Chest Pain & Respiratory Distress Flashcards
*Differences between STABLE, UNSTABLE, and ATYPICAL ANGINA
- Stable: chest pain w exertion, relative to amt of exertion, improves w rest and nitroglycerin
- Unstable: sxs are worse… an MI waiting to happen. pain more easily provoked by exertion, occurs more requently, longer lived, required more rest and NTG for relief. EMERGENCY- go to hospital to get tx.
- Atypical: occurs at rest
*#1 cause of MI
plaque rupture leading to thrombosis of A
*MONA is used for?
tx of MI
- morphine
- oxygen
- nitroglycerin
- chewable aspirin
*STEMI in V1-V6 means…
Anterolateral L Ventricle MI (most common)
*Q waves are affected more so in…
transmural inferior MI’s
not NSTEMI
*Prior to cardiac Troponins, the cardiac marker used was…
CK-MB, creatine kinase MB iso-enzyme
was there injury to the HT?
*CPR compression-ventilation Ratio
30:2 w/1 -2 rescuers
tx fibrillation w electricity
*Aortic Arch Aneurysm/Dissection presents w pain to…
tearing pain between scapula
2 Aortic Dissection acute complications mentioned in class…
- —> Acute Renal Failure dt decreased blood to the KDs
- —> Acute Aortic Valve Regurg. if tear is near there
An MI can cause _______ which is the MC eti of death after an MI.
Ventricular Fibrillation Arrhythmia
MI Sxs
- chest pain
- dyspnea (SOB)
- diaphoresis
- HALF ARE CLINICALLY SILENT or non-classic presentation (FEMALES, DIABETES)
*Beck’s Triad is what and used for what?
PE findings in Cardiac Tamponade
- low BP (can’t return blood to HT efficiently)
- JVD, acute onset
- muffled HT sounds
- What is Pulsus Paradoxus?
- conditions
nothing to do w PULSE!!
- decreased systolic on inspiration (at least 10mmHg)
- cardiac tamponade, PE, Pericardial Effusion, R Ventricular Failure/Infarction, respiratory failure in asthma
Electrical Alternans
alternating shape of QRS complex in amplitude
- seen in cardiac tamponade, pericardial effusion
- wobbling heart in fluid sac
*What is Virchow’s Triad?
group of causes that lead to thrombosis and thus PE:
- alteration in blood flow (bed rest, injury, pregN, obesity, CA)
- factors within vessel wall (surgery, catheterization)
- factors affecting coag. of blood (hormones, genetics, deficiencies, smoking, CA)
*Differences and Similarities between Well’s Score for PE and DVT:
- PE: clinically suspected DVT, tachycardia, prior Hx of DVT or PE, hemopysis
- DVT: pitting edema, tenderness, swollen leg/calf, superficial veins
- PE and DVT: alt. dx less likely, immobilization/surgery, prior Hx of DVT, CA
MC SXS of PE
- feeling of dread
- dyspnea/SOB
- pleuritic chest pain
- cough
- hemoptysis
3 D’s (Sxs) in children w Epiglottitis
- dysphagia
- drooling
- distress
… sitting position w trunk leaning forward, neck hyperextending w chin thrust forward “tripod” position and HOT POTATO voice
*Stages of Acute Asthma
- FEV1 50-80% of norm.; MILD
- FEV1 50% or less; MODERATE, wheezing, respiratory distress at rest
- FEV1 25-11%; SEVERE; marked wheezes OR absent breath sounds; mb pulsus paradoxus, SCM contraction
- FEV1 10% or less; RESPIRATORY FAILURE, lethargy, confusion
*During Anaphylactic Shock, are there C/I to Epi? How much?
NO!
IM EPI 0.3-0.5 mg of a 1mg/mL prep
*What type of reaction is Anaphylaxis? How is this different from Anaphylactoid?
IgE… loss of vascular integrity, edema of throat/neck, closes airway.. fluid in LU.. decreased vol. in blood –> shock
- Anaphylactoid is non-IgE mediated but resembles anaphylaxis…. often occurs w 1st exposure to certain drugs. Asthma pts at high risk! .. (remember Samter’s Triad: nasal polyps, sens. to ASA, NSAIDS, hay fever)