‘Aos-ea-a mal reserts oe emergency department wth chest pan. An ECG rete ST ators n ‘East Landay" Tomboy harap on hepa ae samnieres and epan esokes haus ‘radiate patent develops nyptenion He genes ecurenceo ches pan. His teroertue S75 C 06") bod pressuets BUS mm fy pulse 9b, end esratons ae 1Sran Hs rnedcazors nude andogyeern are, bela tock. api, heath and suas. Evanson reals ‘etter venaus peste ot 14em call clr eafenies, an clear ig ls Based on Ns ‘fomaten Whats the net het sep npn’ manager? ‘8 Ba dparane PH 1 8 B Anise rma sne an stopiegheer I] eins ntavraus reser 5] © ite temporary ea pact] Stop trogen an sat data ip (46) Biplanation: seria s08079 Tho ST devators in leads I and AVF inde hat hs pba has sured nn wall myocatal flatcon i). Acte manageret ofan ST sega eaten tocar ration STEM) general ‘ncuiesepeusion(hrembs ao peeutaneous eps) usa rap, morphs, Pepa, utes, andbte lockers. Nukes and ea eka ar cervarceaed ncaa ocumstances, Fowere: Naas ae olin ne act of sate sane econ phosphodetrae vo oe, oF "at verze arin ich occurs reba 30% af eases era th). ie verter Pfatcans severe rahe cause hypaerion dso preset wy palranay era, A YerM ur Patcns preset wth ces ies gue vermis eran aa hyptersin are aso equey seen fie sein fa scan RY rac asm ate. Wen he oleic coke Youre decreases, {aida oul sirpated. There ay medeston ht esuces pron (aes oats) ll ‘Siconetan noe amano, Tete ibe eae Py ase (Choices Aand E) hn cl exuchston door nt mprvehemedynamics, butane maybe ured 2 ‘eres caro cuputaugh ope and rcraope slain Howeter Ppoorsne pobre shold(eins intaverausueserice [5] © iat temporary cara pci [5 Stop trogyeein an iat dare cp (1%) Eiplanaion seria 606973 Tho ST elevator nla I and AVF ingest spar has sured nore wal myocar "farcon i) Acute management of an ST segment seven myocardial rfrcon (STEM) general ‘tutes eperusin(hrembsy sce peetanens erpepse), spttherapy, morRE, Ppamh utes, endbetelckes. Nukes an ea eka re cerarceaedn cela ocunstance, Fowere: Nuaes ae rolinediea ne set of sate stanoi econ phosphodestrae vo oe, oF Fah erica acto ich occurs mre han 30% of eases lero all). hoe veri Platcons sever enough ie case Mypcerion doo preset wih palranay era, i vertu Pfatcons proce uth clean hale. tu venous tartan andhyptenin ate aso requey seen ‘nosing ofa oyna RY efectos mi patent Won the gle coke vou decreases, aida oupulisirpated. Theor, ay medeton ht ecuces pc (aso dubs) ll facerataraer than prove sypioms, Toft slap nb earner vertical ‘iadresvctaon fo nress he avo lune end eohance keh verte Hing. (holes A and Einar a eusetston dbase myrvenemcdyames, dbutine maybe use 2 crease carta cupultcugh nope and hvnaope simu owetr, pers paberts Shols ‘ts vec dparine beauzedobane can worsen hypotension ten ane, {hole 6) ravenous reser woul be naprprie ecause i woultdecreas he prebad his pvere {hole 0) ot ete stoke vie s consonance ne ouput of he Pt ere (RY) [Sopenas one fea rae. eaaes of AV jaca Wercon cogheseaby adhe enperay tings used oytmize RV ou Tha pert however sat raja ucaonalabactive Cerung ee ypaenson and jug venous ditesion te ein of ani al i re sggecte fan FU are Fresurciston te appropte anagem ae nisies shoul be ace “Tine Sper 128 seconds oprah © USHLEWerdLLC. Last ued 111020111Seaueee eeeeeceue aaeees Ao, ele presets a your ec or atte chackup. She has no compas and past. hnedeanstrys naga Shetsnat ig ay medcalons ara oie ug abuse er leu pressue 2 120Go mnlg endear ean, Cardaeaucutan reveals ey acc mura ate eh Serato it ste nox best sep ne anager hs pate? 