Respiratory and Allergy Presentations
Differentiate airway, parenchymal, pleural, vascular and allergic disease while anticipating deterioration.
How to prepare for FRCEM SBA
Protect the full Emergency Medicine curriculum, prioritise the published item counts and practise the decisions expected of a clinician approaching independent practice.
Core concepts
Concept 1
Use work of breathing, oxygenation, ventilation, tempo, triggers and comorbidity to rank asthma, COPD, infection, embolic, pleural and allergic causes.
Exam cue: Recognise silent chest, exhaustion, rising carbon dioxide, severe hypoxaemia, tension physiology and evolving anaphylaxis.
Concept 2
Match oxygen, bronchodilation, antimicrobials, anticoagulation, pleural intervention or allergy treatment to severity and contraindications.
Exam cue: Use blood gases, imaging, peak flow and probability-based testing without allowing investigations to delay treatment of a threatened airway or breathing problem.
Risk pitfalls and guardrails
Treating an abnormal oxygen saturation as the diagnosis instead of identifying the respiratory or circulatory process causing it.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Choosing an answer that is generally true but does not fit the patient's physiology, urgency, evidence or current decision point.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Memory anchors
What frames decisions in respiratory and allergy presentations?
Use work of breathing, oxygenation, ventilation, tempo, triggers and comorbidity to rank asthma, COPD, infection, embolic, pleural and allergic causes.
Which respiratory and allergy presentations findings change urgency?
Recognise silent chest, exhaustion, rising carbon dioxide, severe hypoxaemia, tension physiology and evolving anaphylaxis.
How should investigation be planned in respiratory and allergy presentations?
Use blood gases, imaging, peak flow and probability-based testing without allowing investigations to delay treatment of a threatened airway or breathing problem.
What makes management complete in respiratory and allergy presentations?
Match oxygen, bronchodilation, antimicrobials, anticoagulation, pleural intervention or allergy treatment to severity and contraindications.
What common error should be avoided in respiratory and allergy presentations?
Treating an abnormal oxygen saturation as the diagnosis instead of identifying the respiratory or circulatory process causing it.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
A 68-year-old man with COPD presents with increasing breathlessness and drowsiness. On 28% Venturi oxygen, arterial blood gas shows pH 7.24, PaCO2 9.2 kPa, PaO2 7.8 kPa and bicarbonate 30 mmol/L. He is cooperative and protecting his airway. Which treatment should be initiated?
A 23-year-old woman with asthma has received oxygen, repeated nebulised salbutamol and ipratropium, systemic corticosteroid and intravenous magnesium. She is exhausted, barely audible on auscultation and has a PaCO2 of 6.3 kPa. What is the best next step?
Answer all questions to submit.
Next step personalized recommendations
Continue learning
Move forward only after this module is stable.
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