Course 2: Pathophysiology Flashcards
1
Q
CAD diagnosed by
A
Cardaic catheterization
2
Q
CAD assoc. meds
A
Aspirin (ASA) 324mp PO
Nitroglycerin (NTG) 0.4mg SL
3
Q
Aspirin
A
ASA
4
Q
Nitroglycerin
A
NTG
5
Q
CAD chief complaint
A
chest pain - worse with exertion
chest pressure
6
Q
CAD is the single greatest risk factor for ___
A
an MI
7
Q
Stress tests or _____ assess the severity of CAD.
A
Cardiac Catheritization
8
Q
A patient has CAD if they have a PMHx of ____
A
Angia, MI, CABG, Cardiac stents, angioplasty
9
Q
Risk factors of MI
A
CAD, HTN, HLD, DM, smoker, FHx of CAD
10
Q
MI diagnosed by
A
EKG (STEMI) or elevated Troponin (non-STEMI)
11
Q
MI assoc. meds
A
ASA, NTG, B-Blocker, Thrombolytic (Heparin)
12
Q
Acute MI patients must receive ___ ASAP
A
ASA 324mg
13
Q
STEMI patients must get to ___ within 90 minutes of arrival.
A
Cath-lab
14
Q
STEMI MI
A
ST elevated MI
15
Q
NON-STEMI
A
Non-STEMI
16
Q
CHF chief complaint
A
shortness of breath
worse lying flat
17
Q
Paroxysmal Nocturnal syspnea
A
PND
18
Q
Dyspnea on exertion
A
DOE
19
Q
CHF PE
A
Rales in lungs, JVD in neck, pitting pedal edema
20
Q
Jugular Vein distension
A
JVD
21
Q
Rales
A
Crackles
22
Q
CHF diagnosed by
A
CXR or elevated BNP
23
Q
B-type Natriuretic Peptide
A
BNP, released by cardiac tissue in the heart when exerted/stretched
24
Q
CHF can be thought of as __ in the heart, fluid gets backed up in the __ and down the legs (__)
A
fluid jam
JVD
Pedal edema
25
CHF assoc. meds
Diuretics (lasix, furosemide)
26
AFIB chief complaint
palpitations (fast, pounding, irregular)
27
AFIB risk factors
Paroxysmal A Fib, Chronic A Fib
28
AFIB PE
Irregulary irregular rhythm, tachycardia
29
AFIB diagnosed by
EKG
30
AFIB assoc. meds
Coumadin (Warfarin): blood thinner
| Digoxin: slows heart rate
31
RVR
rapid ventricular response
32
NSR
Natural sinus rhythm
33
Cardiovert
Restarting the heart to get it to normal rhythm
34
Pericarditis
Inflammation of the sac surrounding the heart causing CP
35
Pleurisy
Inflammation of the sac surrounding the lungs causing pleuritic CP
36
Costochondritis
Irritation of the ribs causing CP worsened by pressing on the sternum
37
Chest Wall Pain
Irritation of the chest wall causing pain with palpation of the chest
38
Pleural Effusion
Fluid collecting around the lungs causing SOB or CP
39
Angina
Chest pain when the heart isn't getting enough blood during exertion
40
PE risk factors
Known DVT, PMHx of DVT or PE, FHx, recent surgery, cancer, AFIB, immobility, pregnancy, BCP, smoking
41
Cheif complaint of PE
SOB or pleuritic chest pain (worse with deep breaths)
42
PE diagnosed by
CTA Chest or VQ scan
| D-dimer (aids in detecting clots, but cannot diagnose)
43
PNA risk factors
elderly, bedridden, recent chest injury, recent surgery
44
PNA chief complaint
SOB or productive cough
45
PNA assoc. Sx
Cough with sputum, fever, chest pain
46
PNA assoc. meds
Rocephin and Zithromax
47
PE of PNA shows
Rhonchi
48
PNA diagnozed by
CXR
49
Community acquired pneumonia
CAP
50
CAP protocol requires documenting of
Abx, vitals, mental status, and blood cultures
51
Pneumothorax
PTX, lung collapse
52
PTX chief complaint
SOB and one-sided chest pain
| sudden onset, often trauma patients
53
PE of PTX
Absent breath sounds unilaterally
54
PTX diagnosed by
CXR
55
Percentage of lung collapsed must be ___
documented
56
Chronic obstructive pulmonary disease
COPD
57
COPD risk factors
smoking
58
COPD chief complaint
SOB
59
PE of COPD
decreased breath sounds, wheezes, rales
60
COPD assoc. meds
Home 02
61
COPD diagnosed by
CXR and HX of smoking
62
Reactive airway disease
RAD
63
RAD chief complaint
SOB/Wheezing
| improved by nebulizer (bronchodilators)
64
PE of RAD
Wheezes
65
RAD assoc. meds
Inhalers, nebulizers, corticosteroids
66
RAD diagnosed by
clinically
67
Ischemic cerebral vascular accident
CVA
68
CVA chief complaint
unilateral focal neurologic deficits
one sided weakness, numbness
changes in speech/vision
69
CVA risk factors
HTN, HLD, DM, hx TIA,CVA, smoking, FHx CVA, AFIB
70
PE of CVA
Neuro deficits
71
CVA diagnosed
clinically
72
Always document the ___ of the time a CVA pt was last known well
date and time
73
tPA
powerful blood thinner that can reverse a CVA
| (if stroke occures
74
brain bleed chief complaint
headache, sudden onset
75
HCVA assoc. sx
changes in speech, perception, motor strength, AMS, seizure, headache
76
PE of HCVA
unilateral neurological deficits
77
Hemorrhagic CVA
HCVA, stroke
78
HCVA diagnosed by
CT hear, LP (lumbar puncture)
79
If HCVA, document tPA not indicated due to __.
