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IPAP > Cardiology: Block 1 > Flashcards

Cardiology: Block 1 Flashcards

1
Q

In humans, the formation of a linear heart tube from the primary cardiac crescent occurs between days _ and _ of gestation

A

21 - 23

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2
Q

Looping of the heart tube and trabecular formation of the ventricle occur at day _ of gestation

A

26

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3
Q

At __ weeks, the embryonic interventricular communication closes, followed by thickening and remodeling of the ventricular walls in the first trimester

A

6

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4
Q

By the end of week __, heart development is essentially finished, although the heart continues to enlarge throughout gestation

A

7

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5
Q

What happens during Phase 0 of myocardial contraction?

A

Depolarization
Na channels open, + Na flow into membrane causing depolarization
Na depolarizes SA Node

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6
Q

What happens during Phase 1 of myocardial contraction?

A

Brief repolarization
Peak positive point as Na influx slows and stops
K leaks out
Slow voltage Ca channel opens allowing influx and transition to Phase 2

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7
Q

What happens during Phase 2 of myocardial contraction?

A

Plateau phase
Influx of Ca balances w/ efflux of K
Ca influx initiates troponin and myosin causing contraction and marks the beginning of a contraction

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8
Q

What happens during Phase 3 of myocardial contraction?

A

Repolarization
Voltage gated K open and allows efflux from cell causing rapid repolarization and includes completion of contraction and relaxation

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9
Q

What happens during Phase 4 of myocardial contraction?

A

Resting Potential

K is equal intra/extracellularly and allows for resting potential and is ready to receive action potential

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10
Q

Ca inflow/K outflow occurs during Phases _ -_

These phases represent what event?

A

1-3

Myocardial contraction= QRS complex

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11
Q

What process returns the myocardium to a resting state?

A

NKAtp

Sodium Potassium Adenosine Triphosphatase

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12
Q

What four processes can cause/lead to myocardial atrophy?

A

Bed rest
VAD
CA
Weightlessness

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13
Q

What two processes can cause/lead to physiological hypertrophy?

A

Exercise

Pregnancy

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14
Q

What three processes can cause/lead to physiological hypertrophy?

A

HTN
MI
Neurhumoral activation

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15
Q

What happens when persistent stress is present on a pathologic hypertrophied heart?

A

Heart failure

Ventricular arrhythmia

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16
Q

What are the layers of the pericardium?

A

Fibrous layer
Parietal / Serous- forms sac
Pericardial cavity
Epicardium / Visceral

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17
Q

How much pericardial fluid is contained within the pericardium and where does it come from?

A

10-20cc formed by the serous layer

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18
Q

What happens if there is too much pericardial fluid?

A

Pericardial effusion then inflammation

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19
Q

What direction does the heart sit in the chest?

A

Rotated Left
Tilted forward
R ventricle- most forward
L atrium- furthest posterior

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20
Q

What borders the heart?

A 
Anterior= sternum and L side of costal cartilage 3-5
Post= descending aorta, esophagus, trachea and posterior lungs
Lateral= lungs
Superior= ascending aorta and superior vena cava
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21
Q

What is a normal PMI diameter?

A

1 - 2.5cm

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22
Q

What is Erb’s Point best used for hearing?

A

Aortic/Pulmonic origin
HCM
Aortic insufficiency

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23
Q

What does it mean if a cardiac pulsation is visible lateral to left MCL?

What does a sustained apex impulse mean?

A

Cardiac enlargement

LVH

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24
Q

On a lateral x-ray, what forms the anterior border?

What primarily forms the posterior border?

A

Superior- pulmonary trunk
Inferior- right ventricle

Left ventricle, inferior vena cava

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25
Q

Characteristics of S1

A

Closure of M/T valves (vetricular contraction)
Timed w/ pulse in carotid artery and onset of systole
Heard at 5ICS and critical for maintaining pressure
Hypovolemia induced regurg heard here

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26
Q

Characteristics of S2

A

Closure of A/P valves

Corresponds w/ onset of diastole- 2/3 and most important part of cycle

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27
Q

Define Physiologic Splitting

A

Inspiration delayed closing of pulmonic valve preceded by aortic valve closing from the decrease in intrathoracic pressure

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28
Q

Characteristics of S3

A

Dull/low pitched signaling the filling of ventricles after S2 during diastole and associated w/ lower leg swelling
Most of time= pathologic
Usually caused by: CHF, mitral/tricuspid insufficiency

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29
Q

What is a pathologic finding in S3 called?

