SAEM MS4 CURRICULUM EXAM 2024 WITH 100% CORRECT ANSWERS

First steps for SOB Answer - 1. Vitals 2. O2 via NC or NRB, BVM if not breathing adequately on their own 3. IV access 4. Cardiac and pulse Ox monitoring 5. EKG 6. CXR 7. US 8. Ddimer 9. BNP 10. trops When do you use Non-Invasive PPV? Answer - -moderate to severe dyspnea -accessory muscle use -paradoxical abdominal movement -fatigue -RR 25 bpm -pH 7.35 -pCO2 45 When do you not use NIPPV? Answer - -respiratory arrest -hemodynamic instability -aspiration risk -airway obstruction -unable to tolerate mask -AMS DDx for SOB? Answer - - CHF exacerbation - ACS - Anaphylaxis - Asthma/COPD - Tamponade - PE - PNA - airway obstruction Causes of systolic heart failure Answer - Heart cannot "squeeze" due to: - ischemic heart disease - CAD - Hypertension - fluid overload - arrhythmia - renal DZ - regurgitant valvular disease Leads to eccentric hypertrophy Causes of diastolic heart failure Answer - Heart cannot "relax" due to: - hypertension - cardiomyopathy - CAD - DM - LVH - stenotic valvular DZ Leads to concentric hypertrophy