hemorrhage
80
Transient Ischemic Attack
TIA
81
TIA chief complaint
transient focal neuro deficit
| changes in speech, vision, strength, or sensation
82
TIA diagnosed by
clinically
83
TIAs are known as ____
mini-strokes
84
TIAs usually last
85
With TIA document tPA considered and no indicated due to __
issue resolved
86
Meningitis chief complaint
headache and neck pain
87
Meningitis assoc. sx
fever, neck pain, neck stiffness, AMS
88
PE of meningitis
meningismus, nuchal rigidity
89
Meningitis diagnosed by
lumbar puncture
90
Spinal Cord Injury chief complaint
neck pain, back pain, bilateral extremity weakness
91
PE of Spinal Cord Injury
Midline bony tenderness, deformities, or step-offs
| bilateral extremity weakness, numbness, decreased rectal tone
92
Spinal cord injury diagnosed by
CT cervical/thoratic/lumbar spine
93
PE of a spinal cord injury immobilized with a ___
C-collar and backboard
94
Seizure
SZ
95
SZ chief complaint
seizure activity, syncope
96
SX assoc. sx
injuries (tongue bite), confusion, headache, incontinence
97
PE of SZ
somnolent, confused (post-ictal: aggitation, confusion after SZ)
98
SZ assoc. meds
Dilantin, Tegretol, Kreppa, Depakote, Neurontin
99
Bells Palsy Cheif complaint
Facial Droop
| sudden onset
100
Bells Palsy assoc. sx
jaw or ear pain
| increased tear flow from one eye
101
Bells Palsy pert. neg
no extremity weakness
| no changes in speech or vision
102
Bells Palsy diagnosed
clinically
103
PE of bells palsy
unilateral weakness of upper and lower face
104
____ is the most common cause of facial droop in young patients who do not have CVA risk factors
Bells Palsy
105
Headache
HA (cephalgia)
106
HA chief complaint
headache (gradual onset)
| pressure, throbbing
107
HA pertinent negatives
no fever, no neck stiffness, no numbness/weakness
| no changes in speech of vision
108
Altered mental status
AMS
109
AMS risk factors
diabetic, elderly, demented, ETOH use, drug use
110
AMS chief complaint
confusion, decreased responsiveness, unresponsive
111
AMS diagnosed by
case dependent
112
AMS causes
hypoglycemia, infection, intoxication, neurlogical
113
AMS is generalized and is typically caused by things that affect ____
the whole brain
114
Focal neuro deficits are localized weakness/numbness in one specific area, corresponding with ___
damage at one specific site in the brain
115
Most common cause of AMS for patients without a hx of dementia is from ___, most often caused by a ___.
infection
| UTI
116
Fainting, passing out
Syncope
117
syncope
temporary loss of blood supply to the brain resuling in loss of consciousness, due most commonly to vasovagal and low blood volume. other causes are cardiac/neurologic.
118
syncope chief complaint
passing-out (not "about" to pass-out)
119
Document what happened prior, during and after the syncopal episode in order to ___.
