# data[].attributes.body
63 year old pensioner

immune system low

prone to get disease

pensioner - not active lifestyle

less contact with another person

presented to emergency department

patient in chronic condition

need immediate treatment

left lateral stabbing chest pain while breathing

sharp chest pain

trauma

rib fracture

pneumothorax

pleuritis

MI

pericarditis

muscle strain

pulmonary embolism

costochondritis

GERD

angina

anxiety attack

viral pneumonia

cytomegalovirus

RSv

covid

tuberculosis

shortness of breath

dyspnea

check oxygen

movement

nose flaring

reduced blood flow- emboli - insufficient oxygen

smoking maybe?

COPD- gas exchange

# data[].attributes.body
63 year old pensioner

presented to emergency department

left lateral stabbing chest pain while breathing

shortness of breath

# data[].attributes.body
1. symptoms appeared soon after he fell on his chest

2. two days before.

3. The chest pain radiated to the shoulder of the same

side and increased with inspiration.

4. was agitated and disturbed emotionally

5. no leg swelling

6. no history of contact with patients with chronic cough

7. He has a history of benign essential hypertension.

8. No history of asthma, COPD, heart disease or history of previous hospitalisations.

9. His family history was unremarkable.

10. The patient did not smoke,No history of alcohol or drug abuse.

11. No history of recent long air travel

# data[].attributes.body
1. benign essential hypertension

benign does not involve organ

malignant involves organ damage

persistently elevated blood pressure with no indentifiable underlying course

# data[].attributes.body
1. symptoms appeared soon after he fell on his chest two days before

blunt trauma (sharp trauma causes bleeding)

can be pneumothorax

rib fracture- rib poking his lung

2. The chest pain radiated to the shoulder of the same

side and increased with inspiration

can be CVS problem because heart is located at the left

unstable angina

costochondritits

clavicular fracture

pleuritis

3. was agitated and disturbed emotionally

very painful/ feeling restless

4. no leg swelling

no edema, no heart failure

5. no history of contact with patients with chronic cough

no tb, covid

6. He has a history of benign essential hypertension

high bp with non inditifiable medical course

increase PR, that s why bp high, will have headache ,dizziness,nose bleeding

can form thrombus, embolim and chest pain

stasis, hypercoagulating state and inflammation

immobility- cannot move

7. No history of asthma, COPD, heart disease or history of previous hospitalisations.

normal blood flow

no chronic respiratory or cvs disease

8. His family history was unremarkable.

family semua okay

9. The patient did not smoke,No history of alcohol or drug abuse.

healthy and fit guy

no risk , health compromisation

10. No history of recent long air travel

no DVT stasis

no pulmonary embolism

# data[].attributes.body
trauma (rib fracture)

pneumothorax

pleuritis

MI

pericarditis

costochondritis

angina

anxiety attack

pulmonary embolism

GERD

viral pneumonia

cytomegalovirus

RSV

covid

tuberculosis

COPD

# data[].attributes.body
1. vital signs

respiratory rate

pulse rate

temperature

blood pressure

2. physical examination

respiratory system

inspection

nasal flaring

accessory muscle

tracheal deviation

percusion

auscaltation

CVS

GIT

3. CXR

4. check BMI

# data[].attributes.body
sharp chest pain

trauma

rib fracture

pneumothorax

pleuritis

MI

pericarditis

muscle strain

pulmonary embolism

costochondritis

GERD

angina

anxiety attack

viral pneumonia

cytomegalovirus

RSsharp chest pain

trauma

rib fracture

pneumothorax

pleuritis

MI

pericarditis

muscle strain

pulmonary embolism

costochondritis

GERD

angina

anxiety attack

viral pneumonia

cytomegalovirus

RSV

covid

tuberculosis

COPD

# data[].attributes.body
1. Crepitus = crackling or popping sounds or sensation that can be heard when certain structures in the body moves.

2. hyper-resonance = presence of air in pleural space

# data[].attributes.body
1. Normal temperature

2. normal heart rate

3. High respiratory rate

4. High BP

5. Borderline normal oxygen saturation

6. patient was found alert and in mild respiratory distress. There

was no cyanosis or pallor. His upper airways were clear.

7. no tracheal deviation

was found.

8. Reduced chest wall movement on the left side of the chest

9. localised tenderness over

the patient left lateral chest wall

10. crepitus over the 2nd to 6th left

ribs at the midaxillary line

11. hyper-resonance on

percussion over the left chest wall with decreased breath sounds.

12. BMI normal

13. no palpable lymphadenopathy.

14. The rest of the examination was unremarkable.

# data[].attributes.body
trauma (rib fracture)

pneumothorax

pleuritis

MI

pericarditis

costochondritis

angina

anxiety attack

pulmonary embolism

GERD

viral pneumonia

cytomegalovirus

RSV

covid

tuberculosis

COPD

# data[].attributes.body
1. CXR

2. FBC (to confirm the blood count,WBC)

3. Arterial Blood Gas (CAN dydx TYPE 1/TYPE 2 respiratory failure)

# data[].attributes.body
1. haemodynamically stable - Everything blood normal

2. encompassing - only 25% pneumothorax

3. chest tube - flexible tube inserted into pleural space to remove air/fluid/pus

# data[].attributes.body
HOPI - SOCRATES

O - sudden or gradual (when started)

C - stabbing or crushing

R - does the pain move exp. left arm - anywhere more pain

A - fever-headache-dizzy-coughing-night sweat etc

T - how long the pain last

E - SOB when lean forward - does standing (anything) makes it better - how many pillow used

S - scale 1- 10 how painful the pain is

PMH -

ant disease

any accident or trauma

any prescription

surgery

history of past disease

SOCIAL HISTORY

smoking

alcohol

drug abuse

traveled recently

pet

mental health

any close contact

environmental living

immunization history

family history

dyslipidemia

any genetic diseases

HT

single ke tu

how many living together

high prob anxiety