SOB Flashcards
1
Q
What are the new PERC rules to rule out pulmonary embolus
A
Do wells first-If Low risk then do PERC
- Age <50
- Satting >94%
- Pulse <100
- No prior PE or DVT
- No recent surgery or trauma
- No hemoptysis
- No estrogen use
- No leg swelling
2
Q
Wells criteria
A
- DVT
- HR >100
- Imobilization for more than 3 days
- Surgery in the past 4 weeks
- Previous PE/DVT
- Hemoptysis
- PE most likely diagnosis
- Malignancy with treatment discussions in the past 6 months
3
Q
When to use a years score
A
Pregnant patients and suspecting PE
4
Q
Years rules
A
Any of:
- DVT
- Hemoptysis
- PE most likely
Then D Dimer cut off <500
If none of the above D Dimer cut off <1000
5
Q
What tests would you do for SOB
A
ECG Echocardiogram Troponin BNP pH PaO2 CXR PFT CT chest if no clear diagnosis
6
Q
List three life threatening Dx of SOB
A
Foreign body
Anaphylaxix
Pneumothorax
7
Q
Someone comes in with Pneumo. It is unilateral, large, and spontaneous. What do you do
A
Observe for 4 hours, repeat x -ray, discharge if stable
Don’t put in drain
8
Q
List 7 non resp or cardiac causes of dyspnea
A
- Anxiety
- Altitude
- Thyroid
- GERD
- Deconditioning
- Anemia
- Abdominal mass
- Allergy
9
Q
What would you do in office for someone with SOB (Assessment wise)
A
Vitals (HR, SpO2, RR, BP) Home or exertional Pulse ox Peak flow Resp exam CV exam ENT exam including thyroid