A

Ventricular gallop from volume overload
S1 S2 S3
Slosh ing in

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30
Q

Characteristics of S4

A

When atria contract late in diastole

Caused by HTN

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31
Q

What is called an Atrial Gallop?

A

Stiff ventricle noise heard during S4 from pressure overload
a STIFF wall
S4 S1 S2

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32
Q

Right atria received deoxygenated blood from what structures?

A

Sup/Inf Vena cava

Coronary sinus

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33
Q

Define Atrial Kick

A

When both atria contract act the end of diastole and correlates w/ S4

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34
Q

What structure in the right ventricle houses/carries the right bundle branch?

A

Moderator band

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35
Q

How much thicker is the left ventricle than the right?

What else is different about the left ventricle?

A

3x thicker

Only 2 papillary chordae, more of a sheet of fibers

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36
Q

AV valves open during ?, close during ? and correspond with ?

A

Diastole
Systole
S1 and pulse in carotid artery

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37
Q

What are the two leaflets of the mitral valve called?
The mitral area is AKA ?

What are the three leaflets of the tricuspid valve called?

A

Anteromedial/Posterolateral
Apical/Apex

Anterior, Medial, Posterolateral

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38
Q

What causes the semilunar valves to close and in correspondence with ?

A

Open during systole, close during diastole from backwards pressure
S2
Aortic + pulmonic closing= DUB

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39
Q

What are the 3 cusps of the aortic valve?

What are the 3 cusps of the pulmonic valve?

A

Right, Left, Non-Coronary cusp

Anterior, Right, Left

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40
Q

When do the papillary move and in what direction?

A

Pull leaflets down and together at onset of isovolumtetric ventricular contraction to prevent regurgitation

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41
Q

Tears or ischemia of papillary muscles cause regurgitation of ? valve and is often heard during?

A

Mitral

MI

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42
Q

Where are the ostia that feed the coronary arteries?

When are they supplied w/ blood?

A

Behind L and R coronary cusps

Fill during diastole

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43
Q

What parts of the heart does the RCA supply blood?

A 
Inf/Post wall of L ventricle
R atrium
R ventricle
Posterior 1/3 of septum
SA/AV node
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44
Q

What does the posterior descending artery supply?

A

Parts of septum

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45
Q

What does the LAD supply blood to?

A

Anterior 2/3 of septum
Bundle branches
Anterior left ventricle

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46
Q

What does the LCX supply blood to?

A

SA node (25% of PTs)
Lat/Post L ventricle
L atrium
PDA in 10% of PTs

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47
Q

What is the sequence of events during depolarization and PQRST?

A 
SA node
Interatrial/nodal path
AV node
Junction/His bundle
R/BB
Ant/Post facicles
Purkinje fibers
Ventricle
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48
Q

Autonomic nervous system regulates cardiac output through regulation of what 3 things?

A

SA node pacemaker rate
Myocardial contractility
Vascular smooth muscle tone
(HR, impulse speed, contraction force)

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49
Q

NS that influences the cardiac cycle emerge from what part of the spine and innervate ? structures through ? types of receptors?

A

T1-5
Meet at cardiac plexus near aorta arch
Innervate through Beta-1 receptors
SA Node, Atria, AV node, ventricles

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50
Q

How does the parasympathetic NS slow the HR/force?

A

Dorsal motor nucleus to vagus nerve to the SA node, Atria, AV node and Ventricles

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51
Q

What is the equation for CO?

A

CO= SV x HR
SV- volume ejected w/ each contraction
HR- number of beats/min

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52
Q

Define Preload

A

Load that stretches heart muscle prior to contraction (ventricle wall tension at end of diastole)

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53
Q

What are the 4 components of preload?

A

Total volume
Distribution of blood
Atrial contraction
Compliance

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54
Q

How is CO measured?

A

Ventricle end diastolic volume
Ventricular end diastolic pressure
Directly measured during left heart catheterization
Estimated during right heart catheterization through pulmonary capillary wedge pressure

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55
Q

Define Afterload

What two factors determine it?

A

Force that the left ventricle has to pump against

Aortic pressure- mean BP
Volume of ventricular cavity and thickness of ventricular wall

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56
Q

What factors influence aortic pressure?

Define Law of LaPlace

A

Peripheral vascular pressure
Blood volume

Afterload increases, SV and CO decrease

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57
Q

What 3 mechanisms contribute to the regulation of HR?

