Return to Diagnosis ListShow Learning Points most relevant to Phase 1:

Worsening shortness of breath

Clinical Discipline(s)/Organ System(s)
Respiratory Medicine, Respiratory System, Radiology
Progress Test Topic(s)
A 70 year old NZ European man presents to your clinic due to worsening shortness of breath on exertion. You arrange a chest X-ray which shows a diffuse abnormality of both lung fields.
Progress Test-Type Questions:   Question 1 | Question 2 | Question 3 | Question 4 | Question 5
Applied Science for Medicine 
   - Microanatomy of the lung parenchyma
   - Physiology of breathing: mechanics, gas exchange, control, work of breathing
   - Classification and pathology of diffuse lung disease
   - Immunology of diffuse lung disease
   - CT anatomy of the thorax
   - Radiologic patterns of diffuse lung disease
Clinical and Communication Skills 
   - Elicit history from patient with chronic shortness of breath; obtain an 'exposure history', including an occupational history; history relevant to other conditions associated with diffuse lung disease
   - Perform and report the examination of the respiratory system
   - Describe and interpret chest X-ray showing diffuse lung disease
   - Understand indications for and basic interpretation of high resolution CT (HRCT) of thorax
   - Interpret lung function tests of restrictive lung disease (lung volumes, flows, diffusing capacity, arterial blood gas)
   - Causes, investigation and management of diffuse lung disease
   - Prognosis of diffuse lung disease
   - Role of occupational and environmental physicians (and other associated health professionals)
Personal and Professional Skills 
   - Open disclosure and adverse events
   - Role as patient advocate
   - Patient counselling re risk vs. benefit of treatment
Population Health 
   - Epidemiology of diffuse lung disease subtypes
   - Global health: diffuse lung disease in developing countries
   - Epidemiology of occupational lung disease
   - Environmental exposures and lung disease
   - Compensation of occupationally-acquired illness
   - Public education re inhalational hazards
Conditions to be considered relating to this scenario
idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis), asbestosis, sarcoidosis, hypersensitivity pneumonitis (extrinsic allergic alveolitis), diffuse lung disease associated with connective tissue diseases
Less common but 'important not to miss'
diffuse alveolar haemorrhage, drug-induced diffuse lung disease, occupational lung disease
Related Scenarios
[Chronic shortness of breath]