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Gerona araosanhy 1 © 0 Ecracacorpty 4) E Nofrther woop 23K Eoplanation sera: sono72 Daca nd continous murmurs reveled on cade uscuaion shoul avays be vestigate, because ‘hereby hata oma eaves resets Nah Mioytle so marr ade IND ah Ssymptomat: Yeung poe fe sun benign ard reed nother wou choles) Tarseracic Beppe echocasograpy is ararnasve ana very ee tol corte presente Tow nora, rahe couse. ad oscess te ont oe prob Ctetraaton and angeaapy (holes C) can ales een ctr detet an aseees te seventy ot ‘epoca, bt ls esi hereto, echcerdegyapy ie eplyed st (hasta) (Chloe Bana eerecatoyan (Chole A) reo ran specie ana havelrteuse Such [Esvcatonal Objectve: Disa nd conus murmurs aswel 3 ud systole murorsreveae on caracavscutaton suid avers be nese using anshracl Dome echocadozephy Misystte sot murs race) Flanasnreteaveyeungpaten se us) beng nd need nourher weet Conia USHLEWortLLC. ast ue 117102011)Aye Cauca male presets oor aie caroaning a pogesane eral depres has Become especalybomarsome ree pave mnths reset, Pe becaes cht fet ater Sma ene Noh at'stara. He dens any agra pens nti pat Hester ay Meson Se dens smoky or aing dol Hs temperate 372°C (87) uses Ta, od Pressures a0?s mmat Ha an espratans we Iara Chest examination evegs harsh sake frau best ead al he gt aceon econ pace wh adn along me crc aris. An. Aisheatd tte apex Sand en ese rags, temas May caise os parts SMS? XW A Wipatephic coamepay BM) 1 Nyoman vate degeneration (Rhoumste hart ssa 6] 17 6 B.Beuspd ane vane [735] Seneca mre ent 8) Biplanation: seria 808079 Tis part appears tobe suing rom cengesve het faite as a consequence aot stenosis. A arch seals numa ete ih upr tral ede wi fodabon tothe cate anos sa dasa ‘osenptn te mur caused by aut stenosis. The 4 ecu asthe suk kal ick apa ‘tierce, nate steoae, th hah rebtarce gered bye stonooed sri ab cauree oncerte hypertohy and sue al ele vere esukngnhw 4. Thence ost cron causes Sr soe rusts nw dene populate oe see cae ate eros Beuspdl cre ae an ‘euch dona. The moat mparantrt the ndeiyg ebay ef hs patens ane senate Ns elavel ya age. Atcuspd arc ve ste cause fae senoasn the gry a aber under yeas ob sos se most MB cause ois parts ate stron (Choice AT murat perio coon canbe can coke ahem ‘rrr ef typertape coomycpaiy usualy bot apprcted me lowerlok emalrce an bee Tinpealy dee athe coe {Chole 8) yamacus ve degeneration she pica patio erty tat causes ial ve elapseere Beesaae ceueseaeags seeceueee fi (Rheum heat bea |] 1. Bcospi ani whe [35] E Sane calc are sensi 10%) Eoplanation sera: son072 “Ths tert appears tobe suing fom conesve heat as consequence zr stn. A Fare seals ram eri upper eral ede wih radon othe ct aes saa: ‘hscipbond the mur cavee by abi tenes. The St ecuts asthe es eh ai ck apo Setvertce. mace Seow he gh esitance geneted Oye stetosed aoe va causes Eoncerte hpertopy and ser