Brainscape's Knowledge GenomeTM

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


See full index

NM703 Primary Care of the Woman > Chest Pain & Pulmonary - Module 5 > Flashcards

Chest Pain & Pulmonary - Module 5 Flashcards

1
Q

What are the most common causes of non-cardiac chest pain?

A

Muscoloskeletal, gastrointestinal, psychiatric, and pulmonary disease

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

How does life span relate to chest pain?

A

Younger patients have more benign underlying conditions. Older patieints (especially with comorbidities) are more likely to have serious causes. ALL patients should have cardiac & life-threatening non-cardiac conditions ruled out first.

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

What are nonmodifiable risk factors for coronary artery disease (CAD)?

A

Gender, age( male >45; female >55), family history of premature CHD

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

What are modifiable risk factors for CAD?

A

Smoking, dyslipidemia (low HDL: 130) , diabetes mellitus, increased waist to hip ratio, physical inactivity, poor diet, psychosocial stress, poor dental health, and hypertension

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

What determines the risk for cardiovascular events?

A

The composition, morphology and stability of the coronary artery plaque. NOT the degree of plaque stenosis.

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

When should the patient with chest pain be sent to the ER?

A

Hemodynamic instability; positive ancillary studies (ECG, pulse ox, CBC, ABG, serum cardiac biomarkers, CXR,Echo, stress test, angiography) or high clinical suspicion.

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

Clinical Presentation - Cardiac Chest Pain Quality:

A

Vise-like pressure; constricting.

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

Clinical Presentation - Location:

What does pain that localizes to a small area of the chest suggest?

A

Pleural or chest wall involvement

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

Clinical Presentation - Intensity:

What causes an abrupt onset of pain with the greatest intensity at the beginning?

A

Aortic dissection, pneumothorax, or pulmonary embolism.

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

Clinical Presentation - Intensity:

What causes a more gradual onset of pain?

A

Ischemic chest pain

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

Clinical Presentation - Intensity:

When is the onset of pain more vague?

A

Psychogenic

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

Clinical Presentation - Duration

If the chest pain lasts only seconds or has been constant for weeks, it is NOT ___________.

A

cardiac

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

Clinical Presentation - Aggravation

Symptoms related to eating (dysphagia, odynophagia, & heartburn) suggest:

A

Esophageal chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical Presentation - Aggravation

Pain that worsens with exercise is reflective of:

A

cardiac ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical Presentation - Aggravation

Pain aggravated by position changes, deep breathing, or cough:

A

Musculoskeletal or pleural disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clinical Presentation - Alleviation

Repeated relief from antacids or food:

A

Gastrointestinal source.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clinical Presentation - Alleviation

Relief with nitroglycerin:

A

Esophageal and cardiac causes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clinical Presentation - Non-Cardiac Chest Pain Quality:

A

Sharp, stabbing, or knife-like pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What words might a patient use to describe angina?

A

Variable; pressure, heaviness, aching, constriction, tightness, squeezing,numbness, or burning sensation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Exam findings of MI:

A

1) Chest pain: pressure, heavinesss, squeezing, crushing, aching
2) Nausea & vomiting
3) Diaphoresis
4) Dyspnea
5) Possible atrial gallop (s4)
6) hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

NSTEMI (non-ST-segment elevation MI) is most often caused by _______________.

A

coronary artery narrowing caused by a non-occlusive thrombus (developed from a ruptured atherosclerotic plaque).

22
Q

STEMI (ST-sement elevation MI) is most often caused _____________________.

A

when an atherosclerotic plaque ruptures, resulting in coronary artery occlusion.

23
Q

Are ST-segment elevations or history and presenting symptoms more diagnostic of MI?

A

History and presenting sx

24
Q

Difference between men & women presenting with MI?

A

Women will many times present with c/o indigestion. Women 20% mortality; men 8% mortality

25
Q

Hx & Sx: recent orthopeadic surgery, sharp anterior chest pain, hemoptysis, RR-24, slightly decreased excursion and breath sounds at R base; Negative for chills, fever, orthopnea, calf pain

A

PE; Needs CXR; Send to ER

26
Q

Key indicators for Dx of Asthma:

A

1) Wheezing
2) Hx of one: cough, recurrent wheeze, recurrent diff in breathing, recurrent chest tightness
3) Sx occur or worsen with : exercise, viral infection, inhalant allergens, irritants, changes in weather, strong emotional expression, menstrual cycles
4) Sx occur or worsen at night.

