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Illness Scripts > Chest Pain > Flashcards

Chest Pain Flashcards

1
Q

Symptoms of PE

A

Pleuritic chest pain worse on inspiration
Breathlessness
Haemoptysis

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2
Q

Signs of saddle or large PE

A

Dizziness
Syncope / pre-syncope
Haemodynamic instability

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3
Q

PE on examination

A

Tachycardia
Tachypnoea
Hypoxia
Clear chest

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4
Q

Sudden onset SOB and pleuritic chest pain, haemoptysis, raised RR

A

PE

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5
Q

Investigations for PE

A

Wells score
D-Dimer
FBC
U&Es
LFTs
CRP
ABG
ECG

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6
Q

What will a CXR show in PE?

A

Normal, small wedge, small effusions

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7
Q

ECG findings in PE

A

Sinus tach
If large, right heart strain (S1 Q3 T3) RBBB R axis deviation

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8
Q

When don’t you do a CTPA?

A

Pregnancy - consider V/Q scan

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9
Q

What wells score makes u do CTPA

A

Over 4

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10
Q

What do u do wells score 3?

A

Do D-dimer

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11
Q

How do you manage a normal PE?

A

Oxygen
Anaelgesia
Anticoagulation - LMWH or apixaban

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12
Q

How do you manage massive PE

A

Consider thrombolysis

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13
Q

What is Virchows triad?

A

Hypercoagulability
Stasis blood flow
Endothelial injury

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14
Q

Is pneumothorax type 1 or 2 respiratory failure

A

Type 1

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15
Q

Symptoms of pleurisy

A

Sudden onset
Sharp pain
Worse on inspiration
Recent viral symptoms

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16
Q

Lung sounds in pleurisy

A

Pleural rub

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17
Q

Is it a PE or pleurisy?

A

Pleurisy - infective symptoms and pleural rub

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18
Q

What does CXR show in pleurisy?

A

Consolidation

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19
Q

How do you treat pneumothorax less than 2cm?

A

Oxygen and observe

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20
Q

How do you treat pneumothorax over 2cm?

A

Aspirate, chest drain

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21
Q

What is pleurisy?

A

Inflammation of the pleura due to viral infection

22
Q

Symptoms of CAP

A

Fever
Rigours
Breathlessness
Cough green sputum
Chest pain

23
Q

Exam findings in CAP

A

Increased RR
Tachycardia
Course crackles
Bronchial breathing

24
Q

Investigations for CAP

A

FBC
U&Es
LFTs
CRP
WCC
CRP
Elevated neutrophils
Sputum cultures
ABG
CXR

25
Q

What does CXR and ABG show in CAP

A

Type 1 resp failure
Consolidation

26
Q

What does CURB 65 mean?

A

For predicting mortality in CAP

27
Q

Symptoms of lung cancer

A

Breathlessness
Chest pain
Haemoptysis
Weight loss
Cough

28
Q

Signs of lung cancer on exam

A

Clubbing
Hypoxia
Cachectic
Lobar collapse
Pleural effusion

29
Q

Pancoast tumour

A

Horner syndrome
Weakness and muscle wasting in the hand of affected side

30
Q

Horner syndrome

A

Flushing on one side of face
Not sweating on affected side of face
Constricted pupil and droopy eyelid on affected side

31
Q

Risk factors for MI

A

HTN, diabetes, previous IHD, high cholesterol, smoking

32
Q

Bloods to do in MI

A

FBC
Lipids
U&Es
HbA1c
LFTs
Troponins

33
Q

Immediate drug treatment for MI

A

Aspirin 300mg
Clopidogrel 300mg or Tecligor

34
Q

Ongoing drug treatment following MI

A

Beta blockers, CCBs, ACEi, statin, aspirin or Clopidogrel

35
Q

Why take beta blockers or CCBs after MI?

A

Reduce cardiac work

36
Q

Why take ACEi or CCB after MI?

A

Reduce blood pressure

37
Q

Drug treatment for angina

A

GTN
Opioids
Beta blockers
CCBs
ACEi
Statins

38
Q

Symptoms of aortic dissection

A

Sudden onset severe central ripping chest pain
Radiates through to back and neck
Rapid collapse

39
Q

Examination in aortic dissection

A

Hypotension
Hypovolaemic shock
Different BP in each arm
New early diastolic murmur
Wide pulse pressure

40
Q

What do we do about aortic dissection?

A

Group and save, crossmatch
Fluid resus
Surgery

41
Q

Symptoms of pericarditis

A

Sharp anterior chest pain
Acute onset, often following viral illness
Can have fever or viral symptoms

42
Q

Quality of pain in pericarditis

A

Sharp
Anterior
Relieved by leaning forwards
Worse on deep inspiration or lying down

43
Q

Symptoms of cardiac tamponade

A

Reduced cardiac output
Low blood pressure
Raised JVP
muffled heart sounds

44
Q

Can cardiac tamponade occurs in pericarditis?

A

Yes

45
Q

Treatment for pericarditis

A

Pericardiocentesis

46
Q

How to diagnose cardiac tamponade

A

Echo

47
Q

ECG changes with pericarditis

A

Widespread saddle ST elevation, later T wave inversion

48
Q

What is Dressler’s syndrome

A

When you get a pericarditis following an MI

49
Q

How do you know if it’s an MI or pericarditis?

A

Sometimes viral stuff in pericarditis
Pericarditis pain relieved leaning forwards, worse lying down or coughing/breathing deeply

50
Q

Cancer Red flags with GORD

A

Dysphasia
Upper abdo pain
Dyspepsia
Haematemesis

51
Q

Consequences of prolonged GORD

A

Barrett’s oesophagus
Oesophageal cancer
Oesophagitis
Ulcers
Structures

52
Q

How do you know if the chest pain in MSK?

A

Anywhere
Worse with movement
Worse breathing in
Clear cause or trigger
Tender to touch

Illness Scripts (5 decks)

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