Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MOCA peds > Chest pain in children and adolescents–understanding the differential diagnosis and evaluation > Flashcards

Chest pain in children and adolescents–understanding the differential diagnosis and evaluation Flashcards

1
Q

What percentage of children complain of chest pain?

A

98%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the prevalence of a cardiac origin in children who present with chest pain?

A

Less than 6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the differential diagnosis for child presenting with chest pain?

A
  1. Musculoskeletal
  2. Pulmonary
  3. Gastrointestinal
  4. Miscellaneous
  5. Cardiac
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the signs and symptoms, physical findings and lab imaging findings for musculoskeletal chest pain?

A

Signs symptoms history: Reproducible chest pain on the rib cage
Physical exam: Point tenderness that can develop gradually or started suddenly
Imaging: Chest x-ray to look for bony lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the signs and symptoms, physical findings and labs/imaging findings or evaluation for pulmonary origin of chest pain?

A

Signs symptoms: Increased work of breathing, increased cough, dyspnea, severe sudden chest pain
Physical findings: Wheezing, crackles, rhonchi, hypoxia
Chest x-ray or imaging: Lung pathology, collapsed lung or radiodensity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the signs/symptoms, physical findings and lab/imaging findings or evaluation for gastrointestinal origin of chest pain?

A

Signs/symptoms: Chest pain associated with certain foods or medications, pain improves after taking in an acid
Physical exam: Pain in the right upper quadrant that can spread to the right shoulder blade or back, burning epigastric pain
Labs/imaging: H. pylori testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the signs/symptoms, physical findings and lab/imaging findings or evaluation for miscellaneous origin of chest pain?

A

Signs/symptoms: Chest pain associated with precipitating stressful events, recurrent somatic complaints, lightheadedness, and paresthesias
Physical exam: Chest pain associated with numbness, weakness, or vesicular rash
Labs/imaging: Tests cluster of vesicles for herpes and MRI of spine if chest pain associated with numbness or weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the signs/symptoms, physical exam, lab/imaging findings or evaluation for any inflammatory cardiac origin of chest pain?

A

Signs/symptoms: Sharp chest pain, palpitations, and shortness of breath
Physical findings: This and for murmurs or arrhythmias
Labs/imaging: Chest x-ray, ECG, and echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the signs/symptoms, physical exam, lab/imaging findings or evaluation for a cardiac origin of chest pain involving increased myocardial demand or decreased supply?

A

Signs/symptoms: Family history of genetic or connective tissue disorder (Marfan syndrome) and palpitations
Physical exam heart murmur or arrhythmia
Labs/imaging: Chest x-ray, ECG, and echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs/symptoms, physical exam, labs/imaging findings were evaluation for a cardiac origin of chest pain due to coronary artery abnormalities?

A

Signs/symptoms: Chest pain with history of Kawasaki disease, COVID-19, coronary vasculopathy and heart transplant patient.
Labs/imaging chest x-ray, ECG, and echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the signs/symptoms, physical exam, lab/imaging findings or evaluation for a cardiac origin of chest pain due to miscellaneous cardiac causes?

A

Signs/symptoms: Sudden severe, sharp pain in chest or upper back
Physical exam: Heart murmur, low blood pressure, rapid weak pulse
Chest x-ray, EKG, and echo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the signs/symptoms, physical exam, lab and imaging findings for a cardiac origin of chest pain due to drugs?

A

Signs/symptoms: Chest pain with tobacco smokers, cocaine, and other sympathomimetic drugs
Physical exam: Vasoconstrictive activity of drugs lead to myocardial ischemia
Labs/imaging: Chest x-ray, EKG, and echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 7 items in the musculoskeletal differential for noncardiac chest pain?

A
  1. Costochondritis
  2. Tietze syndrome
  3. Slipped rib syndrome
  4. Trauma/muscular strain/overuse injury
  5. Xiphoid pain or xiphoidalgia
  6. Sickle cell vaso-occlusive crisis
  7. Nonspecific/idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 8 subcategories of pulmonary differential for chest pain?

A
  1. Bronchial asthma
  2. Exercise-induced/cough variant asthma
  3. Bronchitis
  4. Pleurisy
  5. Pneumonia
  6. Pneumothorax
  7. Pulmonary embolism
  8. Acute chest syndrome (a potential fatal complication of sickle cell disease and is accompanied by fever, respiratory symptoms, and new radiodensity on chest x-ray)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 5 subcategories for the gastrointestinal differential diagnosis of chest pain?

