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TCD Week 5
Chest Pain
| Question | Answer |
|---|---|
| 3 causes of CP due to CVS | Angina ACS Aortic Dissection Pericarditis |
| 3 causes of CP due to Respiratory System | PE Pleurisy Pneumonia |
| 3 causes of CP due to MSK | Rib fracture Muscle Injury |
| 3 causes of CP due to skin | Shingles |
| 3 causes of CP due to GI | Peptic Ulcer Disease Oesophageal Spasm Oesophageal Rupture Gallstones (cholengitis and cholelithitis?) |
| the typical symptoms and signs of ACS? | Symptoms: Acute, crushing pain radiating to the jaw or arm Exertional pain relieved by rest Signs: Sinus tachycardia Xanthelasma Tar staining A new murmur of Mitral regurgitations (pan-systolic murmur) |
| Risk factors for ACS? | High blood pressure High blood cholesterol Cigarette smoking Lack of physical activity Unhealthy diet Obesity or overweight Diabetes |
| Typical symptoms of stable angina? | Symptoms: Exertional pain/discomfort in the centre or left side of chest, throat, neck or jaw relieved by rest or GTN within a few minutes May radiate to neck, jaw or left arm Sometimes there may not be any pain but breathlessness (angina equivalent) |
| Signs of stable angina | Examination usually normal except indication of risk factors, e.g., xanthelasma, tar staining on fingers |
| Risk factors for stable angina | Same as ACS |
| Myocarditis signs, symptoms, risk factors? | Symptoms: Fever Dyspnoea Fatigue Chest pain (if myopericarditis) May be pleuritic Recent viral or other infection Signs: Fever Tachycardia Risk Factors: Recent viral illness |
| Pericarditis Signs, symptoms, risk factors | symptoms: Constant or intermittent sharp pain often aggravated by breathing or position (classically worse on lying down and relieved by sitting or leaning forward) Sign: Tachycardia Pericardial Rub Risk factors: Recent viral illness |
| Thoracic aortic dissection signs, symptoms, risk factors: | Symptoms: Sudden, tearing pain radiating to the back Some patients have syncope, stroke, or leg ischemia Signs: Pulsus paradoxus Difference in BP in both arms Risk Factors: ^BP aortic aneurysm Bicuspid aortic valve Marfan’s syndrome |
| PE signs, symptoms and risk factors:: | Symptoms: Sudden onset pleuritic pain with associated dyspnoea and tachycardia. Sometimes mild fever, haemoptysis and syncope Signs: Tachycardia Swollen leg Risk Factors: Immobile Clotting disorders Surgery or broken bone cancer DKA/Sepsis |
| Tension pneumothoraxc signs, symptoms and risk factors | Symptoms: Significant dyspnoea Hypotension Neck vein distension Signs: Tracheal deviation Unilateral diminished breath sounds Hyperresonance to percussion. Risk Factors: Male Genetic Smoking Lung Disease (e.g. emphysema) Marfan’s syndrome |
| Pneumonia signs, symptoms and risk factors | Symptoms Pleuritic chest pain Fever Productive cough Purulent sputum Signs Reduced air entry Bronchial breathing, Crepitations Risk factors: Immunosuppression Older age Underlying chronic lung disease Infective contacts |
| Pleurisy symptoms, signs and risk factors | Symptoms: Pleuritic chest pain. May be exacerbated by cough. May have preceding pneumonia, pulmonary embolism, or viral respiratory infection Signs Pleural rub Risk factors Recent infection |
| Oesophageal rupture symptoms, signs and risk factors | Symptoms: Sudden, severe pain following vomiting or instrumentation Signs Severe epigastric pain with guarding and rigidity Risk factors Gastroscopy Transoesophageal echocardiography Catheter ablation for atrial fibrillation |
| Pancreatitis Gallstones / cholecystitis Hepatitis All symptoms signs risk factors | symptoms: Pain in the epigastrium or lower chest that is often worse when lying flat and is relieved by leaning forward Vomiting Upper abdominal tenderness Signs Epigastric pain Jaundice Risk factors: High alcohol intake Raised BMI Female gender |
| Gerd symptoms signs risk factors | Symptoms Recurrent burning pain radiating from epigastrium to throat that is exacerbated by bending down or lying down and relieved by antacids Sign Mild epigastric tenderness Risk Factors: Raised BMI Stress anxiety Smoking Coffee, chocolate |
| Peptic ulcer disease symptoms, signs, risk factors | Symptoms: Recurrent, vague epigastric discomfort, that is relieved by food, antacids, or both Signs: Epigastric discomfort Risk factors: High blood pressure cholesterol Cigarette Lack of physical activity diet Obesity or overweight Diabetes |
| MSK pain symptoms, signs, risk factors | symptoms: Often suggested by history Pain typically persistent (typically days or longer), worsened with passive and active motion Signs Diffuse or focal tenderness Risk Factors: Recent injury/heavy lifting Osteoporosis |
| Shingles signs and symptoms and risk factors | Symptoms Sharp, band-like pain in the thorax unilaterally Classic linear, vesicular rash Pain may precede rash by several day Signs Rash on chest with vesicles RF Immunosuppression Older age |
Created by:
Mustafak