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Paradoxical Breathing on Physical Exam

Paradoxical breathing is often a sign of breathing problems. It causes the
Paradoxical Breathing ... It causes the chest ... DDx includes flail ... #Breathing #PhysicalExam ... clinical #video #pulmonary
Causes of Chronic Dyspnea - Differential Diagnosis Algorithm
Pericardial
 • Effusion
 • Cardiac Tamponade*
 • Constriction
Myocardial
 •
• Sub-Valvular Disease ... Coronary Artery Disease ... Stable Angina • Acute ... • Asthma • COPD ... Chest Wall Abnormalities
Hypoxemia / Hypoxia - Rapid Response Management Algorithm

Stridor - Upper airway pathology:
 • Anaphylaxis
 • Foreign
pneumothorax, COPD ... asthma • Pleural disease ... 12 / shallow breathing ... Hypoventilation: • CNS ... compliance (e.g., flail
Acute and Chronic Causes of Dyspnea - Differential Diagnosis
Pulmonary/Chest Wall:
 • Acute: Trauma, COPD exacerbation, Asthma
Causes of Dyspnea ... Differential Diagnosis Pulmonary ... Pleural effusion, Pulmonary ... hernia, Obesity CNS ... #Chronic #Causes
Abnormalities in Rate and Rhythm of Breathing 
Normal 
The respiratory rate is about 14—20 per min
Abnormalities in ... restrictive lung disease ... bronchitis, and COPD ... #Pulmonary #Abnormalities ... Abnormal #Diagnosis #PhysicalExam
Neurological Manifestations of Tuberculosis
Spinal Arachnoiditis & Polyradiculopathy:
 • Subacute onset of limb weakness, bladder/bowel dysfunction, muscle
weakness, sensory abnormalities ... lesion Pott's Disease ... lymphadenopathy, pulmonary ... neurological symptoms • Caused ... or abruptly • CN
Acid Base Disorders - Blood Gas Interpretation

Steps for Blood Gas Interpretation: 
1. Acidemia or Alkalemia? 
2.
Acute or chronic ... Classically” noted with pulmonary ... acidosis: - CNS ... restrictive lung disease ... (COPD, OSA, Asthma
Endocarditis Summary

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV substance use
• IV catheter
• Recent
Culture (+): Acute ... Cerebral > Splenic, pulmonary ... Septic Emboli Cause ... excrescences • Paradoxical ... EKG: Conduction abnormalities
Endocarditis - Overview and Differential Diagnosis Framework

Who?
Infectious:
• Pre-existing valvular disease
• Prosthetic valve
• Congenital heart disease
• IV
Culture Positive: • Acute ... Cerebral > Splenic, Pulmonary ... excrescences • Paradoxical ... EKG: Conduction abnormalities ... Treat underlying cause