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Flashcards in SOB Deck (23):
1

symptoms of SOB

pain
fever
cough
fatigue
vom/diarrhea
weight loss

2

common causes of SOB

COPD exacerbation
MI, PE, CHF
pneumonia
anemia (men: norm. HGB: 14-16, women: HGB: 13-15)
maligancy
arrythmias
reactive airway disease (like bronchospasm)

3

5 life-threatening conditions of SOB

status asthmaticus
acute MI
PE
tension pneumothorax
acute pulmonary edema (sim. to CHF, but happens FAST!)

4

SOB dx (besides hx, hx, hx)

CXR (portable)
EKG
CT scan, MRI (diff: MRI-no radiation, good for preggos but time consuming)
V/Q scan (vent/perf scan)
labs
ABG
lower extrem. venous doppler (good alt. to CAT scan)

5

complications of SOB

worsening condition
death/disab. due to underlying condition
med SEs

6

med SEs

arrythmias (albuterol), bleeding (ASA,anticoags), elev. BP (albuterol, antichol, sympathomim.), hyperglycemia (steroids), allergic rxn (abx)

7

SOB tx depends on...

cause
consider risk vs. benefits, poss. complications

8

COPD tx
(bronchospasm, inflammation, mucous production)
typ. chronic, can have acute exacerbation

bronchodilators (albuterol-tachycardia, hypokalemia, zolfamax? $, less SEs)
anticholinergics
steroids
epinephrine (if necessary)
Mag sulfate
O2

9

oxygen capacity depends on ???

HGB, CO

10

MI tx

BOAT MAN (old school)

B-blockers
O2
Aspirin
TPA(thrombolytics) if necessary (less for MI, more for CVA)

Morphine
Anticoags
Nitro (SL, transderm, IV)

newer tx: Plavix (antiplatelet)
coronary angiogram

11

status asthmaticus

(sev. resp. distress-->bronchospasm-->crash) *take over airway!*

12

PE tx/dx
(mostly from legs, R UE)

anticoag (LMWH)
tPA if needed (criteria: worsening even with anticoag, clot is so big need to bust open)
pulm. angiogram (take catheter to clot, sm. doses clot busters (tPA), risk of bleeding)
tx underlying cause of PE (protein C/S def., stasis, OCT)

13

tension pneumothorax tx
(air from outside, trauma)
(emphysema, emboli bust open)

needle decompression (2nd IC space)
chest tube placement (get air/fluid out from pleural space)
tx cause of pneumo

14

acute pulm. edema/CHF
(pump fails, fluid inc. pressure in pulm. vasculature, leaks out-->fluid in lungs)

tx symps:
aspirin
nitro
diuresis (dec. lung flooding, BP, Lasix)
stabilize vitals
O2
BIPAP or intubation (high press O2 to push fluid out)
tx underlying cause of CHF

15

PE risk factors

OCT and smoking!

16

MRI vs CT

MRI-no radiation, good for preggos but time consuming
also those allergic to radiation fluid (also V/Q scan)

17

SOB labs

CBC
Troponin
D-dimer (helps if negative (sens., good at ruling out) , not specific

18

STEMI in DM pts:

SOB, *blunted pain response* NEED EKG
lateral wall
V1, V5 (2+ leads), inferior?

19

most common EKG in PE
most common CXR

sinus tachycardia or S1Q3T3
normal

20

pulmonary HTN causes

right sided heart pressure, dilation
saddle emboli

21

CHF causes

uncont. HTN, MI, valvular heart disease, congenital HD, cardiomyopathies, arrythmia/irreg. heart rhythms (doesn't allow heart to fill), toxic ingestion (cocaine)

22

causes of CHF exacerbation

do not intubate my pt against med ADvice
diet
non-compliance w. meds
infection
MI
PE
arrhythmias
metab. abn
anemia
drugs

23

multilobar pneumonia risk for..

CHF