A
  1. GERD
  2. Esophageal spasm
  3. Peptic ulcer disease
  4. Drug-induced esophagitis/gastritis
  5. Cholecystitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 6 subcategories for miscellaneous differential diagnosis of chest pain?

A
  1. Panic disorder
  2. Hyperventilation
  3. Breast related conditions
  4. Herpes zoster
  5. Psychogenic
  6. Spinal cord/nerve root compression
17
Q

What are the 2 subcategories for an inflammatory cardiac origin of chest pain?

A
  1. Pericarditis
  2. Myocarditis
18
Q

What are the presenting signs and symptoms in someone with pericarditis?

A

May present with sharp chest pain, palpitations, and shortness of breath. This is due to inflammation of the heart lining.

19
Q

What are the most common associated diseases, viral infections, and bacterial infections that can cause pericarditis?

A

Diseases: Post pericardiotomy syndrome, SLE, Crohn’s, and other autoimmune diseases
Viruses: Coxsackie B, adenovirus, hepatitis C, CMV, echovirus, influenza, EBV, and parvovirus B19
Bacteria: Streptococcus, Staphylococcus, pneumococcus
Physical findings may reveal a friction rub with a patient leaning forward on exam

20
Q

What are the presenting signs and symptoms of the patient with chest pain and when and myocarditis?

A

Myocarditis is caused by inflammation of the heart muscle. May present with acute chest pain, shortness of breath, and arrhythmias.

21
Q

What are the infectious causes both viral and bacterial of myocarditis?

A

Viral causes: Coxsackie B, adenovirus, herpes see, CMV, echovirus, influenza, EBV, and Parvovirus B19
Bacterial: Staphylococcus, Streptococcus, diphtheria, and beryllia burgdorferi from Lyme disease

22
Q

What are the 3 subcategories for a patient with chest pain of and increased myocardial demand or decreased supply?

A
  1. Cardiomyopathy
  2. Left ventricular outflow tract (LVOT) obstruction
  3. Arrhythmias
23
Q

What is the cause of a cardiomyopathy, and what are some important features in the history for patient who complains of chest pain from a cardiac origin?

A

May be dilated or hypertrophic, they may present with chest pain, and a family history of genetic or connective tissue disorders such as Marfan’s

24
Q

What are some of the echo features of left ventricular outflow tract obstruction or LVOT?

A

Look for aortic stenosis, subaortic stenosis, or supravalvular aortic stenosis on echocardiogram

25
Q

What are some of the physical findings for arrhythmia presenting his chest pain?

A

Decreased cardiac output, look for chest pain with palpitations

26
Q

For chest pain from a cardiac origin due to coronary artery abnormalities with COVID 2 subcategories in the differential?

A
  1. Congenital coronary artery abnormalities
  2. Acquired coronary artery abnormalities
27
Q

What are some of the common congenital coronary artery abnormalities found that may contribute to chest pain.

A
  1. Anomalous left coronary artery from the pulmonary artery or a LCA PA
  2. Anomalous left coronary artery from the right coronary sinus or ALCA
  3. Coronary fistula
28
Q

What are the findings for coronary artery abnormalities of chest x-ray, echocardiogram, and cardiac catheterization?

A

Chest x-ray may show an enlarged heart
Echocardiogram may provide more definitive diagnosis
3 cardiac catheterization will provide definitive diagnosis

29
Q

What are some of the causes of an acquired coronary artery abnormality?

A

Kawasaki disease
Postsurgical situations
Post transplant coronary vasculopathy

30
Q

What are the 6 subcategories for miscellaneous causes of cardiac origin of chest pain?

A
  1. Aortic dissection
  2. Rupture of aortic aneurysm
  3. Pulmonary hypertension
  4. Mitral valve prolapse
  5. Atrial myxoma
  6. Cardiac device/stent complications
31
Q

What are some of the presenting pain symptoms of a patient with aortic dissection?

A

Sudden, severe, sharp pain of the chest and upper back, diastolic heart murmur, low blood pressure, rapid weak pulse, heavy sweating, or loss of vision.

32
Q

What are some of the presenting signs and symptoms of the patient with rupture of the aortic aneurysm?

A

Look for deep, constant pain in the abdomen and back, positive pulse near the umbilicus, hypotension, or loss of consciousness.

33
Q

What are some of the presenting signs and symptoms of a patient with pulmonary hypertension?

A

Chest pain, fatigue, shortness of breath, syncope, lower extremity edema, or heart palpitations

34
Q

What are some of the signs and symptoms of the patient with mitral valve prolapse?

A

Palpitations, arrhythmia, or shortness of breath with a heart murmur and a systolic click.

MOCA peds (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions