Chest Pain

Question 1

Most common causes of chest pain

Answer 1

Chest wall pain (20%), reflux esophagitis (13%), costochondritis (13%)

Question 2

What causes chest wall pain?

Answer 2

Cough, subacute cough, vomiting, heavy lifting

Anything that causes شد عضلي بـ intercostal muscles

Question 3

Findings of chest wall pain and costochondritis

Answer 3

Localized muscle tension, stinging pain, pain reproducible by palpation

Question 4

Findings in reflux esophagitis

Answer 4

Burning retrosternal pain, acid regurgitation, sour or bitter taste, one week trial of PPI relieved symptoms

Question 5

Findings in pneumonia

Answer 5

Fever, productive cough, rusty sputum, hx of URTI, hx of travel, contact with patients

Question 6

If the pain is diffused, poorly localized, or retrosternal, we suspect..

Answer 6

MI

and PE

Question 7

If the pain is localized over skin or superficial structures, such as costochondral jointsm and reproduced by palpation, we think of..

Answer 7

MSK pain
Costochondritis
Chest wall syndrome

Question 8

If the pain is localized in less than three cm in the regoin of the left nipple, we think of..

Answer 8

Non cardiac pain

ie. MSK, psychogenic, gaseous distention of the stomach

Question 9

If theain radiate to the medial aspect of the left arm/shoulder, right arm/should, or both arms, we think of..

Answer 9

MI
pericarditis
Cholecystitis (right shoulder)

Question 10

If the pain radiates to the lower jaw, neck, or teeth, we think of…

Answer 10

MI

Question 11

If the pain rafiates to the back, we think of…

Answer 11

Aortic dissection 
MI
Thoracic aneurysm 
Pericarditis
Esophageal disease
Pancreatitis
Peptic ulcer

Question 12

Of the pain is relievd by sitting up and leaning forward, we think of..

Answer 12

Pericarditis

Pancreatitis

Question 13

If the pain is relieved by holding the breath at deep expiration, we think of …

Answer 13

Pleuritis

Question 14

Wells criteria is for diagnosing..

Answer 14

PE

Question 15

Pneumothorax management is..

Answer 15

Needle decompression 2nd intercostal midclavicular line

Question 16

Is cough an upper or lower respiratory symprom?

Answer 16

LOWER

Question 17

Most common cause of acute cough is..

Answer 17

Post nasal drip( caused by viral URTI)

Question 18

Most common causes of common cold are..

Answer 18

Rhinovirus, adenovirus, parainfluenza, and respiratory syncytial virus

Question 19

IS the onset of symptoms in common cold sudden or gradual?

Answer 19

Gradual

Question 20

When there is a dry cough we think of..

Answer 20

ACEI use

Question 21

Most common causes of chronic cough in adults

Answer 21

ACEI use
Asthma environmental triggers
GERD
Tobacco use
Upper airway cough syndrome

Question 22

Most common causes of chronic cough in children

Answer 22

Asthma protracted bacterial bronchitis

Upper airway cough syndrome (in older than six)

Question 23

Chronic cough in children is defined as cough lasting more than…

Answer 23

Four weeks

Question 24

Normal sputum amount

Answer 24

Less than 100 ml/day

Question 25

Normal color of sputum

Answer 25

Clear and white mucus

Question 26

Rusty mucus indicates

Answer 26

Pneumonia

Question 27

Bright red blood sputum

Answer 27

TB

Question 28

Foul smelling purulent sputum indicates..

Answer 28

Lung abcess with anaerobic infection

Question 29

Pink frothy secretions is an indication of…

Answer 29

Pulmonary edema

اديم بنت خالتي تحب الوردي

Question 30

Most common cause of hemoptysis is..

Answer 30

Acute infection like exacerbation of COPD

Question 31

Chronic dyspnea is shortness of breath that lasts more than…

Answer 31

One month

Question 32

Taking OCP of estrogen increases the risk of getting…

Answer 32

PE

Question 33

SOB when lying flat, we think of..

Answer 33

CHF

Question 34

Lying on one sife increases SOB(aka trepopnea), we think of…

Answer 34

Unilateral pleural effusion and CHF (they like to lay on their left side)

Question 35

Wells criteria (7 items), what are they?

Answer 35

1- signs of DVT
2 HR > 100/min
3- recent surg or immo
4- previous PE or DVT
5- hemoptysis
6- malignancy 
7- alternative diagnosis is less likely