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Med Surg 2 > Acute Coronary Syndromes > Flashcards

Acute Coronary Syndromes Flashcards

1
Q

if a patient has chest pain what is the first 2 thing we need to do

A

determine if it is cardiac or non cardiac
and how emergent the situation is

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2
Q

how will herpes zoster appear

A

linear rash

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3
Q

what are some examples of cardiac chest pain

A

MI
stable angina
myocarditis
pericarditis
valve disease

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4
Q

what are some vascular reasons why might someone will have chest pain

A

aortic dissection
AAA

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5
Q

what are some pulmonary reasons why someone might have chest pain

A

pneumothorax
pneumonia
bronchitis
tumors
pulmonary emboli

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6
Q

what are some GI issues issues why someone have chest pain

A

ulcer disease
cholecystitis
acute pancreatitis
esophagitis
GERD

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7
Q

if someone has chest pain during exercise this might be what type of angina

A

stable angina

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8
Q

if someone has chest pain during rest this might be what type of angina

A

unstable angina

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9
Q

how to know if the patient is hemodynamically stable

A

vital signs
EKG

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10
Q

should the patient drive themself

A

no call 911

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11
Q

how might coronary ischemic pain present

A

pressure
substernal pain
radiates to shoulder/arm/jaw

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12
Q

how might an aortic dissection be described

A

tearning
may go to arms, abdomen, back, legs

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13
Q

pulmonary emboli present as

A

stabbing
radiates to neck and shoulders
could be assymp.

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14
Q

pneumothorax presents as

A

severe chest pain with sudden onset
sharp

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15
Q

penumonia presents as

A

burning or stabbing
cough

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16
Q

alot of the times if the pain radiates to the legs it is not cardiac except

A

aortic dissection

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17
Q

if there is severe abdominal pain

A

abdominal aortic anyrseum

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18
Q

if pain occurs when lying down it could be

A

GI related

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19
Q

risk factors for CAD

A

> 40
smoking
hypertension
DM
high cholesterol
family history
male
cocaine or alcohol
obesity
sedentary
high BMI

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20
Q

difference between modifiable and non

A

non we cannot do anything about

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21
Q

examples of nonmodifiable risk factors.

A

age
heredity
race
sex

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22
Q

modifiable risk factors

A

cigarette smoking
high cholesterol
hypertension
physical inactivity
obesity
diabetes mellitus

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23
Q

common associated symptoms with MI

A

N/V
syncope

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24
Q

what pain does NTG relieve

A

angina and esophagitis

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25
Q

pain suggestive of ischemia

A

uncomfy pressure and squeezing
imending doom

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26
Q

if someone has sharp or knife like pain that get worse with cough, do we think this is respiratory

A

no

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27
Q

what is the difference between. stable and unstable plaque

A

stable plaque is fixed
unstable has an opening that has platelet aggregation and then forms tighter clot

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28
Q

who might present weird with MI

A

women
diabetics

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29
Q

how might women present after MI

A

fatigue

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30
Q

how might diabetics present

A

not conventionalw

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31
Q

what do we do after intervention

A

reassessment

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32
Q

what is the most specific maker?

A

troponin

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33
Q

how do we draw Tropinin and Ck? why?

A

we draw serial, every 4-6 hours

it takes a long time to elevate and just because it isn’t elevated one time doesn’t mean that it is not cardiac related

34
Q

questions to ask for onset

A

when did your symptoms start
what were you doing when it began

35
Q

questions to ask for provocation/palliative/precipitating

A

did anything bring on the pain
does anything make it better or worse

36
Q

questions to ask for quality

A

how would you describe it

37
Q

questions for region/radiation/referal

A

where exactly is your discomfort
does the pain go anywhere

38
Q

how do we as severity

A

numerical

39
Q

questions to ask for timing

A

does it come and go or is it a constant pain

40
Q

what might diabetics think that MI symptoms are caused by

A

diabetes/ or sugar control

41
Q

stable anina

A

predicatable
typically exercised induced
relieved with nitro

42
Q

unstable angina

A

change in previously established stable pattern of angina
more intense

43
Q

variant/prinzemtal angina

A

midnight to 5am
same time every night
spasm

44
Q

what type of sclerosis do we see

A

atherosclerosis

45
Q

criteria for type 1 MI

A

identification of coronary thrombus by angio inducing intracornonary imaging

46
Q

criteria for type 2 MI

A

imaging evidence of new loss of viable myocardium or new regional wall motion abnormality in a pattern consistent with an ischemic etiology

47
Q

criteria for type 3 MI

A

cardiac death
- patients dead

48
Q

will troponin and CK be elevated right away

A

normally not

49
Q

what coronary artery supplies the nodes most of the time

A

RCA

50
Q

what node does the RCA supply most of the time in most people

A

AV

51
Q

ischemia wave

A

depressed T wave

52
Q

injury wave

A

ST elevation

53
Q

infarct wave

A

depressed Q and ST elevation

54
Q

what might happen post MI

A

bundle branch block

55
Q

which leads are responsible for inferior MI

A

II
III
aVF

56
Q

which leads are responsible for anterior MI

A

V2
V3
V4

57
Q

II
III
avF cause what type of MI

A

inferior

58
Q

II III avf are associated with what coronary artery

A

RCA

59
Q

V2, V3, V4 are associated with what MI

A

anteroir

60
Q

what coronary artery is V2 V3, V4 associated with

A

Left

61
Q

the more leads involved means

A

more severe

62
Q

when might PCI be the treatment of choice

A

cariogenic shock
contraindications of fibro

63
Q

when might we use fibrinolytic

A

if PCI is not used

64
Q

contraincitiaons of fibrinolytic therapy

A

previous hemorrhagic stroke
intracranial bleeding
bleeding now

65
Q

what is the goal for fibrinolytic therapy

A

30 min

66
Q

drugs associated with anticoag

A

heparin

67
Q

drugs associated with platelet inhibitors

A

asprin
glycoprotein IIB/IIIA inhibitors

68
Q

what should be included in our immediate assessment

A

IV
O2
Monitor
ABC

69
Q

how long to do our immediate assessment

A

<10min

70
Q

immediate general treatment

A

MONA

71
Q

MONA
- M

A

morphine
2-4mg q5-10

72
Q

MONA
-O

A

oxygen 4L

73
Q

MONA
- N

A

nitroglycerine
sublingual or IV

74
Q

MONA
- A

A

aspirin 160-325 chew nd swallow

75
Q

complications of PCI

A

closure of stent
groin hematoma
retroperitoneal hematoma

76
Q

what should we monitor for reocculsion of stent

A

ST trend and pain

77
Q

what should we monitor for retroperitoneal hematoma

A

persistent low back pain

78
Q

patient education

A

avoid valsalva
smoking cessation
diet
meds

79
Q

what might cause long QT

A

meds

80
Q

what is a bundle branch block
- defintion

A

block of the entire ventricle of electrical impulse

81
Q

what is our main cue with bundle branch block

A

QRS width
- longer than 0.12

82
Q
A

Med Surg 2 (29 decks)

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