A

Autonomic NS
Bainbridge reflex response to atrial stretch
Thoracic pressure changes during respiration of venous return

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58
Q

What 5 physiological things can affect the heart?

A 
Hypoxia
Hypercapnea
Ischemia/Infarct
Acidosis
ETOH
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59
Q

What are the Hs and Ts?

A 
Hypovolemia
Hypoxia
H+ excess
Hypoglycemia
Hyperkalemia
Hypothermia

Tension Pneumo
Tamponade
Toxin
Thrombosis

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60
Q

Narrow QRS’ is a ? problem

Wide QRS’ is a ? problem

A

Mechanical/RV

Metabolic/LV

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61
Q

Define the Bainbridge Reflex

A

Response to atrial stretching
Baroreceptors cause increased HR
Inc HR allows body to redistribute blood volumes

62
Q

How is primary cardiac function assessed?

A

Ejection Fraction

Fraction of end diastolic volume ejected from ventricle ejected during systolic contraction (55-75%)

63
Q

Ejection fraction can’t be directly measured, how is it estiimated?

A 
Nuclear ventriculography
Echo
MRI
Gold Standard= cardiac catheterization
EF=SV/end diastolic volume
64
Q

What are the two acute and chronic mechanisms for compensation?

A

Acute= Frank Starling, Sympathetic Stimulation

Chronic= Ventricular Hypertrophy/Dilation

65
Q

Define Frank Starling Mechanism

A

Relationship between stroke volume and end diastolic pressure
SV increases in response to increased volume of blood in the ventricle before contraction

66
Q

What does the Frank Starling curve estimate?

What is the difference between inotrope and chronotripics?

A

CO vs Preload

Inotrope- alter contractions
Chrono- alter HR

67
Q

Done w/

A

Lect 1

68
Q

Why are PA and Lateral Chest x-rays ordered?

When should the be ordered?

A

Structure/function of heart, lungs, and great vessels

Nearly every PT with potential cardiac presentation within 30min

69
Q

What are the primary indications of getting a CT scan for cardiac PTs?

A

Suspected great vessel problems including aortic aneurysm/dissection in a stable PT
Pericardial abnormalities

70
Q

CT scans of the heart, when indicated, can be used to evaluate what four things?

A

Great vessels
Pericardium
Myocardium
Coronary arteries

71
Q

What is the main use for Electron Beam CT Scanners?

A

Evaluate pericardial disease and cardiac tumors

72
Q

Define Agatstan Score and it’s use

A

When CT scan is performed correctly, score is achieved and correlates w/ atherosclerotic plaque burden and considered a cardiac risk predictor

73
Q

What are the benefits and limitations of newer generation CT scanners?

A

Benefits- quick, less invasive than angiography, inexpensice

Limits- contrast dye, significant radiation exposure, artifacts from movement, no degree of stenosis present

74
Q

MRI is AKA? and best used for ?

A

Cardiovascular magnetic resonance

Differentiating tissues w/out contrast

75
Q

What are the indications for ordering a CMR?

A

Same as CT but w/ greater potential to evaluate function, perfusion, viability, tissues, blood flow and morphology

76
Q

Define CMRA

A

Cardiovascular magnetic coronary angiography

Sensitive/accurate for CAD in LMCA and proximal midpoints of 3 coronary vessels
Congenital coronary abnormalities

77
Q

What is the use of a MRI w/ contrast?

A

Gadolinium used to find infarcted area to distinguish between reversible and non-reversible areas

78
Q

What are the two purposes of US imaging?

A

Cardiac structures- M, 2D, 3D

Blood flow

79
Q

What are the two types of US?

A

Trans-Thoracic Echo- transducer placed in PT chest wall to obtain images but can be impaired by habitus
Trans-esophageal Echo- transducer placed in esophagus by endoscope

80
Q

What are the indications for ordering an Echo?

A

Valvular lesions- quantify regurg/stenosis
Assess ventricles- thickness, masses, ejection fraction, function
CAD- wall motion post MI, R ventricle function quality
Cardiomyopathy
Pericardial disease

81
Q

What type of info do TTEs offer?

A 
Estimated ejection fraction
Assess LV for RV dilation
L atrium size
Paradoxical septal motion
Blood flow direction
82
Q

What test would be ordered to assess the severity of a valve obstruction from calcification?

A

Continuous wave Doppler

83
Q

What advantages do a TEE offer?

