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Differential Diagnosis for Sudden Onset of Breathlessness

Single Most Likely Diagnosis

  • B. Type 1 Respiratory Failure: The patient's ABG shows a low PO2 (8 kPa) with a normal PCO2 (35 mmHg), which is consistent with Type 1 respiratory failure, characterized by hypoxemia without hypercapnia. The sudden onset of breathlessness also supports this diagnosis.

Other Likely Diagnoses

  • C. PE (Pulmonary Embolism): A sudden onset of breathlessness can be a symptom of a pulmonary embolism, which can lead to Type 1 respiratory failure. The ABG findings alone do not rule out PE.
  • B. Type 1 Respiratory Failure (also listed as the single most likely diagnosis, but included here for completeness as it fits well within both categories due to its likelihood and the presentation of the patient).

Do Not Miss Diagnoses

  • E. Morphine Overdose: Although less likely given the information, morphine overdose can cause respiratory depression leading to respiratory failure. It's crucial not to miss this diagnosis because it requires immediate intervention, including potential administration of naloxone.
  • C. PE (Pulmonary Embolism): Also listed under other likely diagnoses, but it's a "do not miss" due to its potential for high morbidity and mortality if not promptly treated.

Rare Diagnoses

  • A. Respiratory Acidosis: The provided ABG does not support respiratory acidosis as the primary issue since the PCO2 is within the normal range, and the pH is slightly alkalotic.
  • D. Type 2 Respiratory Failure: Characterized by hypercapnia (elevated PCO2) and hypoxemia, which does not match the patient's ABG results showing a normal PCO2 level.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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