Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
DU PA Emer CP/Card
Duke PA Chest Pain/Cardiac Emergency
| Question | Answer |
|---|---|
| Deep inspiration sharply worsens __ pain | Pleuritic chest pain |
| Inflammation of pleurae, usually caused by infection or connective tissue/inflammatory dz, friction rub with low grade fever | Pleurisy |
| Pleuritic chest pain, loud P2, right ventricular lift may indicated what | Pulmonary hypertension |
| Pleuritic pain with associated SOB, cough, fever, sputum production, rales and dullness may indicate what | Pneumonia |
| Dyspnea, chest tightness, wheezing and cough may indicate what | Asthma/COPD |
| Severe respiratory distress, frothy pink or white sputum, rales, S3/S4, PND, orthopnea, edema may indicate what | Pulmonary edema |
| Chest pain may be squeezing or pressure like (substerna/epigastric), exertional or at rest, diaphoresis, radiation, N/V, post-prandial, postural changes, spasm and may be relieved with antacids/NTG may indicate what | Heartburn/GERD |
| Innervation for the heart is similar to the innervation of what other organs | Esophagus, and stomach |
| Someone with a Mallory-Weiss tear will have what symptoms other than chest pain | Hematemesis with or without prior vomiting episode |
| Burning epigastric pain, post prandial sx, relieved with food, may have N/V, wt loss, anorexia and bleeding may indicate what | PUD |
| Acute, severe, unrelenting and diffuse pain in chest, neck or abdomen. May radiate to back or shoulders and swallowing may exacerbate pain may indicate what | Esophageal perforation |
| Epigastric/RUQ visceral pain with fever/chills, N/V, anorexia may radiate to back or scapular region may indicate what | Cholecystitis |
| Midepigastric, piercing pain, constant, radiates to back, associated with N/V, abdominal distention, low grade fever, tachycardia and hypotension may be present with what | Pancreatitis |
| Sharp pain, worse with movement/palpitation may be what | Musculoskeletal chest pain due to inflammation or irritation of chest wall structures |
| Rule out MI with serial __ | ECGs and cardiac biomarkers(CK/MB, troponin levels) |
| Deep, pressure-like pain in substernal region, may radiate to jaw, neck or left shoulder/arm. Frequently associated with SOB, transient, precipitated by physical exertion or stress, responsive to rest or SL NTG may be what | Stable angina pectoris |
| Cardiac enzymes should be __ for stable angina | Negative |
| Treatment for stable angina pectoris | 81-325 ASA daily, beta blocker, ACE I, nitrates, statins |
| What does MOAN stand for in the treatment of unstable angina/NSTEMI | Morphine, O2, ASA, NTG |
| Ov ½ of deaths from acute STEMI occur within __ of event from V-fib | 1 hour |
| Physical signs of acute STEMI | HTN or hypotension, tachy/bradycardia, S3 or S4 or both, systolic murmurs, friction rub (day 2 or 3) |
| In acute STEMI early peaked T waves are seen __hrs after event | 0-6 |
| In acute STEMI ST segment elevation is seen in __hrs after event | 0-18 |
| In acute STEMI Q waves are seen in at least __hrs after the event | 18 |
| Conditions causing chest pain and hypovolemia | MI, aortic dissection, leaking AAA |
| There is an increased risk of aortic dissection with __ | Bicuspid aortic valve or coarctation of the aorta |
| >95% of aortic dissections occur in the __ | Ascending aorta just distal to aortic valve or just distal to the left subclavian |
| What makes a Stanford A aortic dissection | Any involvement of ascending aorta |
| What makes a Stanford B aortic dissection | Not involving ascending aorta |
| Sudden onset retrosternal and back pain, may see infarct pattern on ecg, neurologic deficits/CVA, limb ischemia, syncope, shock, hypertensive, pulse discrepancies, tamponade possible may indicate | Aortic dissection |
| Evaluation of acute aortic dissection includes what | CXR, echo, CT, EKG |
| Useful for serial follow-up of aortic dissection | MRA/MRI |
| Appearance of aortic dissection on CXR | Widened aortic silhouette, widened mediastinum, left pleural effusion, 10-20% are normal |
| Medical treatment for acute aortic dissection | Beta blocker then nitroprusside to maintain SBP of 100-120 mmHg |
| Type __ aortic dissection gets surgical repair | A |
| Type __ aortic dissection gets medical treatment | B |
| What exceptions would cause a type B aortic dissection to qualify for surgery | Rupture, limb or visceral ischemia, ongoing pain, saccular morphology, uncontrolled HTN, Marfan’s or AI (rare) |
| Pain if present, described as epigastric fullness or lower back and hypogastric region, gnawing, hours to days in duration, not positional may be what | AAA |
| If suspected in hemodynamically stable pt, __ is 100% sensitive for AAA | Bedside ultrasound |
| 85% of __ is associated with viral etiology | Acute pericarditis |
| Excessive __ can cause hemorrhagic effusion leading to acute pericarditis | Anticoagulation |
| Pleuritic, sharp, stabbing chest pain that radiates to shoulders, back, neck that is worse on deep inspiration or movement, worse supine and relieved by sitting up and leaning forward may be what | Acute pericarditis |
| Occurs when the pressure in the pericardial sac exceeds normal RV filling pressure, resulting in restricted filling and decreased cardiac output is | Cardiac tamponade |
| What is the most common etiology of cardiac tamponade | Malignancy |
| beat to beat variability in the amplitude of the P & R waves unrelated to inspiratory cycle…really only see ~ 20% of time, but is diagnostic of cardiac tamponade if present | Electrical alternans |
| hypotension, elevated systemic venous pressures (JVD), small quiet heart | Beck’s triad |
| what is Beck’s triad | Hypotension, elevated systemic venous pressure (JVD), small quiet heart |
| what is the treatment for cardiac tamponade | Massive volume resuscitation, pericardiocentesis, admit and consider pericardial window |
| severe elevation of BP, no evidence of progressive TOD, absence of raised intracranial pressure is what | Hypertensive urgency |
| short term treatment of hypertensive urgency | Labetalol, clonidine or captopril with outpatient follow up within 72 hrs is recommended |
| hypertensive emergency requires __ reduction of BP | Gradual (not to the normal range) |
| acute severe elevation in BP, evidence of rapidly progressive TOD is what | Hypertensive emergency |
| rapid correction of BP to normal levels in hypertensive emergency puts patient at risk for __ | Worsening cerebral, renal or cardiac ischemia |
| hypertensive urgency usually has a BP of >__ | 220/120 |
| hypertensive emergency usually has a BP of > __ | 220/140 |
Created by:
bwyche
Popular Medical sets