A

Increased sensitivity and specificity for anatomic abnormalities- aortic dissections, endocarditis, prosthetic valve dysfunction, LA thrombus prior to cardioversion

84
Q

TTE or TEE can be performed with simultaneous venous saline agitation in order to ID ?

This test is called a ?

A

Intracardiac Shunt

Bubble study

85
Q

What is the pattern/sequence of viewing structures with a TEE?

A 
Mitral valve and L chambers
Aortic valve
Left atrial appendage
R side structures
Interatrial septum
Base of heart
Transgastric area
Aorta
86
Q

Normal HR ?

P wave duration ?

A

50-100bpm

<0.12 sec

87
Q

PR interval length

QRS duration

A

90-200msec

75-110msec

88
Q

QTc for males and females

QRS axis

A

390-450/390-460

-30 - +90

89
Q

Normal heart beat ranges for newborn, 2y/o, 4y/o and 6+y/o

A 
New= 110-150
2= 85-125
4= 75-115
6= 60-100
90
Q

What type of BBB is more dangerous and needs immediate evaluation?

A

Isolated LBBB- 2x increased risk of CV event/dying from cardiovascular cause

91
Q

What nuclear medicine test is ordered to assess left ventricle function?

A

MUGA- multi-unit gated acquisition, AKA RVG
Images blood passing through heart and great vessels Locate areas of ischemia
Assess myocardial metabolism

92
Q

What nuclear medicine test is ordered to assess myocardial perfusion?

A

PET- positron emission tomography

93
Q

What is the primary purpose of a Radionuclide Ventriculography?

A

Left or right ventricle ejection fraction by radiolabeling RBCs w/ T-99m

94
Q

What are the advantages and disadvantages of a RVG study?

A

Highly accurate, info in RV and LV simultaneously, no habitus limitation, less than 30min

Radiation exposure, no info on valves, less accurate in PTs w/ arrhythmia

95
Q

How does a PET Scan of the heart work and what info is provided?

A

Assessment of myocardial perfusion and viability from N-13, Fl-18 or Ru-82 uptake that is proportional to blood flow
Viability assess from radionuclide sugar solution

96
Q

What test is used to identify areas of impaired blood flow or injured myocardium?

A

PET Scan

97
Q

When are PTs requested to wear holter monitors?

A

Suspected frequent, recurrent arrhythmia

98
Q

What test is usually ordered first for PTs with frequent/daily Sxs like palpitations or unexplained syncope or dizziness?

A

oolter monitor

99
Q

Continuous ECG monitoring in the inpatient setting is called?

A

Telemetry

100
Q

What are the uses and benefits of an event monitor?

A

AKA Loop Monitor, worn for 3days-3wks with ECG recording triggered by the PT and provides increased diagnostic yield
Used in PTs w/ infrequent arrhythmia-type Sxs of in PTs w/ non-diagnostic holter monitor eval

101
Q

When is an implantable loop recorder used?

A

PTs w/ infrequent but concerning Sxs that suggest a pathologic arrhythmia ie, unexplained syncope

102
Q

What type of ambulatory monitoring would be most appropriate for PTs with intermittent palpitations that occur every 1-2wks?

A

Wearable defib vest

103
Q

What are the three types of cardiac stress tests?

A

Treadmill exercise stress test
Treadmill stress imaging- echo or nuclear
Pharmacological stress testing

104
Q

What is the diagnostic principle and primary goal of stress testing?

A

Inducing stress increases O2 demands that can induce EKG changes

Determine likelihood of clinically significant underlying CADz

105
Q

What are the four purposes of a cardiac stress test?

A

Prognostic assessment
Functional capacity assessment
Determine therapy effectiveness
Evaluate exercise induced arrhythmia

106
Q

What are absolute contraindications to ALL stress testing modalities?

A 
STEMI 2 days or less
High risk ACS- perform coronary angiogram
HF- decompensated
Current endocarditis
Aortic stenosis
Sx HOCWhatM
Myo/pericarditis
Physically disabled and prevents safe/adequate testing
107
Q

Define Bayes’ Theorem and whom it works best for

A

Probability of PT having a disease after Dx test is completed is related to Dz probability before the test and the probability that the test provides a true result

Intermediate pre-test probability

108
Q

Define High, Intermediate and Low probability of CAD

A 
High= +85% +40men/+60women w/ anina and risk factors (DM, smoking, hyperlipidemia)
Intermediate= 15-85%, -40/-60y/o w/ possible angina
Low= <15%, possible angina in PTs w/out combination of risk factors
109
Q

What baseline EKG abnormalities preclude ECG base testing?

