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CPS > Case 7- Confused teenage girl > Flashcards

Case 7- Confused teenage girl Flashcards

1
Q

DDx of chest pain in children

A

s

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2
Q

Must not miss diagnoses (x5)

A

Aortic dissection, pneumothorax, pericardial tamponade, pulmonary embolism, MI

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3
Q

Ultrasound technology

A

s

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4
Q

Hx of Ped Patient

A

family (genetic), surgical, social, past medical hx and description of pain

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5
Q

Mid systolic click=

A

Mitral valve prolapse

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6
Q

Chest wall syndrome

A

painful area of chest wall

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7
Q

costochondritis

A

frequent left 4th sternocostal

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8
Q

Teitze

A

= painful swelling 2/3 rib

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9
Q

Precordial catch syndrome

A

brief sudden sharp pain, increased with inspiration.

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10
Q

Slipping rib syndrome

A

8-10 ribs. Dx: with hooking maneuver

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11
Q

Xiphoid pain

A

tenderness of xiphoid

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12
Q

Sickle cell vaso occlusive episode

A

rib or lung infarction

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13
Q

Causes of palpitations (life threatening)

A

arrhythmia (WPW syndrome, prolonged QT), hypertrophic cardiomyopathy, myocarditis, sick sinus, pacemaker malfunction

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14
Q

Causes of palpitations (non life threatening)

A

premature atrial contraction, premature ventricular contractions, fever, anemia, exercise

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15
Q

Pertinent negatives of case:

A

not pneumonia, endocarditis, pleurisy, congenital heart disease, no chest wall tenderness

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16
Q

Mitral valve prolapse sx

A

dyspnea, exercise intolerance, dizziness/syncope, panic attacks, numbness/tingling, abnormal resting ECGs

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17
Q

Most murmurs during valsalva?

A

decrease in length and intesity

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18
Q

Exceptions to decreased length/intensity of murmurs during valsalva. What are murmurs like?

A

Hypertrophic cardiomyopathy, mitral valve prolapse
Squatting= later click, shorter murmur
Standing/Valsalva= early click and long murmur

19
Q

MVP or Hypertrophic cardiomyopathy?

A

Mid systolic click= MVP

Hand grip- intensifies MVP but diminishes hypertrophic cardiomyopathy

20
Q

Valsalva maneuver and standing

A

decreased preload

21
Q

Squatting

A

increased preload and afterload, rise in pressure

22
Q

Hand grip

A

increase afterload (TPR) and increase back pressure on mitral valve

23
Q

Ultrasound

A

no radiation, can see blood flow (doppler ultrasound). Sonar technology with transducer

24
Q

Diagnosis of MGP

A

systolic mitral leaflet displacement >2mm above annular plane in parasternal or apical long axis

25
Q

MVP associated with

A

Von willebrand, hypomastia, mesenchymal dysplasia

26
Q

Risk factors for MVP

A

ehlers danlos, marfan, polycystic diseas, graves disease, pectus excavatum, bipolar, low BMI

27
Q

Sx only in marfan syndrome- not in MVP

A

Ectopia lentis, aortic involvement, skeletal findings, fam hx

28
Q

Mg deficiency

A

60% of MVP patients

29
Q

MVP treatment

A

B-blockers, behavior changes, endocarditis prophylaxis (only if regurgitation is very severe)

30
Q

What tells us an athlete with MVP can participate in sports?

A

normal sinus rhythm, mild-moderate regurg, normal LV size and function

31
Q

Low activity if pt (with MVP) has

A

syncope, sudden cardiac death (in fam member with MVP), tachycardia, ventricular tachyarrhythmias, severe mitral valve regurg, prior embolic events, LV systolic dysfunction

32
Q

BMI

A

25= obese

33
Q

Vit requirements?

A

calcium, VitD, weight bearing activity, limit cola, no cigarettes

34
Q

You might be a lesbian?

A 
BE PATIENT
you are not alone
you are normal
take care of your body (safe sex)
be aware of your feelings, find answers from reliable sources
35
Q

Bisexuals vs heterosexuals?

A

Bisexuals have more penile intercourse and have bad contraception use

36
Q

Lesbians have higher rates of?

A

hx sexual abuse/prostitution

37
Q

Rate of lesbians

A

1/10 have attraction to other girls

38
Q

bisexual

A

attraction to both sexes, doesnt have to be equal

39
Q

gender identity

A

sense of being masculin, feminine etc

40
Q

hermpahrodite

A

offensive term for intersex

41
Q

intersex

A

person is born with reproductive anatomy that doesnt fit typical definitions of male/female

42
Q

transsexxual

A

identification of gender other than the one a person feels at birth

43
Q

sexual identity

A

how a person identifies as female/male

CPS (5 decks)

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