SAEM MS4 Curriculum Questions with Complete Solutions, Latest Updated 2024/2025 | Scored A+

SAEM MS4 Curriculum Questions with Complete Solutions, Latest Updated 2024/2025 | Scored A+. When do you use Non-Invasive PPV? -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? -respiratory arrest -hemodynamic instability -aspiration risk -airway obstruction -unable to tolerate mask -AMS SAEM MS4 Curriculum Questions with Complete Solutions, Latest Updated 2024/2025 | Scored A+ DDx for SOB? - CHF exacerbation - ACS - Anaphylaxis - Asthma/COPD - Tamponade - PE - PNA - airway obstruction Causes of systolic heart failure 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 Heart cannot "relax" due to: - hypertension - cardiomyopathy - CAD - DM - LVH - stenotic valvular DZ Leads to concentric hypertrophy S&S of CHF exacerbation? - dyspnea - orthopnea - exercise intolerance - PND - weight gain PE of CHF exacerbation? - respiratory distress - rales in dependent portions of lung (may be wheezes if bronchospasm, which makes it get confused with COPD) - S3 = fluid overload - S4 = stiff ventricle - JVD - pedal edema - hepatojugular reflux - hepatomegaly - venous stasis changes in legs Framingham Criteria major signs - pulmonary edema - cardiomegaly - hepatojugular reflux - neck vein distension - PAD/orthopnea - rales - S3 - weight loss 4.5 kg in response to Tx Framingham criteria minor - ankle edema - dyspnea on exertion - hepatomegaly - nocturnal cough - pleural effusion - Tachy 120 bpm Dx of CHF - EKG - cardiac enzymes (need to rule out new MI) - CMP (lytes and BUN:creat) - CBC - BNP (+ if 500 pg/mL) - CXR (cardiomegaly, Kerley B lines, pleural effusions) Tx of CHF - O2 (CPAP/BiPAP best) - nitrates to decrease preload - diuretics if evidence of fluid overload - be mindful of Pts in shock who need inotropes and pressors (not diuretics!) S&S of asthma exacerbation - progressive SOB - non-productive cough - wheezing in all lung fields - "chest tightness" Triggers of asthma - URI is most common - allergens - exercise - psych - cold Reasons to intubate someone with an asthma exacerbation - beta agonists are not working - significant hypoxia even with O2 - too tired to breathe on their own Management of asthma - O2 - B2 agonism/anticholinergic (Duonebs)