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Block 13 - The Development of Cardiorespiratory Disease > ALS Lecture 8 - Cardiac Symptoms and Signs DONE > Flashcards

ALS Lecture 8 - Cardiac Symptoms and Signs DONE Flashcards

1
Q

spectrum for acute coronary syndrome (3)

A

unstable angina, NSTEMI MI, STEMI

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2
Q

unstable angina

A

angina without exertion

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3
Q

NSTEMI (3)

A

non-ST elevation MI, partial blockage coronary artery, raised troponin

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4
Q

STEMI (2)

A

ST elevation MI, completely blocked artery

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5
Q

cardinal symptoms of acute coronary syndrome (8)

A

chest pain, breathlessness, palpitations, syncope, haemoptysis, oedema, cough, fatigue

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6
Q

acute coronary syndrome chest pain character

A

crushing ischaemic pain

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7
Q

acute coronary syndrome radiation

A

left arm, jaw

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8
Q

SOCRATES

A

site, onset, character, radiation, associated symptoms, time course, exacerbating/alleviating factors, severity

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9
Q

cardiac chest pain

A

site

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10
Q

character of cardiac chest pain (2)

A

tight, crushing

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11
Q

time course of MI

A

always there

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12
Q

time course of angina

A

comes with stress/exertion

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13
Q

label the diagram of cardiac chest pain (A)

A

done

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14
Q

chest pain is not likely to be stable angina (4)

A

prolonged, unrelated to activity, brought on by breathing in, other symptoms

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15
Q

fill in the table of classification of chest pain (B)

A

done

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16
Q

fill in the table of classification of angina (C)

A

done

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17
Q

fill in the table of angina vs MI pain (D)

A

done

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18
Q

pericarditis pain character (2)

A

sharp, stabbing

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19
Q

pericarditis is worse with (2)

A

inspiration, lying flat

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20
Q

pericarditis is eased by (2)

A

sitting up, NSAIDs

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21
Q

pericarditis comes on (2)

A

hours, days

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22
Q

pericarditis causes (2)

A

infection, pericardial infusion

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23
Q

pericarditis changes on ECG (2)

A

concave scooped ST elevation on all leads, PR depression

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24
Q

look at the ECG example of pericarditis (E)

A

done

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25
Q

aortic dissection pain character (4)

A

sudden, tearing, knife-like, excruciating

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26
Q

aortic dissection radiates to

A

back

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27
Q

aortic dissection is often seen in (3)

A

elderly, hypertension, stressful job

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28
Q

aortic dissection associated symptoms (20-40%)

A

abdo pain

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29
Q

pulmonary embolus pain character

A

pleuritic pain

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30
Q

pulmonary embolus associated symptoms (4)

A

SOB, tachycardia, AF, tachypnoea

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31
Q

look at the diagram of the diagnostic algorithm (F)

A

done

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32
Q

acute coronary syndrome is an umbrella term that encompasses (3)

A

unstable angina, NSTEMI, STEMI

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33
Q

bretahlessness can be (2)

A

dyspnoea, tachypnoea

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34
Q

dyspnoae

A

uncomfortable awareness of breathing

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35
Q

tachypnoea

A

faster breathing than normal, >24breaths per minute

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36
Q

pulmonary oedema time course (2)

A

abrupt, minutes

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37
Q

pulmonary oedema breathlessness associated symptoms (4)

A

pink frothy sputum, orthopnoea, cold, clammy

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38
Q

pulmonary oedema causes (3)

A

MI, left ventricular dysfunction, renal artery stenosis

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39
Q

pulmonary embolism chest x-ray (3)

A

cardiomegaly, bats appearance (fluid/congestion), fluid in interstitial space (kerley B lines)

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40
Q

paroxysmal nocturnal dyspnoea (5)

A

breathless, wake from sleep, frightening, cough, wheeze

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41
Q

how long does PND last?

A

15-30mins

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42
Q

PND relevant question

A

do they have to sit up whilst sleeping?

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43
Q

PND causes (2)

A

reduced respiratory drive, adrenergic activity of myocardium at night

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44
Q

chronic heart failure symptoms (5)

A

exertional breathlessness, orthopnoea, nocturnal cough, PND, ankle oedema

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45
Q

classes of chronic heart failure symptoms (1-4)

A
  1. none
  2. severe exertion, more than normal
  3. modest exertion
  4. at rest
46
Q

sensitivity is the probability of a

A

positive test in patients with disease

47
Q

specificity is the probability of a

A

negative test in patients without disease

48
Q

palpitations

A

unpleasant awareness of heart beat

49
Q

syncope (3)

A

fainting, collapse, due to cerebral hypoperfusion

50
Q

exertional syncope worrying in young people as it could indicate

A

underlying heart disease

51
Q

in syncope it is important to try and get

A

witness account

52
Q

defining characteristic symptoms of syncope (5)

A

transient, self-limited loss of consciousness, falling, rapid onset, prompt spontaneous recovery

53
Q

questions about circumstances prior to syncope attack (5)

A

position, activity, situation, predisposing factors, precipitating events

54
Q

questions about onset of syncope attack (5)

