5.8.2013(Chest Pain)

Question 0

Common sites of radiation of anginal pain

Answer 0

Neck
Jaw
Teeth
Shoulder
Arms

Question 1

Most common cause of chest pain other than MI

Answer 1

Gastro esophageal causes 
  GERD
   PUD
   Esophageal motility disorders
  Gall stones

Question 2

Aggravating factors of SIHD

Answer 2

Exertion
Emotional excitement
After heavy meals

Question 3

Duration of anginal pain

Answer 3

2-10min

Pain that is fleeting or lasts for several hours is rarely anginal

Question 4

Diff btw chest pain due to angina and ACS

Answer 4

ACS pain
  At rest or awakens from sleep
  Not relieved by nitrates
  Prolonged
  Associated symptoms

Question 5

Cardiac syndrome X

Answer 5

Anginal pain
ST segment depression
Normal coronary arteriograms

Question 6

Cause of pain in pericarditis

Answer 6

Inflammation of parietal pleura

Question 7

Diseases affecting pericardium that cause pain

Answer 7

Infectious pericarditis(as it involves adjacent pleura)
No pain
  Uremic pericarditis
  Post MI pericarditis
  Cardiac tamponade

Question 8

Characteristics of pericardial pain

Answer 8

Shoulder,neck to abdomen and back
Worse in supine position
Relieved by sitting upright and leaning forward
Aggravated by coughing or deep respiratory movements

Question 9

Aortic dissection in women under 40yrs of age occur during

Answer 9

Pregnancy

Question 10

Pain of aortic dissection

Answer 10

Sharp,severe pain in chest and between shoulder blades

Question 11

Pain of thoracic aortic aneurysm

Answer 11

Usually asymptomatic

But steady deep chest pain

Question 12

Onset of peptic ulcer pain

Answer 12

60-90min after a meal

Question 13

Dermatomal distribution of chest pain

Answer 13

Intercostal muscle spasm
Cervical disc disease
Herpes zoster

Question 14

Most common cause of anterior chest musculoskeletal pain

Answer 14

Costochondral

Chondrosternal pain

Question 15

ECG changes in emotional chest pain

Answer 15

Hyperventilation induced ST T wave abnormalities

Question 16

Which has high likelihood of MI?

Radiation to rt or lt shoulder

Answer 16

Rt shoulder

Question 17

Role of therapeutic trials with nitroglycerine and antacids in diagnosing MI?

Answer 17

MI cannot be ruled out

Question 18

Lab test in aortic dissection

Answer 18

Elevated D dimer levels

Question 19

Indications for chest X ray in chest pain cases

Answer 19

CCF
valvular heart disease
Aortic dissection
Pericardial disease
Aneurysm

Question 20

Sensitivity of ECG in diagnosis of AMI

Answer 20

20-60%

Question 21

Chest pain characteristics that have low likelihood ratio

Answer 21

Sharp,stabbing pain

Question 22

Duration of cardiac chest pains

Answer 22

Stable Angina- 2 to 10 min
Unstable angina- 10 to 30 min
MI- more than 30min