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COPD (breathlessness) MedEd CSI Year1 Recording

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Summary

In this on-demand teaching session, Blue, a fourth-year medical student focusing on global health, guides fellow students through a case study presentation on breathlessness. The interactive session begins with a quiz on recognized scales for breathlessness severity, which includes the Medical Research Council scale and the Borg scale. After briefing on these scales, Blue elaborates on the various conditions that can lead to breathlessness. While admitting the possible confusion presented by the wide range of conditions, Blue emphasizes that the heart and lungs are interconnected, as the primary element that goes into them is blood. The causes of breathlessness include, but are not limited to, problems with the respiratory system such as asthma, pneumonia, TB, lung cancer etc., heart problems, anemia, anxiety and renal failure. Attendees can expect enlightening discussions on the complexities of breathlessness, which will help with preparation for Phase 1A of your CSI.

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Learning objectives

  1. At the end of the teaching session, learners will be able to discuss the two recognized scales for measuring the severity of breathlessness; the Medical Research Council scale and the Borg scale.

  2. Learners will understand the important differential diagnoses to consider when treating a patient with breathlessness. These could range from issues in the respiratory system including diseases such as asthma, pneumonia, TB, pulmonary fibrosis among others to problems with the cardiovascular system including heart failure, arrhythmias, valvular diseases, myocardial infarction etc.

  3. They will be able to understand and describe the close relationship and dependence between the respiratory and cardiovascular systems.

  4. They will get an understanding of how conditions such as anemia, anxiety, and renal failure can also lead to breathlessness.

  5. Learners should gain an understanding of the symptoms related to severe cases of breathlessness, such as frothy pink sputum in heart failure patients.

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Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

The. Ok. Yes, yes, yes. Ok. Hello everyone. Um I hope you can hear me and everything. Um I am, my name is Blue and I am presenting um uh breathlessness. So let me just get up my slides. Sorry. Ok, great. I hope you all can hit. Can someone just message in the chat and say whether you can see my slides, please would be good. And can you see when I move it like? Ok, great. Thank you, Catherine. Ok, so hello everyone. My name is Blue. Um I'm 1/4 year. It always takes a bit of time to remember that these days because it still feels like I'm in first year. Um Yeah, so I'm in fourth year. I'm doing my BS see in global health and today I'm giving you your le on breathless or a case of breathlessness, Philip Craven um for phase one A your CSI um which I assume is coming up. Um So, but don't worry guys, you're in safe hands. So I'll start with a question. Ok. Yeah, it should come up here. Ok. So which of the following is reco is a recognized scale for severity of breathlessness ness choose as many as apply. I don't know if you can choose multiple. I think you can only choose one but there's two correct answers. So um you can say which one you think? Ok, great. So we got eight responses. Don't be afraid we're here to make mistakes. OK? It's a, this is a low stakes environment. So um yeah, so the two most popular ones which both got 37% were the Medical Research Council scale and the Borg scale which yes, those are the two that I were looking for. Um And then the other ones, I'll just run through them because some of you pick some of the other ones. So well, score. That is a scoring system used for DVTs. So deep vein thromboses C 65 is for uh it's like for pneumonia like whether you should send someone to hospital, the Medical Research Council have like so many scales for everything, but they've got one for breathlessness. PHQ nine is one for dere depression and then the borg scale is another one for severity of breathlessness. So um yeah, so those two. So there's a lot of differentials for breathlessness. I thought I had a slider. Anyway, let's just we can talk about these a bit more. So the Medical Research Council has it's a scale from it's difficult because some textbooks have it as 0 to 4 and another one has it from 1 to 5. But in your like prereading, it was from 1 to 51 being completely healthy like running a marathon and you're fine and then five being you cannot like the most severe form of breathlessness. Um which and it's based on functionality. So like um like what you can do. So, so um one I believe is walking. So one is completely normal. Two is like walking like um uphill, you get a bit tired or walking on the flat for quite a long time, you get quite tired. So that's two then. Three. Um, three is sorry. Now I'm just forgetting. Um, three is let me just, we'll check. Um Oh my gosh. I don't know why that slide went. I mean it's coming up later. No. Ok. Um, but that's ok. I wouldn't really worry about it too much but let's just do it. Yeah. So, so, um, so yeah, one is like only getting um like out of breath with strenuous exercise. Two is if you walk slower than people of the same age or you have to stop quite often. Um, when you're walking um, on flat. Um No, wait, sorry. Now I'm gonna, oh my gosh, I'm getting really confused. Now we'll come back to this at the end. Ok. Not to worry. Ok. Ok. So let's think about differentials for breathlessness. So there's heart, the heart. So basically what I wanted to show is the, the heart, the lungs are not in isolation and predominantly the main thing going into them other than air is um blood. And so a lot of problems can go wrong, causing breathlessness, like loads. So you can have loads of problems with the respiratory system. As we already know like asthma co PD pneumonia, TB, pulmonary fibrosis. I don't know if you know what that is. Um you will find out um lung cancer, pleural effusion, pneumothorax, pulmonary embolism, like all of these things can go wrong it within the actual lung tissue itself. But then you can also get like things like um heart causes so like heart failure because if the heart's not pumping, pumping, then all those blood sort of can end up like like um sort of staying within the lungs which can causes like which cause obviously disrupts the um like alveoli um like the gas exchange barrier cause you don't have like as rapid flow of blood through. Um And it can also cause the lungs like become like quite like swollen and edematous. Um And you can get like frothy pink sputum and like heart, heart failure. You can also similarly arrhythmias when your heart's not pumping, like in the in the correct rhythm, it can cause this as well. Valvular disease. Similarly, septic septal defect, myocardial infarction, et cetera, anemia, of course, um anxiety renal failure. I don't know if you guys have seen um like pictures of the Pope recently because he's really not. Well and he the his doctor said he has renal failure and you can see his entire, like he's way more like put on loads of.