Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med 4 > Approach to Chest Pain > Flashcards

Approach to Chest Pain Flashcards

1
Q

associated sxs w/ typical anginal CP?

atypical?

A

typical- diaphoresis, nausea, dyspnea

atypical- none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what specific things do you need to ask about social hx when interviewing pt w/ chest pain

A

illicit drug use

tobacco use

ETOH use

travel (long car/ plane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

if the CP is relieved by GI cocktail, what is the likely etiology

A

GI causes but does not satisfactorily distinguish from cardiac pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

cough

dyspnea

pleuritic CP

calf/leg pain

A

PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

onset of PE

abrupt/gradual?

A

abrupt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hypotension

JVD

distant muffled heart sounds

A

becks triad-

associated w/ cardiac tamponade

911!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

onset of aortic dissection

abrupt/gradual?

A

abrupt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

if the CP is aggravated by palpation, what is the likely etiology

A

MSK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

if the CP is associated with syncope, what is the likely etiology

A

ischemia

aortic dissection

PE

psychogenic causes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

idiopathic or viral causes of CP

A

pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are some additional studies you should get on a pt w/ CP

A

CBC

CMP

coagulation indices

cardiac enzumes (troponin, CK-MB)

D-Dimer

BNP

CXR (PA and lateral(

EKG

CT chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

if the CP is sharp, what is the likely etiology

A

pulmonary

chest wall

neuropathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PE pt education

A

compression socks

smoking cessation

D/C oral contraceptives

avoid sitting for a long time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

if the CP is worse with respiration, what is the likely etiology

A

(pleuritic chest pain)

pulmonary

chest wall

cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

becks triad

A

hypotension

JVD

distant muffled heart sounds

(associated w/ cardiac tamponade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MSK causes of CP

(less critical)

A

costochondritis

rib fracture

cervical stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

onset of esophageal rupture

abrupt/gradual?

A

abrupt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

if the CP is associated with belching/ dysphagia/ unpleasant taste, what is the likely etiology

A

GI

MI can also cause indigestion/ belching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

postprandial CP

A

GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are some things you should look for in the

abdominal physical exam of CP

A

tenderness

gaurding

masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

westermarks sign

A

PE

(on CXR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

is typical anginal CP reproducible?

atypical?

A

typical- not reproducible

atypical- reproducible w/ palpation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

typical anginal CP location?

atypical?

A

typical- substernal, radiating to neck/ jaw shoulders

atypical- lateral chest wall/ back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

