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Differential Dx > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What are the three common items that lead to blood clotting?

A

Venous stasis, hypercoaguability, and vessel damage

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2
Q

(true/false) Dyspnea is often associated with chronic heart AND lung disease.

A

True

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3
Q

What are causes of dyspnea?

A

activity, exertion, or body position

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4
Q

What position is optimal for offloading the pulmonary system?

A

seated and standing

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5
Q

What position is optimal for offloading the heart?

A

supine

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6
Q

Why is dyspnea worse at night?

A

Fluid collection –> indicative of possible CHF

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7
Q

What are causes of coughing?

A

illness, medication, cardiac disease

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8
Q

A cough becomes chronic if it lasts how long?

A

> 3 weeks

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9
Q

What is a non-productive cough often associated with?

A

ACE-inhibitors

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10
Q

If a cough is nocturnal, what should you suspect?

A

HF

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11
Q

Coughing caused by allergies should have what colored sputum?

A

clear

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12
Q

Coughing caused by illness will have what colored sputum?

A

green

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13
Q

Coughing caused by damage to the bronchioles will have what colored sputum?

A

rust colored

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14
Q

What is peripheral edema commonly associated with?

A

venous insufficiency, CHF, DVT, pulmonary HTN

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15
Q

Edema measurements should be taken where?

A

> 1 cm above the ankles
2 cm at the midcalf

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16
Q

Palpitations are associated with what?

A

arrythmias

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17
Q

What are causes of syncope?

A
  • reduction in blood flow to the brain
  • metabolic origins
  • psychogenic origins
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18
Q

Does the incidence of syncope trend upward or downward with age?

A

upward

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19
Q

What is a common finding with acute MI?

A

pain with sweating

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20
Q

When examining pain with sweating, what should you look for?

A

Atypical pain patterns and diaphoresis

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21
Q

What are atypical pain patterns with sweating?

A

tooth
R shoulder
Midthoracic region
Bilateral arm pain
ulnar/T1 distribution

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22
Q

What are red flags for MI?

A
  • chest pain
  • PMH of CAD, HTN, Smoking, DM, elevated cholestrol (> 240)
  • men over 40
  • females over 50
  • pressure in the chest
  • pain in shoulder, neck, or arms
  • lightheadedness/fainting
  • SOB
  • sweating
  • nausea w/o chest discomfort
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23
Q

What are the 3 P’s to rule out MI?

A

Pleuritic pain worsened with deep breathing

pain with palpation

Pain with changes in posture

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24
Q

What is the cardiac pain pattern for men experiencing an MI?

A

substernal pressure

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25
Q

(true/false) Women will have subtle s/s of MI

A

true

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26
Q

Where do most women and elderly people have pain when experiencing an MI?

A

R biceps pain

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27
Q

Heart attack pain is relieved by what position?

A

supine

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28
Q

What is the normal presentation of stable angina?

A
  • predictable pattern
  • alleviated by rest and/or medications
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29
Q

What is the normal presentation of unstable angina?

A
  • Unpredictable pattern
  • Doesn’t respond to nitroglycerin
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30
Q

What s/s of unstable angina warrant immediate transport to the ED?

A
  • substernal squeezing/crushing pressure
  • SOB, pallor, or diaphoresis
  • angina lasting > 30 mins
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31
Q

What is the typical angina pain pattern?

A

Unilateral neck and upper trap pain + T1 distribution

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32
Q

What is the atypical angina pattern seen in females?

A

chest/abdominal pain, sternal pain, middle trap pain

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33
Q

What are red flags for stable angina?

A
  • chest pain/pressure that occurs with predictable levels of exertion
  • s/s are predictably alleviated with rest or sublingual nitroglycerine
34
Q

What are red flags for unstable angina?

A
  • chest pain that occurs outside of the predictable pattern
  • no response to nitroglycerin
35
Q

What is the angina scale?

A

1+ light/barely noticeable

2+ Moderate/bothersome

3+ Severe/very uncomfortable

4+ Most severe pain ever experienced

36
Q

What is angina often misdiagnosed as?

37
Q

What population is angina most commonly found in?

A

post-menopausal women

38
Q

Angina is delayed __-__ minutes after activity

A

3-5 minutes

39
Q

When do pericarditis s/s emerge?

A

When increased HR isn’t sufficient

40
Q

What are s/s for pericarditis?

