Course 2 Pathophys Review Questions Flashcards
What other past histories would suggest that a pt has CAD?
PMHx of Angina, MI, CABG, Cardiac stents, or Angioplasty
Does a PMHx a A-Fib or CHF, do they also have CAD?
No
Does a PMHx of CVA mean the pt has CAD?
No
Does a surgical history of angioplasty mean the pt has CAD
Yes
Explain the difference between CAD and MI.
MI is acute, CAD is chronic
If someone has a PMHx of A-fib or CHF, do they also have CAD?
No
What are the “cardiac risk factors?”
CAD, HTN, HLD, MD, Smoker, FHx of CAD
How is CAD diagnosed?
Cardiac Catheterization (Not in the ED)
Name two ways that an MI can be diagnosed?
EKG (STEMI) or elevated Troponin (Non-STEMI)
What are some associated symptoms of an MI other than CP?
Diaphoresis, N/V and SOB
What are some associated symptoms of CHF?
SOB with pedal edema and orthopnea
What 2 studies would diagnose CHF
CXR or BNP (B-type Natriuretic Peptide)
CHF Lab
What is A-Fib?
Atrial Fibrillation
What might someone feel with A-Fib?
Palpitations (Fast, Pounding, Irregular)
How is an A-Fib diagnosed?
EKG (ECG)
What could the CC of someone with a PE?
SOB or Pleuritic chest pain (CP worse with deep breaths)
What are risk factors for a PE?
Known DVT, PMHx of DVT or PE, FHx, Recent surgery, Cancer, A-Fib, immobility (from traveling) , Pregnancy, BCP, Smoking.
What study would diagnose a PE
CTA Chest (CT with IV contrast) or VQ scan. D-Dimer aids in detecting lots but doesn’t dx a PE
What part of the heart does CAD affect; Arteries, Veins, or Nerves?
Arteries
Can a CT Chest without IV contrast diagnose a PE? Why or Why not?
No because you need to see where the blockage is.
What is a PTX?
Pneumothorax
What is the most common cause of PTX?
Trauma or a spontaneous small rupture of the lung
How is a PTX diagnosed?
CXR
What social history will most COPD patients also have?
Smoking
What is the difference between an inhaler and a nebulizer for asthma?
Hand device vs a machine
What is asthma?
Reactive Airway Disease (RAD) - constricting of the airway due to inflammation and muscular constriction of the bronchioles, known as a “bronchospasm”.
What physical exam finding closely associates with asthma?
Wheezes (Inspiratory or Expiratory)
What is PNA?
Pneumonia
What might a person with PNA complain of?
SOB or Productive cough (phlegm)
How is PNA diagnosed?
CXR
Name all 7 areas of the abdomen
Epigastrium, suprapubic, periumbilical, RUQ, LUQ, RLQ, LLQ
What is the layman’s name for GERD
Acid Reflux
What might someone with GERD complain of?
Epigastric pain: Burning, Improved with antacids
For older pts with GERD symptoms, what life-threatening disease may also need to be ruled out?
Cardiac risk factors (MI, CAD)
What does bile do? Where is it stored?
Breaks down fat, stored in the gallbladder
What is the difference between Cholelithiasis and Cholecystitis?
a gallstone vs inflammation of the gallbladder
How are gallstones diagnosed?
abdominal US, RUQ
Name associated symptoms of appendicitis (APPY)
Decreased appetite (anorexia), Fever, N/V
How is appendicitis diagnosed?
CT A/P with PO contrast
What would someone with pancreatitis c/o?
LUQ, Epigastric pain
How is a pancreatitis diagnosed?
Elevated Lipase ab test (or sometimes elevated Amylase)
Name four possible CC’s for a GI bleed
Hematemesis, Coffee ground emesis, Hematochezia, Melena
What are we worried about for someone with a GI bleed?
Can lead to anemia
What is the pre-existing condition you must have before you can get diverticulitis?
Diverticulosis
What will be the CC for someone diverticulitis?
