Topic Info - BotMed Application

TopicName

Acute dyspnea (SOB)

ClinicalTests

CBC with dif, ferritin (Anemia, Pneumonia); 
Blood culture;
TSH (Hypothyroid);
D-dimer (PE);
BNP (CHF);

ImagingStudies

Echocardiography (Aortas Stenosis); 
ECG (MI); 
Peak expiratory flow, PEF (Asthma, COPD); 
Chest x-ray (bronchiectasis, pneumonia); 
CT scan (cancer, metastasis); 
Endoscopy with biopsy (GERD); 
x-Ray (Pneumonia);

PhysicalExams

Vitals + puls ox.  – tachycardia, tachypnea, hyper/hypotensive, fever;
General appearance – signs of distress, LOC, sense of doom, restlessness;
HEENT - Exam of nasal mucosa, oropharynx – erythema, lymphadenopathy, examine pharynx;
Heart – JVP distention, murmurs, carotid bruits;
Respiratory – symmetric chest expansion, orthopnea, dullness/ consolidation, hyper resonance, wheeze, stridor, rales, rhonchi, intercostal retraction/ use of secondary respiratory muscles, dry or productive cough;
Peripheral vascular – cyanosis, clubbing, edema;

Comment

Always RO: COPD, Asthma, PE, CHF, Pneumonia
Location, quality, severity, radiation, duration, context (exertional, postprandial, positional, cocaine use, trauma); associated symptoms (sweating, nausea, dyspnea, palpitations, sense of doom, fever);  exacerbating and alleviating factors (especially medications); history of similar symptoms; known heart or lung disease or history of diagnostic testing; cardiac risk factors (hypertension, hyperlipidemia, smoking, family history of early MI); 
pulmonary embolism risk factors (history of DVT, coagulopathy, malignancy, recent immobilization);
R/O: thoracic aortic aneurism;

WebLink

https://www.aafp.org/afp/2003/1101/p1803.html