A

nausea, vomiting, cold feeling, sweating, aura

55
Q

questions about syncope attack, eye witness (4)

A

skin colour, duration, movements, tongue biting

56
Q

questions about end of syncope attack (7)

A

nausea, vomiting, cold feeling, confusion, skin colour, wounds, aches

57
Q

questions about background of syncope patient (5)

A

happened before, fh, cardiac disease, medication, neuro history

58
Q

pink frothy sputum (1)

A

pulmonary oedema

59
Q

clear white mucoid sputum (2)

A

viral, longstanding bronchial irritation

60
Q

thick, yellowish sputum (1)

A

bacterial

61
Q

rusty sputum (1)

A

pneumococcal pneumonia

62
Q

blood streaked sputum (4)

A

TB, bronchiectasis, lung cancer, pulmonary infarction

63
Q

haemoptysis causes (4)

A

pulmonary oedema, mitral stenosis, pulmonary infarction, lung cancer

64
Q

haemoptysis

A

expectoration of blood, streaked or lots

65
Q

peripheral oedema causes (4)

A

cardiac failure, chronic venous insufficiency, hypoalbuminaemia, drugs

66
Q

ankle oedema isn’t

A

specific/sensitive for coronary heart failure

67
Q

peripheral oedema can also be caused by

A

low protein states

68
Q

low protein states that can cause peripheral oedema (5)

A

nephrotic syndrome, cirrhosis, low albumin, drugs, pregnancy

69
Q

jugular venous pulse is a measure of

A

right atrial pressure

70
Q

JVP normal height

A

2-3cm, elevated >4cm

71
Q

label the graph of JVP height with time (G)

A

done

72
Q

causes of elevated JVP (5)

A

heart failure, constrictive pericarditis, cardiac tamponade, renal disease, SVC obstruction

73
Q

large A waves in JVP causes (3)

A

pulmonary hypertension, tricuspid stenosis, cannon waves in CHB or VT

74
Q

JVP no A wave cause (1)

A

atrial fibrillation

75
Q

JVP giant V wave causes (3)

A

complete heart block, VT, tricuspid regurgitation

76
Q

JVP steep Y descent cause (1)

A

constrictive pericarditis

77
Q

schamroth window test (3 steps)

A
  1. pt holds nails against each other
  2. should be diamond space
  3. if missing = clubbing
78
Q

clubbing of toes but not fingers indicates (1)

A

patent ductus arteriosus

79
Q

clubbing causes (3)

A

infective endocarditis, congenital cyanotic heart disease, atrial myxoma

80
Q

splinter haemorrhage causes (5)

A

gardening, infective endocarditis, vascular disease, rheumatoid arthritis, systemic lupus erythematous

81
Q

palmar erythema causes (2)

A

high oestrogen, liver disease

82
Q

peripheral cyanosis cause (1)

A

deoxygenated Hb rises

83
Q

capillary refill should be

A

<2-3secs

84
Q

general inspection steps (3)

A

breathless, hands/nails, face

85
Q

in the face look for (5)

A

central cyanosis, anaemia, poor oral hygiene, high arched palate, malar flush

86
Q

look at the pictures (H)

A

done

87
Q

pulse rate

A

count for 15secs, times 4

88
Q

tachycardia

A

> 100bpm

89
Q

bradycardia

A

<50bpm

90
Q

1st heart sound

A

closure of mitral and tricuspid valves

91
Q

2nd heart sound

A

closure of aortic and pulmonary valves

92
Q

breath sounds (4)

A

crackle, wheeze, rhonchi, pleural rub

93
Q

crackles (3)

A

explosive, sharp, discrete bursts

94
Q

wheeze (3)

A

continuous, high-pitched through respiration

95
Q

rhonchi (3)

A

low-pitched, disappear after cough, no consequence

96
Q

pleural rub (3)

A

sound of inflamed pleurae, vibrations, PE

97
Q

palpation (3)

A

apex beat, thrills, heaves

98
Q

where is the apex beat?

A

5th intercostal space, mid-clavicular line

99
Q

osler nodes (2)

A

painful lesions on fingers, deposition of immune complexes

100
Q

janeway lesions (2)

A

black spots on thenar/hypothenar eminence, septic emboli

101
Q

roth’s spot (2)

A

retinal haemorrhage, infective endocarditis

102
Q

when auscultating, listen to (3)

A

heart sounds, added sounds, murmurs

103
Q

S3 sounds like

A

ken-tuc-ky

104
Q

S4 sounds like

A

ten-es-see

105
Q

gallop rhythms

A

S3, S4

106
Q

S3 is

A

start of diastole after S2

107
Q

S4 is

A

end of diastole before S1

108
Q

S3 causes

A

failing left ventricle (dilated congestive heart failure)

109
Q

S4 causes (4)

A

blood into hypertrophic ventricle, aortic stenosis, hypertension, hypertrophic cardiomyopathy

110
Q

S4 is best heard at

A

cardiac apex

111
Q

heart murmur is very common in

A

prosthetic valves

112
Q

label the table of aortic stenosis vs. sclerosis (I)

A

done

Block 13 - The Development of Cardiorespiratory Disease (14 decks)

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