Home' Australian Pharmacist : Australian Pharmacist August 2014 Contents Australian Pharmacist August 2014 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
1. Which of the following statements
about dyspnoea is CORRECT:
a) Pulmonary and cardiac disease can be
associated with dyspnoea.
b) Patient questioning may assist the
assessment of dyspnoea.
c) Dyspnoea is a subjective sensation and
there is no objective measurement.
d) All of the above.
2. Dyspnoea is a characteristic
symptom of heart failure. Which
of the following is CORRECT about
dyspnoea and heart failure?
a) Dyspnoea is seen predominantly in right
ventricular heart failure.
b) Dyspnoea usually progressively
improves in patients with heart failure.
c) Dyspnoea is often seen when the
patient is lying down.
d) Dyspnoea in heart failure patients
occurs mainly in the morning.
3. When determining if asthma is the
cause of dyspnoea, the patient may
a) No history of childhood asthma.
b) Feeling breathless when anxious.
c) Recent respiratory infection.
d) All of the above.
4. Methotrexate-induced lung toxicity
is characterised by:
c) Skin irritation.
d) None of the above.
5. Which of the following statements is
a) Panic attacks are not a cause of
b) Pneumonia is associated with
c) Methotrexate pneumonitis requires
the ceasing of methotrexate and
commencement of corticosteroids.
d) A history of asthma in childhood may
not be associated with adult onset
KEY LEARNING POINTS
Dyspnoea is a common symptom across
a number of cardiac and respiratory
conditions. It is also subjective sensation
that may be described by patients in a
number of ways.
Common aetiology for dyspnoea
includes cardiac and pulmonary
disease, as well as acute blood loss,
metabolic acidosis, anxiety or poor
Dyspnoea can occur through different
pathophysiologic mechanisms such
as an increase in respiratory drive or
stimulation of the irritant receptors in
The incidence of interstitial lung
disease in patients with rheumatoid
arthritis may be related to underlying
disease mechanisms as well as the
medications used in its treatment.
The onset of pneumonitis may be
characterised by acute or subacute
breathlessness, often with cough
and fever. All patients commencing
methotrexate should be made aware of
the need to report new or deteriorating
respiratory symptoms promptly.
• Treatment of methotrexate
pneumonitis involves immediate
cessation of methotrexate, and
usually the commencement of
corticosteroids. Given the long
terminal half-life of methotrexate,
consideration should also be given to
the concomitant use of folic acid.
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