Family Medicine EOR - Urgent Care Blueprint || A+ Certified.
What are the three biggest causes of acute respiratory distress syndrome (ARDS)? correct
answers Sepsis syndrome
Severe, multiple trauma
Aspiration of gastric contents
Pathophysiology of dyspnea correct answers Several mechanisms: Chemoreceptors in lungs
sense low O2 and increase the rate of breathing
Mechanical - due to limitations in respiration (CHF, interstitial lung disease, pulmonary HTN,
severe anemia, obstructions (asthma, COPD), obesity, pleural effusion, ascites, scoliosis).
Psych - anxiety
What are some factors that support a cardio etiology for dyspnea rather than a pulmonary?
correct answers S3 gallop
Pulmonary venous congestion or interstitial edema on CXR
Orthopnea
JVD
Edema
History of CVD
What lab is useful for diagnosing CHF? correct answers BNP (<80 can rule out CHF)
What are CXR findings that suggest CHF as a cause of dyspnea? correct answers Interstitial
edema on CXR
Alveolar edema on CXR
A BNP of <100 suggests a ____ cause of dyspnea and a BNP of >100 suggests ____ cause.
correct answers pulmonary; cardiac
Common causes of acute dyspnea correct answers Bronchospasm
Pulmonary Edema
Pulmonary Embolism
Pneumothorax
Pneumonia
MI
Acute anxiety attack/panic disorder
Anemia
Upper airway obstruction
Common causes of chronic dyspnea correct answers CHF
COPD
Asthma
Interstitial lung disease
Pulmonary hypertension
Pleural effusion
,Obesity
Ascites
Kyphoscoliosis
Anemia
Anxiety
Lung mass
What are some pertinent history questions for dyspnea? correct answers Chest pain
Hx of CVD or pulmonary disease
Fever
Recent surgery or travel
What other respiratory symptoms is dyspnea often associated with? correct answers Tachypnea -
rapid breathing
Orthopnea - SOB while lying down
Paroxysmal nocturnal dyspnea - orthopnea that awakens the patient from sleep
Platypnea - opposite of orthopnea
Hyperpnea - hyperventilation
Common causes of dyspnea in the pediatric population? correct answers FB aspiration
Upper airway obstruction
Asthma
PNA
Bronchiolitis
Diagnostic studies for dsypnea? correct answers Pulse Ox
CXR
PFTs
ABGs
EKG
Echo
Stress test
Labs for dyspnea? correct answers CBC - look for infection or anemia
BNP (brain natriuretic peptide) - elevated with CHF
CXR findings for PNA? CHF? Obstructive lung disease? Interstitial lung disease? correct
answers PNA - infiltrate
CHF - vascular engorgement or pulmonary edema
Obstructive lung disease - hyperinflation
Interstitial lung disease - honeycomb appearance or interstitial lung markings
Treatment for dyspnea due to PE? PNA? Bronchospasm? CHF? correct answers PE -
anticoagulation and hospitalization
PNA - Antibiotics either inpatient or outpatient
Bronchospasm - Bronchodilators
, CHF - Diuretics
What are the classes of the NYHA cardiac disease scale? correct answers Class I - no limitation
Class II - Slight limitation
Class III - Marked limitation
Class IV - Inability to carry out any activity without discomfort.
What are ominous signs/symptoms of dyspnea that may indicate respiratory failure is imminent?
correct answers Inability to speak
Agitation or lethargy as a consequence of hypoxia
Depressed consciousness due to hypercapnia
Paradoxical abdominal wall movement (abdominal wall retracts inward with inspiration,
indicating diaphragmatic fatigue)
How do you treat dyspnea? correct answers No single treatment. In severe dyspnea, the primary
treatment goal is maintenance of the airway and oxygenation with a Pao2 >60 mm Hg and/or
arterial oxygen saturation (Sao2) ≥90%
What are the potential causes of AMS/Coma (AEIOU-TIPS)? correct answers AEIOU-TIPS:
Alcohol
Endocrine, Exocrine, Electrolyte
Insulin
Opiates, OD, Oxygen
Uremia
Trauma, Temperature
Infection (Meningitis, etc)
Psychiatric Disorder
Seizure, Stroke, Shock, Space occupying lesion
At what temperatures can cause the body to go in to a coma? correct answers <32 C or > 42 C
What are PE pearls for AMS/Coma? correct answers Attempt to get a complete history (from
patient, family, bystanders)
Look at your patient (Smell breath, observe RR and patterns, posturing, signs of drug abuse)
Glasgow Coma Scale correct answers
A GCS score of < ___ = Intubate! correct answers <8
How do you manage/treat AMS/Coma? correct answers ABCs first
IV line ---> Fluids, Thiamine, Glucose, Narcan
Check Glucose
Complete H&P (after stabilization)
Radiographic clearance of C-spine
Labs/CT as indicated
What are the three biggest causes of acute respiratory distress syndrome (ARDS)? correct
answers Sepsis syndrome
Severe, multiple trauma
Aspiration of gastric contents
Pathophysiology of dyspnea correct answers Several mechanisms: Chemoreceptors in lungs
sense low O2 and increase the rate of breathing
Mechanical - due to limitations in respiration (CHF, interstitial lung disease, pulmonary HTN,
severe anemia, obstructions (asthma, COPD), obesity, pleural effusion, ascites, scoliosis).