27
Q

Dx of asthma is based on ___________, ____________, and ________________ ____________ especially _________________.

A

history, physical, diagnostic tests, spirometery

28
Q

What is FEV1 and how does it change in mild asthma?

A

Forced expiratory volume at 1 second. It is reduced in mild asthma.

29
Q

Intermittent asthma: Step 1 Tx?

A

SABA (short acting beta agonist - ex. albuterol) PRN; Short course of oral systemic corticosteroids may be needed

30
Q

Persistent Asthma: Step 2 Tx?

A

Low dose Inhaled Corticosteroids

31
Q

Persistent Asthma: Step 3 Tx?

A

ICS + LABA (long acting beta agonists) OR medium dose ICS

32
Q

Persistent Asthma: Step 4 Tx?

A

Medium dose ICS + LABA

33
Q

Persistent Asthma Step 5 Tx?

A

High dose ICS + LABA

34
Q

Persistent Asthma Step 6 Tx?

A

High dose ICS + LABA + oral corticosteroid

35
Q

Asthma Classification for: & Therapy step
Sx & SABA:< /= 2 days/wk
Niightime: 80% predicted
0/1 year times req’d oral sys corticosteroids

A

INtermittent; step 1

36
Q

Asthma Classification for: & Therapy step
Sx & SABA: > 2 days/wk but not daily
Niightime: 3-4/month
Minor activity limitation
FEV1 >80% predicted
>/= 2/ year times req’d oral sys corticosteroids

A

Mild; Step 2

37
Q

Asthma Classification for: & Therapy step
Sx & SABA: daily
Niightime: > 1/wk
Some activity limitation
FEV1 >60% predicted, but /= 2/ year times req’d oral sys corticosteroids

A

Moderate; Step 3

38
Q

Asthma Classification for: & Therapy step
Sx & SABA: Throughout the day
Niightime: often 7x/wk
extreme limitation
FEV1 /= 2/ year times req’d oral sys corticosteroids

A

Severe; STep 4 or 5

39
Q

Dx for Assessment:

Cough with or without sputum, occasional dyspnea or wheezing, normal VS, no tachypnea, tachycardia, rales, or egophany

A

Bronchitis

40
Q

Diagnostic tests needed for bronchitis?

A

Generally, none are needed. Occasionally CXR if possible pneumonia

41
Q

When can the need for CXR be eliminated?

A 
Absence of:
HR >100
RR >24
oral temp > 38
chest exam findings of focal consolidation, egophany, or fremitus
42
Q

Differential dx for bronchitis which are characterized by wheezing, tachypnea, respiratory distress, and hypoxemia

A

pneumonia, asthma, bronchiolitis

43
Q

First line tx for bronchitis

A

Directed toward symptom reduction- rest, increased fluids, humidified air

44
Q

WHen to refer for bronchitis?

A

Does not repsond to symptomatic tx for 2 weeks

45
Q

Who is at most risk for gram positive bacterial pneumonia?

A

People with other chronic conditions - DM, COPD, asplenia, advanced age, CHF, etc.

46
Q

Dx for symptoms:
abrupt onset high fever, shaking, chills, productive cough with purulent sputum, posibble pleuritic type chest pains, consolidation (egophaony, fremitus, dullness onpercussion, rales, rhonchi). CXR - single or multiple lobar consolidation

A

Gram Positive pneumonia

47
Q

Who is at most risk for gram Neg pneumonia

A

Older adults and those with chronic lung conditions

48
Q

Who is at risk for atypical pneumonia

A

Less than 40 yr/old (older children & young adults)

49
Q

Symptoms of atypical pneumonia

A

prodrome of fever, headache,myalgias, dry cough. CXR patchy alveolar densities

50
Q

First line tx for pneumonia

A

macrolide abx

NM703 Primary Care of the Woman (5 decks)

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