critical GI causes of CP

A

esophageal rupture

perforated ulcer

acute cholecystitis

acute pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
EKG shows diffuse ST elevation and PR depression in multiple leads
pericarditis
26
if the CP is aggravated by exertion, what is the likely etiology
angina
27
onset of pneumothorax abrupt/gradual?
abrupt
28
narrow PP
cardiac tamponade aortic stenosis
29
risk factors for PE
recent sx oral contraceptives/ estrogen DVT long time sitting
30
why would you have an MI secondary to a trauma
thrombosis (throw a clot) coronary artery rupture
31
avascular markings distal to embolus is
hamptons hump | (PE)
32
if the CP is tearing/ ripping/ searing, what is the likely etiology
aortic dissection
33
onset of esophageal perf abrupt/gradual?
abrupt
34
what specific things do you need to ask about family hx when interviewing pt w/ chest pain
family hx of CAD family hx of coagulation disorders
35
if the CP lasts for more than 15 minutes, what is it more likely to be
unstable angina acute MI
36
is typical anginal CP affected by exertion? atypical?
typical- worse w/ exertion and relieved by rest atypical- unaffected by exertion or rest
37
wedge shape on CXR
westermarks sign | (PE)
38
onset of MSK problem abrupt/gradual?
gradual
39
if the CP is associated with diaphoresis, what is the likely etiology
**ischemia** GI causes
40
if the CP is burning, what is the likely etiology
neuropathic (herpes zoster, radiculopathy) GI **ischemia**
41
critical cardiac causes of CP
* Myocardial ischemia * angina * ACS (MI and unstable angina) * Non-ischemic * aortic dissection * cardiac tamponade * aortic anuerysm
42
pericardial friction rub on auscultation elevated CRP
pericarditis
43
ruptured aorta on CXR will show
enlarged mediastinum hemothorax
44
what are some things you should look for in the neck physical exam of CP
JVD carotid bruits
45
hamptons hump
PE | (on CXR)
46
if the CP is relieved by nitroglycerin, what is the likely etiology
ischemic causes esophageal spasm
47
PE drugs
LMWH warfarin factor Xa
48
what are some things you should look for in the cardiac physical exam of CP
rate rhythm murmurs rubs muffled heart sounds
49
if the CP is aggravated by positional changes, what is the likely etiology
MSK most likely pericarditis- worse w/ laying down, better w/ sitting or leaning forward
50
if the CP is associated with dyspnea, what is the likely etiology
ischemia non-ischemic cardiac causes pulmonary causes
51
for CP complaints, who should you take special considerations w/
women diabetics elderly
52
water bottle sign
CHF
53
what specialized exam should you do w/ CHF
hepatojugular reflux
54
if the CP lasts for a few seconds, what is it more likely to be
MSK GI *not ischemic pain*
55
if the CP is aggravated by eating (during/ after), what is the likely etiology
GI
56
what are some things you should look for in the skin physical exam of CP
pallor cyanosis hyperesthesia
57
if the CP lasts for less than 15 minutes, what is it more likely to be
angina
58
kerley B-lines
CHF
59
less critical cardiac causes of CP
* Non-ischemic * HF * pericarditis * stress cardiomyopathy * aortic stenosis * mitral valve prolapse
60
if the CP is dull/ heavy/ tightness/ pressure/ ache/ squeezing, what is the likely etiology
ischemia
61
if the CP is relieved by rest, what is the likely etiology
angina
62
drugs for pericarditis
NSAIDS +/- omeprazole colchicine steroids for refractory
63
if the CP is associated with diaphoresis, what is the likely etiology
GI causes ## Footnote **ischemia**
64
onset of esophageal disease abrupt/gradual?
gradual
65
if the CP is associated with cough, what is the likely etiology
HF PE PNA asthma
66
derm causes of CP | (less critical)
herpes zoster
67
CP is sharp and pleuritic febrile recent viral infxn
pericarditis
68
less critical GI causes of CP
GERD esophagitis esophageal spasm PUD gastritis
69
typical anginal CP duration? atypical?
typical- more than 15 minutes and is progressive atypical- a few seconds or days to months
70
typical anginal CP quality? atypical?
typical- progressive pressure, **achy pain** atypical- sharp/ pleuritic/ positional pain
71
if the CP is associated with psych sxs, what is the likely etiology
ischemia panic anxity
72
less critical causes of CP
PNA pleurisy pleural effusion
73
pt education for pericarditis
rest (activity worsens sxs)
74
less critical psych causes of CP
anxiety panic attack panic disorder
75
if the CP lasts for days to months, what is it more likely to be
not ischemic
76
what are some things you should look for in the extremities physical exam of CP
edema peripheral pulses
77
if the CP is relieved by antacids/foods, what is the likely etiology
GI
78
critical pulm causes of CP
PE pneumothorax
79
what are some things you should look for in the resp physical exam of CP
wheezes rales flail chest chest wall tenderness absent or unequal breath sounds
80
critical psych causes of CP
cocaine/ substance abuse
81
what are some things you should look for in the general physical exam of CP
anxiousness diaphoresis alertness
82
if the CP is associated with palpitations, what is the likely etiology
ischemia (secondary AFib, PVCs, PACs) PE w/ arrhythmias HF w/ arrhythmias
83
CP caused by _____ is diffuse and poorly localized CP caused by ____ is well localized (+/- point tenderness)
diffuse- ischemia/ cardiac localized- MSK/ GI/ pulmonary
84
85
CP worse w/ lying down, better w/ sitting up and leaning forward
pericarditis
86
onset of acute MI abrupt/gradual?
either abrupt of gradual
87
pitting edema SOB CP JVD HTN
CHF

Clin Med 4 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions