Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: Asthma |Acute Severe Asthma |Exacerbation of COPD |Pulmonary Embolism |Acute Heart Failure and Cardiogenic Pulmonary Oedema |Pneumothorax |Tension Pneumothorax |Respiratory (Chest) infections Pneumonia |Fat embolism |Hyperventilation Syndrome |ARDS |Respiratory Failure |Diabetic Ketoacidosis
In difficult cases it is reasonable to treat more than one suspected pathology (e.g. PE, pneumonia and pulmonary oedema) at the same time while awaiting test and radiology results. ๐ฉบโ๏ธ
๐ฉบ Cause | ๐ Clinical Presentation | ๐งช Diagnostic Tests | ๐ Treatment |
---|---|---|---|
โค๏ธ Heart Failure | Exertional dyspnoea, orthopnoea, PND, fatigue, oedema, โJVP. | Echo, BNP, CXR (cardiomegaly, oedema), ECG, bloods. | Diuretics, ACEi/ARB, ฮฒ-blockers, lifestyle; ICD/transplant if severe. |
๐ซ๏ธ COPD | Chronic dyspnoea, cough, wheeze, smoking Hx. | Spirometry (โFEV1/FVC), CXR (hyperinflation), ABGs. | Smoking cessation, bronchodilators, ICS, rehab, Oโ if advanced. |
๐ฌ๏ธ Asthma | Intermittent dyspnoea, wheeze, nocturnal cough, triggers. | Spirometry (reversible obstruction), peak flow, allergy tests. | ICS + bronchodilators, trigger avoidance. |
๐ฉธ Pulmonary Embolism (PE) | Sudden dyspnoea, pleuritic chest pain, tachypnoea, haemoptysis, ยฑDVT. | CTPA, D-dimer, V/Q scan, leg Doppler, ECG (S1Q3T3). | Anticoagulation, thrombolysis if massive, Oโ + fluids, embolectomy if needed. |
๐ฆ Pneumonia | Fever, cough, purulent sputum, pleuritic pain, tachypnoea. | CXR (consolidation), sputum/blood cultures, WCC, sats. | Antibiotics, Oโ, hydration, admit if severe. |
๐ฑ ILD | Progressive dyspnoea, dry cough, crackles, clubbing. | HRCT, PFTs, biopsy if needed. | Remove cause, steroids/IS, Oโ, transplant if severe. |
๐ฉธ Anaemia | Exertional dyspnoea, pallor, tachycardia, fatigue. | CBC, retics, iron/B12/folate studies. | Replace deficiency, transfuse if severe, treat cause. |
๐จ Pneumothorax | Sudden dyspnoea, pleuritic pain, โbreath sounds, hyperresonant. | CXR, CT if unclear, ABG if severe. | Observe if small, aspirate/drain if large/symptomatic, surgery if recurrent. |
๐ Myocardial Infarction | Chest pain, dyspnoea, radiation, sweating, nausea. | ECG, troponin, echo, angiography. | PCI/thrombolysis, antiplatelets, ฮฒ-blockers, ACEi, statins. |
โค๏ธโ๐ฉน Congestive Heart Failure | Dyspnoea, orthopnoea, PND, oedema, โJVP. | Echo, CXR, BNP, ECG. | Diuretics, ACEi/ARB, ฮฒ-blockers, aldosterone antagonists, lifestyle; ICD if severe. |