What happens if a test is conducted with these issues present?

A

LBBB, paced rhythm, non-specific IVCD
Any ST depression >1mm
LVH or digoxin therapy w/ any ST depression
WPW

High false positive

110
Q

What is the most common treadmill protocol for exercise stress tests?

A

Bruce protocol- requires PT reaches 85% of max HR
Sensitivity= 60-65%
Specificity= 80-85%

111
Q

Exercise stress tests are conducted until one of what three events occur?

A

Angina
Signs of MI on ECG
Max HR is reached
PT is fatigued

112
Q

Stress tests are used to assess what ?

A 
Risk of CV event
Long term prognosis
Exercise capability
Therapeutic decision making
Localize ischemia areas for treatment
113
Q

How are abnormal cardiac stress tests defined?

A

Clinical parameters- index chest pain
Electrical parameters- ST depression of 1mm or more
Both

114
Q

“Markedly” positive cardiac stress test findings include?

A 
Ischemic ECG findings withing 3min or persist for 5m after test
ST depression >2mm
SBP decreases during exercise
Ventricular arrhythmia
PT unable to exercise for 2min
115
Q

Define Duke Prognostic Treadmill Score

A

3 variables used to estimate prognosis after an exercise treadmill test

116
Q

What findings indicate an adverse prognosis for PTs other than their Duke Score?

A 
ST depression/severe angina <6min
ST depression >2mm in 5 or more leads
ST elevation w/out prior Q waves
DBP dec by 10mm
Sustained VT or complex PVCs
HR dec <12bpm in first minute of recovery is strong indicator of cardiac mortality
Inability to reach 85% of max HR
117
Q

What drug is used for cardiac stress test in PTs unable to exercise for a Stress Echo?

A

IV infusion of Dobutamine (cardiac inotrope)

118
Q

What drugs are used for stress tests in PTs that are unable to exercise for Nuclear Stress Myocardial Perfusion Study?

A

Thallium
Dobuamine
Adenosine/Dipyridamole- induce coronary artery dilation like exercise w/out increasing HR

119
Q

What is the gold standard for invasive cardiac measurements?

A

Cardiac catheterization- most commonly performed catheterization type to evaluate potential CAD

120
Q

What are the therapeutic indications for a Left Heart Catheterization?

A

Balloon angioplasty and stent to treat CAD
Intra-aortic balloon pump for cardiogenic shock
Balloon valvuloplasty for valvular stenosis
Percutaneous closure of intracardiac shunts

121
Q

Define a Left Cardiac Catheterization

Define a Right Cardiac Catheterization

A

Femoral/brachial or Axillary artery access to ascending aorta and left ventricle and atrium

Subclavian/internal jugular/brachial/femoral vein w/ Swan-Ganz catheter w/out requirement for fluoroscopic guidance

122
Q

What measurement approximates the pressure at the left atrium?

A

Wedge Pressure
Inc= wet, volume overload
Dec= dry, volume depletion

123
Q

What type of PT usually gets right sided heart catheterization?

A

Critically ill w/ complex hemodynamics that can’t be assessed by bedside methods

124
Q

What are the indications for ordering a right sided heart catheterization?

A

Assess filling pressure/output in PTs w/ HF
Assess volume status/resistance in PTs w/ sepsis
Evaluate intra-cardiac shunts
Evaluate pericardial disease
Peri-op monitoring PTs w/ high risk of HF during procedure

125
Q

What are the indications for ordering an electrophysiological study?

A

Analysis of recurrent/difficult to manage arrhythmias
Assess pharmaceutical/implant device efficiency
Ablation of recurrent arrhythmias that are unresponsive to medical therapy

126
Q

Done w/

A

Lect 2

127
Q

The central physiological role of the heart is closely intertwined with what five other disciplines?

A 
Surgery
Hematology
Immunology
Nephrology
Endocrinology
128
Q

What are the 4 parts to the clinical approach in cardiology?

A

Anatomic abnormalities
Physiologic abnormalities
Underlying etiology
Functional disability

129
Q

What are the cardinal Sxs?

A 
Dyspnea
Palpitations
Syncope
Edema
Claudication
Fatigue
130
Q

What is the atypical presentation of an atypical AMI?