Psych - anxiety
What are some factors that support a cardio etiology for dyspnea rather than a pulmonary?
correct answers S3 gallop
Pulmonary venous congestion or interstitial edema on CXR
Orthopnea
JVD
Edema
History of CVD
What lab is useful for diagnosing CHF? correct answers BNP (<80 can rule out CHF)
What are CXR findings that suggest CHF as a cause of dyspnea? correct answers Interstitial
edema on CXR
Alveolar edema on CXR
A BNP of <100 suggests a ____ cause of dyspnea and a BNP of >100 suggests ____ cause.
correct answers pulmonary; cardiac
Common causes of acute dyspnea correct answers Bronchospasm
Pulmonary Edema
Pulmonary Embolism
Pneumothorax
Pneumonia
MI
Acute anxiety attack/panic disorder
Anemia
Upper airway obstruction
Common causes of chronic dyspnea correct answers CHF
COPD
Asthma
Interstitial lung disease
Pulmonary hypertension
Pleural effusion
,Obesity
Ascites
Kyphoscoliosis
Anemia
Anxiety
Lung mass
What are some pertinent history questions for dyspnea? correct answers Chest pain
Hx of CVD or pulmonary disease
Fever
Recent surgery or travel
What other respiratory symptoms is dyspnea often associated with? correct answers Tachypnea -
rapid breathing
Orthopnea - SOB while lying down
Paroxysmal nocturnal dyspnea - orthopnea that awakens the patient from sleep
Platypnea - opposite of orthopnea
Hyperpnea - hyperventilation
Common causes of dyspnea in the pediatric population? correct answers FB aspiration
Upper airway obstruction
Asthma
PNA
Bronchiolitis
Diagnostic studies for dsypnea? correct answers Pulse Ox
CXR
PFTs
ABGs
EKG
Echo
Stress test
Labs for dyspnea? correct answers CBC - look for infection or anemia
BNP (brain natriuretic peptide) - elevated with CHF
CXR findings for PNA? CHF? Obstructive lung disease? Interstitial lung disease? correct
answers PNA - infiltrate
CHF - vascular engorgement or pulmonary edema
Obstructive lung disease - hyperinflation
Interstitial lung disease - honeycomb appearance or interstitial lung markings
Treatment for dyspnea due to PE? PNA? Bronchospasm? CHF? correct answers PE -
anticoagulation and hospitalization
PNA - Antibiotics either inpatient or outpatient
Bronchospasm - Bronchodilators
, CHF - Diuretics
What are the classes of the NYHA cardiac disease scale? correct answers Class I - no limitation
Class II - Slight limitation
Class III - Marked limitation
Class IV - Inability to carry out any activity without discomfort.
What are ominous signs/symptoms of dyspnea that may indicate respiratory failure is imminent?
correct answers Inability to speak
Agitation or lethargy as a consequence of hypoxia
Depressed consciousness due to hypercapnia
Paradoxical abdominal wall movement (abdominal wall retracts inward with inspiration,
indicating diaphragmatic fatigue)
How do you treat dyspnea? correct answers No single treatment. In severe dyspnea, the primary
treatment goal is maintenance of the airway and oxygenation with a Pao2 >60 mm Hg and/or
arterial oxygen saturation (Sao2) ≥90%
What are the potential causes of AMS/Coma (AEIOU-TIPS)? correct answers AEIOU-TIPS:
Alcohol
Endocrine, Exocrine, Electrolyte
Insulin
Opiates, OD, Oxygen
Uremia
Trauma, Temperature
Infection (Meningitis, etc)
Psychiatric Disorder
Seizure, Stroke, Shock, Space occupying lesion
At what temperatures can cause the body to go in to a coma? correct answers <32 C or > 42 C
What are PE pearls for AMS/Coma? correct answers Attempt to get a complete history (from
patient, family, bystanders)
Look at your patient (Smell breath, observe RR and patterns, posturing, signs of drug abuse)
Glasgow Coma Scale correct answers
A GCS score of < ___ = Intubate! correct answers <8
How do you manage/treat AMS/Coma? correct answers ABCs first
IV line ---> Fluids, Thiamine, Glucose, Narcan
Check Glucose
Complete H&P (after stabilization)
Radiographic clearance of C-spine
Labs/CT as indicated