A
  • labored breathing
  • venous distention
  • decreased BP with inhalation (cardiac tamponade)
  • faster HR
  • weaker contractions
41
Q

What are red flags for pericarditis?

A
  • sharp/stabbing chest pain that is referred to the lateral neck or shoulder
  • increased pain with LEFT S/L
  • pain is relieved with FWD lean while sitting
42
Q

With CHF, different positions cause a(n) (increase/decrease) in fluid retention.

43
Q

What are s/s of CHF?

A

fatigue
dyspnea
edema
nocturia

44
Q

definition: narrowing or constriction preventing the valve from opening fully

45
Q

definition: when a valve does not close properly & blood flows back into the heart chamber

A

insufficiency/regurgitation

46
Q

definition: occurs when enlarged valve leaflets bulge backward into the left atrium

47
Q

Prolapse of a valve only affects what valve?

A

mitral valve

48
Q

What is rheumatic fever?

A

An infection caused by streptococcal bacteria

49
Q

What population is rheumatic fever commonly seen in?

50
Q

(true/false) rheumatic fever can be fatal or lead to rheumatic heart disease

51
Q

What is rheumatic heart disease?

A

chronic condition caused by scarring and deformity of the heart valves

52
Q

What do the leaflets show when mitral valve prolapse is present?

A
  • increased extensibility
  • Decreased stiffness
  • decreased Strength
53
Q

What is “floppy valve” syndrome?

A

mitral valve prolapse

54
Q

What is the triad that is indicative of mitral valve prolapse?

A
  • palpitations
  • fatigue
  • dyspnea
55
Q

What do statins do?

A

decrease LDL

56
Q

What do diuretics do?

A

decrease BP

57
Q

What do beta-blockers do?

A

relaxes blood vessels and the heart

58
Q

What do alpha-1 blockers and ACE inhibitors do?

A

dilate blood vessels –> decrease BP

59
Q

What do calcium channel blockers do?

A

prevents blood vessel constriction

60
Q

What do nitrates do?

A

dilate the coronary arteries

61
Q

What are red flags associated with chest pain WITHOUT the presence of cardiac disease?

A
  • < 40 y/o
  • Type A male
  • neurotic female
  • high perceived level of vital exhaustion
  • recent uncontrollable and undesirable life events
62
Q

What are guidelines for IMMEDIATE medical attention?

A
  • sudden worsening of intermittent claudication
  • TIA
  • no relief with medication, position, or rest
  • changes in angina pattern (increased intensity, decreased threshold, longer duration of symptoms)
63
Q

What occurs during S1 cardiac sound?

A

Start of systole –> Mitral and Tricuspid heart valve closure during heart contraction

64
Q

What occurs during S2 cardiac sound?

A

End of systole –> aortic and pulmonic valve closure during relaxation

65
Q

What occurs during S3 heart sound (if present)?

A
  • During ventricular filling; enlarged left ventricle?
66
Q

A S3 cardiac sound is normal for patients of what age?

67
Q

What population can you commonly hear a S4 cardiac sound?

A

Can be heard in trained athletes or in older adults

68
Q

What causes a S4 cardiac sound?

A
  • decreased ventricular compliance
  • increased ventricular stiffness
  • increased resistance
69
Q

If S3 heart sound is present in patients over the age of 40, what is the possible cause?

A

Left ventricular failure

70
Q

Left ventricular failure is characterized by what?

A
  • myocardial failure
  • volume overload of the ventricle
  • decreased contractility
71
Q

When do heart murmurs occur?

A

S1 –> S2
OR
S2 –> S1

72
Q

What murmur type occurs from S1 –> S2?

73
Q

What murmur type occurs from S2 –> S1?

74
Q

What pathology causes a SYSTOLIC murmur in the mitral area at the apex?

A

mitral insufficiency

75
Q

What pathology causes a SYSTOLIC murmur in the aortic area?

A

Aortic stenosis

76
Q

What pathology causes a DIASTOLIC murmur in the mitral area at the apex?

A

mitral stenosis

77
Q

What pathology causes a DIASTOLIC murmur in the aortic area?

A

aortic insufficiency

78
Q

What pathology causes a murmur in the tricuspid area (both systolic and diastolic murmur)?

A

ventricular septal defect

79
Q

What pathology causes a murmur in the aortic and pulmonic areas (both systolic and diastolic murmur)?

A

atrial septal defect

80
Q

Murmurs normally have a (short/long) duration.

A

long duration

Differential Dx (13 decks)

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