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Management of Pharyngeal Edema
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Postion. Oxygen. Epinephrine, benidryl, and steroids. Assist breathing.
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Stridor
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Is high pitched nose produced by narrowed airway in upper respiratory tract.
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Epiglotitis
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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.
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Croup
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Is a viral infection of the upper respiratory tract resulting occluding airway producing a barking cough.
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Management of Croup/Epiglotitis
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Oxygen. Racemic Epi nebs. Assist ventilations as needed.
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Lower Airway and Dyspnea
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Asthma. COPD.
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DDx of Wheezes
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Asthma. Pulmonary edema. PE. Anaphylaxisis. Foreign body aspiration. Pneumonia.
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Obstructive Lung Disease
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Chronic Bronchitis. Emphysema.
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Population of Chronic Bronchitis
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Urban male smokeres above the age of 30.
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Population of Emphysema
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Urban male smokers gerater than 40 to 50 years old.
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Management of COPD Excerbation
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Provide oxygen. Monitor carefully, ABG. Assist ventilators.
Nebulized bronchodilators. Steroids. Antibiotics. |
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Epidemology of Pneumonia
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6th leading cause of death in US. Respiratory viruses and mycoplasma responsible for greater than 1/3 of cases.
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Presentation of RSV
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Fever. Chest pain. Dyspnea.
Prodrome phase include mailase, URT infection and GI symptoms. Physical exam reveals wheezing sometimes. Imaging patchy densities or interstitial involvement. |
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Management of Viral Pneumonia
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Supportive treatment. Bed rest. Analgesics. Expectorants. Patient with airway obstruction treat with broncodilators.
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Causes of Atypical Pneumonia
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Mycoplasa. Chlamydia. Legionella.
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Treatment of Atypical Pneumonia
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Macrolides. Flouroquilones. Doxycyline.
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Typical Pneumonia Presentation
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Chills. Tremors. Tachypnea. Tachycardia. Malaise. Anorexia. Myalgias.
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Causes of Pneumothorax
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Pleural blebs. Bullae. Emphysema. Interstial lung disease. Alpha 1 antitrypsin deficiency.
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Traumatic and Iatrogenic Causes
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Penetrating wounds. Line placements. Lung biopsies. Mechanical ventilation.
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Clinical Presentation of Pneumothorax
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Dyspnea. Chest Pain.
Physical examination decreased breath sounds, hyperresonance. decreased tactile fremitus. |
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Work up of Pneumothorax
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Chest x-ray characterized with hyperlucency and lack of lung markings at the periphery.
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Treatment Options Pneumothorax
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Observation is asymptomatic and is less than 15 to 20%. Tube thoracostomy. Simple Aspiration.
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Causes of Pulmonary Edema
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CHF. Toxic inhalants. Aspiration. Drowning. Trauma.
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Work up in Pulonary Edema
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Hx and Physical.
EKG. Echo. BNP CXR ABG. Pulse ox. |
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Treatment of Pulmonary Edema
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Diuretics. Ionotropic agents. ACE inhibitors. Oxygen. MSO4
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Clinical Presentation of PE
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Dyspnea. Chest Pain. Tachycardia. Tachypnea. Hemoptysis.
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PAO2
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Is equal to (FIO2x713) - PACO2/0.8
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Managment of PE
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Oxygen. Assisted ventilation. Anticoagulation. Vena caval interruption. Thrombolytics.
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