PAEA Emergency Medicine EOR Topics Questions and Verified Answers, 100- Score Guarantee Pass (Latest

PAEA Emergency Medicine EOR Topics
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Score Guarantee Pass (Latest 2025)
what is the most common cause of heart failure? specifically left sided? right
sided? - Correct Answers ✅-MC is CAD (coronary artery disease)

-L sided: *CAD* & HTN

-R sided: *L sided HF* & pulmonary dz



decreased ejection fraction, thin ventricular walls, dilated LV chamber, and
an S3 gallop (filling of dilated ventricle) is associated with systolic or diastolic
heart failure? - Correct Answers ✅systolic (MC form of CHF)



*(the sound is actually heard in the diastole though)

-memory trick: "sys-to-lic" 3 consonants = S3



normal ejection fraction, thick ventricular walls, narrowed LV chamber, and
an S4 gallop (atrial contraction into a stiff ventricle) is associated with
systolic or diastolic heart failure? - Correct Answers ✅diastolic



-memory trick: "di-a-sto-lic" 4 consonants = S4



what are the causes of systolic vs diastolic heart failure? - Correct Answers
✅-systolic: post *MI*, *dilated cardiomyopathy*, myocarditis

-diastolic: *HTN*, *LVH*, *elderly*, valvular heart dz, hypertrophic or
restrictive cardiomyopathy, constrictive pericarditis



when the metabolic demands of the body exceed normal cardiac function
(d/t thyrotoxicosis, wet beriberi, severe anemia, AV shunting, Paget's disease
of the bone) this is termed ________ heart failure - Correct Answers ✅high-
output



*fairly uncommon

,PAEA Emergency Medicine EOR Topics
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-low-output HF is just d/t problem w/ myocardial contraction, ischemia, or
chronic HTN



what are some causes of acute vs chronic heart failure? - Correct Answers
✅-acute: *largely systolic*; hypertensive crisis, acute MI, papillary muscle
rupture

-chronic: dilated cardiomyopathy (systolic), valvular dz (diastolic)



explain class I-IV New York Heart Association functional classes - Correct
Answers ✅-class I: *no sx's*, *no limitation* during ordinary physical
activity

-class II: *mild sx's* (dyspnea or angina), *slight limitation* during ordinary
activity

-class III: *comfortable only at rest* (sx's caused maked limitation in activity
even with minimal exertion

-class IV: *sx's even while at rest*, severe limitations, inability to carry out
physical activity



what compensations does the body make when heart failure (can be due to
something that causes either inc pre/afterload or dec contractility) begins? -
Correct Answers ✅1. sympathetic nervous system activation

2. myocyte hypertrophy/remodeling

3. RAAS activation: fluid overload



the following are signs/sx's of what sided heart failure?

inc pulmonary venous pressure, dyspnea, orthopnea, rales/rhonchi, chronic
non-productive cough with pink frothy sputum, HTN, Cheyne-Stokes
breathing, S3 or S4, pale skin/cool extremities, sinus tachy, fatigue - Correct
Answers ✅L-sided HF

,PAEA Emergency Medicine EOR Topics
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the following are signs/sx's of what sided heart failure?

inc systemic venous pressure, peripheral edema, JVD, anorexia, N/V,
hepatosplenomegaly, RUQ tenderness, hepatojugular reflex (inc JVP with
liver palpation) - Correct Answers ✅R-sided HF



-CXR showing Kerley B lines (alternate flow tracts), cardiomegaly, pleural
effusion, pulmonary edema

-echo with dec EF

-inc BNP on labs



are all signs of? - Correct Answers ✅heart failure



*BNP released from atrium with preload too high (volume overload)



what drugs have shown to decrease mortality rates in pts with heart failure?
- Correct Answers ✅*ACE inhibitors* (-prils), ARBs, *beta-blockers* (-lols),
hydralazine + nitrates, spironolactone



in pts who experience the following common side effects of an ACE inhibitor
to treat heart failure, what is the alternative medication?

-1st dose hypotension, renal insufficiency, hyperkalemia, cough, angioedema
- Correct Answers ✅ARBs (-sartans)



what vasodilators are often used to treat heart failure? - Correct Answers
✅hydralazine + nitrates

-good for african americans

-safe in pregnancy

-acts to dec pre/afterload

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-used if pt not able to tolerate ACEi/ARBs/BB or if more control needed



what is the most effective treatment for symptoms of heart failure? -
Correct Answers ✅diuretics

-loop diuretics (-semides) act on inc excretion of Na, Cl, K, H2O (so can go
hypo on these electrolytes), other s/e: hyperglycemia, hyperuricemia

-K-sparing diuretics (spironolactone, eplerenone) aldosterone antagonists;
s/e: hyperkalemia, gynecomastia with spirono

-HCTZ or metolazone (thiazide like diuretic)- s/e: hyponatremia/kalemia,
hyperuricemia, hyperglycemia



what medications are used to treat acute severe heart failure? - Correct
Answers ✅*sympathomimetics* (positive inotropes to inc contractility)

-*digoxin*: but has a narrow therapeutic index (can cause arrhythmias,
seizures, dizziness, GI upset, visual disturbances, gynecomastia); toxicity =
downsloping ST segment; antidote: Digoxin Immune Fab

-*dobutamine*: inc contractility (B1 agonist), peripheral vasodilation

-*dopamine*: inc contractility



giving a synthetic BNP, Nesiritide, works by what mechanism to treat heart
failure? - Correct Answers ✅-dec RAAS activity

-inc Na+/H2O excretion



why are beta-blockers started after ACE inhibitors/diuretics in heart failure? -
Correct Answers ✅want to decrease afterload/preload before slowing
down the heart rate