BCEN Respiratory Emergencies Flashcards

A patient on anticoagulation presents with dyspnea, tachycardia, and pleuritic chest pain after a long flight. What diagnosis must be ruled out?

Answer: Pulmonary embolism

Pulmonary embolism classically follows prolonged immobility and presents with dyspnea, tachycardia, and pleuritic chest pain.

Which diagnostic test is the gold standard for confirming pulmonary embolism?

Answer: CT pulmonary angiography (CTPA)

CT pulmonary angiography is the gold standard for diagnosing PE due to its high sensitivity, specificity, and wide availability.

What does the CURB-65 score assess in pneumonia patients?

Answer: Severity and need for hospitalization

CURB-65 evaluates confusion, urea, respiratory rate, blood pressure, and age ≥65 to determine pneumonia severity and disposition.

A COPD patient presents with worsening dyspnea and a PaCO2 of 65 mmHg. What ventilatory support should be initiated first?

Answer: Non-invasive positive pressure ventilation (NIPPV/BiPAP)

BiPAP is the preferred initial ventilatory support for hypercapnic COPD exacerbations, reducing the need for intubation.

Which intervention is contraindicated in a patient with epiglottitis suspected in the ED?

Answer: Direct visualization of the throat with a tongue blade

Forcing visualization of the throat in epiglottitis can trigger complete airway obstruction and should be avoided unless in a controlled setting.

What is the characteristic barking cough and inspiratory stridor in a child most likely caused by?

Answer: Croup (laryngotracheobronchitis)

Croup causes subglottic swelling producing the classic seal-like barking cough and inspiratory stridor, most commonly due to parainfluenza virus.