fle verte resin nie 8. The tee ost oman causes {toe terosis Owe goers populten we sek ce ate eros buspar var ar Freamae eat asease The res important the nde ebaegy spate are ene Fase yong age Abc\spd atv ste cause of are senossn the Met of pabe ner TD years of 50s sth rose caise cl spades ave sirois {hole A) The maar of hypertopticcaomyapaby canbe esl conte witht ar eros. But es can ease aoystok creaands docteacado murmur ad ar 4. Howe, De ‘murmur typertophcardomyopaty usualy bet apprcted nf lowe et teralberde ahd oes rolbpealyeaatetathecwobda. (Choice B) aroma ake egeertin ste pia png erty that eauses mia va plas {hole 6) As mertones above, heumatic heat disease canbe cause of arc seno's. However, is 3 Fnuchbsstomion cause anor sn alie abe toss of 3 BCUSP! ae Ve {choice ] Sent cae ote snes semis conmrn cause sate tnt pars wha re Seren 70 years As people age Ie ate Yate cn accurate eum. causa Sens, Edvatonl objective: “There mos conan couse of ue tress he geal poplaon ae cence are enon, cusp are ae aratheumate taatsesae Aheugpd aoe ve the couse aoe eras ‘hemoprty af poerts uncer 70 year oe “Tine Spert 10 seconds oprah © USHLEWerdLLC. Last ued 111020111Aster woman acid athe nrc caret th penser. Sheiereceingnavacsactne Sensors eating cman recur escrcd by akc ine TM i Her EEE tice ane eae maw ening Pumonay capllay welgepessue — SmmHg 612MM) Moe venus agen Saban ast 55-755) ‘me oe tog se mas hay caise hs pater conan? 1 Cadogan shock] £8 Perc amponade (gh verano (1255) 6 0 Sete hock 40] x. € Volume deplson B21 a planar > Hemodynamic measurements in shock ED ight presse 2 ‘bras g Pumonary capo x wedge premure | Mean of mm B‘is patents resenstion wn ow puroray epi weap passe PCWP) and gh mies vn pen stron (v0) mas conan an sate shack See stock sa lm Sabie shock ‘ete an uneriogayeami fectonimotang becca este. The syternewlarmaty response aise potpraocolaaton ad detoace seam vce eitarce (VR). The deceared ond ‘wreung tse heat ase ewes POWP. Cardat ouput een cease le comgorcale snd marae sdequetzsv parson 140, high dete hypetdyame crear, prope tibaon ot cardiac cuter andinaity oe wins to aden ena omen Hypotension. wa ea) co (ae) ferertes ond aerator els af caren circa nia (hole ) Cartogene shocks usu ue to giant vere since an eases pry ‘uncton Tere aten iow ctdac aul, etee PCP and creased SVR. Tedetessed ara Sup de:tases sue peu, wh Sgn tesues to exrae more oxygen Hom Me Mood an ecrease ino, (choice B) Percaaltargonace causes teased rt aan vere resus nan to horace equtzaon or ala Nh verter end dasioke, NSPCM pressures Ade: ase 8 ‘ia ops woud alo cats low moet venous yen seu {hoice C) Pains wih igh ercarniacin hve reduced asd ven othe etic, whichin deans ci pe se eat tr ye hton ale mond Feaiced casa: cup ad tase pepe, (hole) Hypvaec shack hs reuced preload PCP) nd reduced cardiac ouput, SVR ineeaces ‘anatent io mariah adoqtepeusonte the val ons. YO, Slow duet redvedtssu peson fd ieraaedongeneeracten by nypoperied ese évcatonal objective: ‘Thetase undemapateshysoarin snc shockis the decrease sytem vaccusresicance dct rr pesperd veer Herodrramicmontarnan ec pts shows le paronaycapony ‘age reste, bw semi vastus eine, Meese cae eat, Sed gh Me! VEN OREN