LLQ pain
What studies would diagnose diverticulitis?
CT A/P with PO Contrast
What might a person with a SBO complain of?
Abdominal Pain, Vomiting
How is SBO diagnosed?
CT A/P with PO contrast
Acute Abdominal Series (AAS)
What is a UTI
Urinary Tract Infection
What is pyelo?
Infection of the kidneys (Pyelonephritis)
What will be the CC of someone with a UTI?
Dysuria
Where would a person feel pain if they had pyelo?
Flank Pain
How is a UTI diagnosed?
Urine Drip, urinalysis
What is CAD
Coronary Artery Disease (CAD)
What might a person with kidney stones complain of?
Flank Pain: sudden onset, radiating to groin
How are kidney stones diagnosed?
CT Abd/Pelvis
RBC in UA may be a clue
What is an ectopic pregnancy?
Tubal Pregnancy- fertilized egg develops outside the uterus, usually in the fallopian tubes.
How is an ectopic pregnancy diagnosed?
US Pelvis -> determine location of fetus
What is ovarian torsion?
Twisting of an ovarian artery reducing blood flow to an ovary, possibly resulting in infarct of the ovary
Name the 2 types of CVA’s
Ischemic Cerebral Vascular Accident Hemorrhagic CVA (brain bleed)
What Sx might a person with an ischemic CVA c/o?
Unilateral focal neurological deficits: One sided weakness/numbness or changes in speech/vision
VND (numb, weak, speech, vision)
How is an ischemic CVA diagnosed?
Clinically, Potentially normal CT Head
What is a common cause for seizures in children?
Febrile
What is the name of the state after a seizure?
Post-Ictal
What are 3 symptoms of meningitis?
Fever, Neck pain, neck stiffness, AMS
What study would diagnose meningitis?
lumbar puncture
What are 4 important things to document for syncopal episodes?
What happened prior, during, and after the syncopal episode, as well as how the patient currently feels
Name 4 causes of altered mental status
Hypoglycemia, infection, intoxication, and neurological
How is AMS different from a focal neuro deficit?
AMS is generalized and is typically caused by things that affect the whole brain. Focal neuro deficits are localized weakness/numbness in one specific area corresponding with damage at one specific site in the brain.
What is a DVT
Deep Vein Thrombosis
What are the risk factors for a DVT
PMHx of DVT or PE, Recent Surgery, Cancer, immobility, Pregnancy, BCP, smoking, LE trauma, LE casts
What are common signs of a DVT?
Extremity Pain and swelling, Calf Tenderness, Cords, Homan’s Sign
What is an AAA
Abdominal Aortic Aneurysm
What is an aortic dissection?
Separation of the muscular wall from the membrane of the artery, putting the patient at risk of aortic rupture and death
What are 3 symptoms of cellulitis?
Erythema, Edema, Increased Warmth and Induration
How is an abscess different from cellulitis?
Abscess have pus pockets
What procedure will be performed for every abcess
Incision and drainage
What is the main concern with an allergic reaction?
Anaphylaxis
What are the only three symptoms of a true allergic reaction?
Swelling due to SOB, rash, itching.
How can Diabetic Ketoacidosis (DKA) be diagnosed?
Arterial Blood Gas (ABG or VBG) showing low pH(acidosis) or positive serum ketones
What is a physicians main responsibility for psychiatric patients?
medical clearance; determining the patient is not medically ill
Name 3 important things to document for any trauma patient.
LOC, HA, Neck Pain, Back Pain
What is a TIA?
Transient Ischemic Attack
How does a TIA differ from a CVA
TIA regains neurological function
What might be the CC of a person with gallstones?
RUQ Pain, Sharp, Worsened with Eating, Deep Breath, and Palpation
What Sx might a person with a brain bleed complain of
Headache, Sudden Onset (Thunderclap, Worst of Life)
What study would diagnose a brain bleed?
CT head or LP
How is a GI bleed diagnosed in the ED?
Heme Positive Stool (Guaiac Positive), Gastroccult
