Cardiopulmonary Differential Diagnosis Flashcards
A 45 year old overweight male with diagnosed heart disease patient presents to your clinic with “pressure like” chest pain that spreads to his neck and left
shoulder that worsens with exertion. He is also sweating, lightheaded and short of breath. His pain does not change with position. He states the pain
started about 30minutes ago at work and he took antacids with no relief of symptoms. What is the likely cause of this chest pain?
• Myocardial infarction
• Aortic Stenosis
• Indigestion
• Pericarditis
Myocardial infarction
A 55 year old male office worker presents to your outpatient clinic with a referral for knee pain. Upon exam he reports pain in his chest at about the
3rd and 4th intercostal spaces which occasionally spreads to his left shoulder. The pain worsens when he coughs, and when lifting objects, especially
overhead. His pain is reproducible with palpation of the 3rd and 4th sternal costal joints.
What is the most likely cause of his pain?
A. Myocardial infarction
B. Dissecting aortic aneurysm
C. Costochondritis (rib pain)
D. Pulmonary embolism
Costochondritis (rib pain)
Palpable swelling is noted in lateral hip and
anterior thigh in BLE The patient states that he can’t recall any specific cause of the pain (fall, strain, sprain etc) and that the pain and soreness occurred about 2‐3 months after taking one of his “heart medications”. He also reports dark colored urine occurring over the past week. You review his medication lists, he takes the following daily.
• Lopressor (Metoprolol), Lipitor (Atorvastatin), Zestril (Lisinopril), Esidrix (HCTZ)
• Which medication is most likely the cause of his thigh muscle pain and soreness?
A. Metoprolol
B. Atorvastatin
C. Lisinopril
D. HCTZ
Atorvastatin
His vitals read as follows: BP rest (sitting): 164/86mmHg; HR 81bpm Auscultation: S1‐S2 no rubs, murmurs or gallops, rhythm regularly regular.
Choose the correct subsequent clinical decision
• Hold physical therapy, the patient has malignant hypertension, contact 911
• Document your findings, Continue physical therapy exam, the patient has
hypertension but is stable, monitor response to exercise.
• Hold physical therapy, the patient has stable hypertension, contact the referring PCP
• None of the above.
• Document your findings, Continue physical therapy exam, the patient has
hypertension but is stable, monitor response to exercise.
• You examine a 55 year old male patient in an outpatient clinic following TKA to the RLE. The patient had a complicated and prolonged hospital
admission and was discharged 1 week ago. The patient presents with decreased breath sounds and crackles in Right Posterior basal segment that improve with coughing, productive sputum is produced with each cough. Respiratory rate 24 breaths per minute. Blood pressure and HR are within normal limits. The patient has a body temperature of 39 deg Celsius afebrile.
• What is the most likely cause of these findings?
A. Bacterial Pneumonia
B. Pulmonary Embolism
C. Post operative atelectasis
D. Pleural effusion
Bacterial Pneumonia
• 68‐year old female office administrator who had been suffering from persistent swelling in her bilateral lower extremities for several years. She demonstrates bilateral +3 pitting edema swelling at the ankles, up
to her lower leg and browning of her skin. She reports a feeling of tightness or heaviness in the calves, and soreness/pain during walking and after sitting too long at her desk. Her medical history is remarkable for bilateral osteoarthritis of the hips, hypertension, and
morbid obesity. Due to her swelling mobility is very limited. What is the most likely diagnosis?
A. Deep Vein Thrombosis
B. Chronic Venous Insufficiency
C. Peripheral Arterial Disease
Chronic venous insufficiency
• You receive a consult to examine a patient on the ortho floor of UTSW following admission for a LLE TKA. The patient demonstrates hemoptysis, a HR of 120, dyspnea, sudden sharp pleuritic chest pain rated 8/10 worsened with deep breathing. Systolic blood pressure
has decreased by 20mmHg. Tracheal position in midline. What is the most likely diagnosis?
A. Acute Myocardial Infarction
B. Rib Fracture
C. Pulmonary Embolism
D. Pneumothorax
PE