A

Female, Elderly, DM, CHF

No chest pain, localized pain in neck, back, jaw or head

131
Q

What is the most common Sx of heart disease?

How is it determined to be of cardiac or non-cardiac origin?

A

Dyspnea

OPQRST

132
Q

Stopped on

A

Slide 41 Lect 3

133
Q

What are the indications for ordering an electrophysiological study?

A

Analysis of recurrent/difficult to manage arrhythmias
Assess pharmaceutical/implant device efficiency
Ablation of recurrent arrhythmias that are unresponsive to medical therapy

134
Q

Done w/

A

Lect 2

135
Q

The central physiological role of the heart is closely intertwined with what five other disciplines?

A 
Surgery
Hematology
Immunology
Nephrology
Endocrinology
136
Q

What are the 4 parts to the clinical approach in cardiology?

A

Anatomic abnormalities
Physiologic abnormalities
Underlying etiology
Functional disability

137
Q

What are the cardinal Sxs?

A 
Dyspnea
Palpitations
Syncope
Edema
Claudication
Fatigue
138
Q

What is the atypical presentation of an atypical AMI?

A

Female, Elderly, DM, CHF

No chest pain, localized pain in neck, back, jaw or head

139
Q

What is the most common Sx of heart disease?

How is it determined to be of cardiac or non-cardiac origin?

A

Dyspnea

OPQRST

140
Q

Stopped on

A

Slide 41 Lect 3

141
Q

Location, Quality, Duration, Worse/Better, S/Sxs of ANgina

A

L: retrosternal; radiates to neck, jaw, arm, shoulder
Q: pressure/burn/squeeze/heavy
D: 2-10min
A/R: exercise, cold, stress / rest, nitro
S/Sxs: S3 or papillary muscle dysfunction murmur during pain episode

142
Q

Location, Quality, Duration, Worse/Better, S/Sxs of Rest or Unstable angina

A 
L: same as angina
Q: same as angina but more severe
D: <20min
A/R: same as angina, dec tolerance for exertion/at rest
S/Sx: transient heart failure can occur
143
Q

Location, Quality, Duration, Worse/Better, S/Sxs of MI

A

L: substernal, radiates similar to angina
Q: heavy, pressure, burning, burning, constriction
D: >30min, but variable
A/R: unrelieved by nitro/rest
S/Sx: N/V, SoB, sweating, weak

144
Q

Location, Quality, Duration, Worse/Better, S/Sxs of Pericarditis

A

L: over sternum/apex, radiates to neck or L shoulder
Q: sharp, stabbing, knife-like
D: hrs to days w/ waxing/waning
A/R: deep breath, rotating chest, supine / sitting, leaning
S/Sxs: friction rub (best heard LLD)

145
Q

Location, Quality, Duration, Worse/Better, S/Sxs of Aortic Dissection

A 
L: anterior chest, radiates to back
Q: excruciating, tearing, knife-like
D: sudden and unrelenting
A/R: HTN, Marfan Syndrome
S/Sxs:aortic murmur, HTN, BP asymmetry, large/displaced PMI
146
Q

Location, Quality, Duration, Worse/Better, S/Sxs of PE

A 
L: substernal or over site of PE
Q: pleuritic or angina-like
D: sudden onset, lasts minutes-hrs
A/R: breathing worsens it
S/Sxs: tachy, dyspnea, Signs of RVFailure
147
Q

Location, Quality, Duration, Worse/Better, S/Sxs of PHTN

A 
L: substernal
Q: pressure, oppressive
D: similar to angina
A/R: worse w/ effort
S/Sxs: pain w/ dyspnea, signs of PHTN
148
Q

What are the key terms associated with the quality of pain for non-cardiac causes of chest pain?

A 
Pneumo w/ pleurisy- pleuritic, local
Spot Pneumo- sharp, very local
MSK d/o- ache
Herpes- burning, itch
Esophageal reflux- burning, visceral discomfort
Ulcer- visceral burning, ache
Gallbladder- visceral
Anxiety- variable and transient
149
Q

What kind of peripheral findings will be noted with an arterial or venous

A

Arterial- diminished/absent pulse, infection, pain, cold to touch
Vein- rarely diminished pulse, swelling, pain, warm to touch

150
Q

What peripheral S/Sx is seen in PTs with CHF?

A

3rd spacing- pitting edema

151
Q

Clubbing in fingers is indicative of ?

A

Chronic hypoxia

IPAP (212 decks)

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