rule out possible dx
120
Vertigo
caused by inner ear (benign) or damage to center of brain
121
vertigo chief complaint
room spinning, off balance
122
vertigo assoc. sx
N/V, tinnitus
123
PE of vertigo
horizontal nystagmus, + romberg, + dix-hallpike test
124
vertigo assoc. meds
Meclizine (antivert)
125
Vertigo diagnozed by
clinically
126
Diseases associated with epigastric region
GERD, MI
127
Diseases associated with RUQ
cholecystitis
128
Diseases associated with LUQ
pancreatitis
129
Diseases associated with Periumbillical region
SBO
130
Diseases associated with RLQ
Appendicitis
131
Diseases associated with LLQ
Diverticulitis
132
Diseases associated with Suprapubic region
ovarian torsion
ovarian cyst
UTI
133
Diseases associated with Flanks
Pyelonephritis
| Renal Calculi
134
Appendicitis
APPY
135
APPY chief complaint
```
RLQ pain (gradual onset)
constant pain
pain worsened by movement
```
136
APPY assoc. sx
decreased appetite (anorexia)
fever
N/V
137
PE of APPY
McBurney's point tenderness
| RLQ tenderness
138
Small bowel obstruction
SBO
139
SBO risk factor
elderly, infants, abdominal surgery, narcotic pain meds
140
SBO chief complaint
abdominal pain, vomiting, constipation
141
SBO assoc. sx
abdominal distension
bloating
no BMs
142
PE of SBO
Abdominal tenderness, guarding, rebound
abdominal bowel sounds
abdominal distension, tympany (tightness)
143
SBO diagnosed by
CT A/P with PO contrast
| Acute abdominal series (AAS, type of xray)
144
Gallstones
Choleithiasis (stones)
| cholecystis (inflammation or infection)
145
gallstones catchphrase
RUQ abd pain after eating fatty foods
146
gallstones chief complaint
RUQ pain (sharp, worsened with eating/palpation)
147
PE of gallstones
RUQ tenderness, murphy's sign
148
Gallstones diagnosed by
abdominal US (ultrasound), RUQ
149
Gastrointestinal bleed
GI bleed
150
GI bleed chief complaint
hematemesis (upper)
coffe ground emesis (lower)
hematochezia (lower)
melena (upper)
151
GI bleed assoc. sx
generalized weakness, lightheadedness, SOB, abdominal pain, rectal pain
152
PE of GI bleed
pale conjunctiva, pallor, tachycardia
153
Rectal exam of GI bleed
melena, grossly bloody stool
154
GI bleed diagnosed by
Heme positive stool (guaiac positive) during a rectal exam
155
ED Concern
the need for a possible blood transfusion due to significant blood loss
156
Diverticulitis
acute inflammation of abdominal pockets of the large intestine
157
Diverticulitis risk factors
diverticulosis, advanced age
158
diverticulitis chief complaint
LLQ pain
159
diverticulitis assoc. sx
nausea, fever, diarrhea
160
diverticulitis diagnosed by
CT A/P with PO contrast
161
pancreatitis risk factors
ETOH abuse
Cholecystitis
specific meds
162
pancreatitis chief complaint
LUQ, epigastric pain
163
pancreatitis assoc. sx
N/V
164
PE of pancreatitis
epigastric tenderness
165
Pancreatitis diagnosed by
elecated lipase lab test
166
Acid Reflux
GERD
167
GERD chief complaint
epigastric pain
burning
improved with antacids
168
PE of GERD
epigastric tenderness
169
GERD assoc. meds
GI cocktail (numbs and sooths the esophagus and stomach)
170
Patients with cardiac risk factors and epigastric pain will always get a ____
cardiac workup
171
Abdominal pain - C. Diff. colitis
opportunistic baceria that causes persistent diarrhea
172
Abdominal pain - Gastroenteritis
vomiting and diarrhea "GI bug" often viral or bacterial
173
Abdominal pain - Chron's disease
immune disorder causing diarrhea and abdominal pain
174
Abdominal pain - IBS
chronically sensitive bowels prone to diarrhea
175
Abdominal pain - Gastritis
irritated stomach with vomiting "stomach ache"
176
Urinary tract infection
UTI
177
UTI risk factors
female
178
UTI chief complaint
dysuria (painful urination)
179
UTI assoc. sx
frequency, urgency, malodorous urine, AMS (elderly)
180
PE of UTI
suprapubic tenderness
181
UTI diagnosed by
urine dip
| urinalysis (test for nitrite, WBC)
182
Pyelonephritis
infection of the tissue in the kidneys, usually spread from a UTI
183
pyelo risk factors
female, frequent UTIs
184
pyelo chief complaint
flank pain with dysuria
185
pyelo assoc. sx
fever, N/V
186
Pyelo diagnosed by
CT abdomina/pelvis
187
Kidney stones
nephrolithiasis, renal calculi, urolithiasis
188
Kidney stones chief complaint
flank pain
sudden onset
radiating to groin
189
kidney stones assoc. sx
hematuria, N/V, unable to void
190
PE of kidney stones
CVA tenderness
191
kidney stones diagnosed by
CT abd/pelvis
| RBC in UA may be a clue
192
Ectopic pregnancy
tubal pregnancy
193
tubal pregnancy
fertilized egg develops outside uterus, usually in the fallopian tube, high risk for rupture and death
194
tubal preg risk factors
preg female, STDs
195
tubal preg chief complaint
lower abdominal pain
| vaginal bleeding while pregnant
196
tubal preg diagnosed by
US Pelvis (determine location)
197
Ovarian torsion
twisting of an ovarian artery reducing blood flow
198
ovarian torsion chief complaint
lower abdonminal pain
199
PE of ovarian torsion
adnexal tenderness, lower abdominal pain
200
Ovarian orsion diagnosed by
US pelvis
201
testicular torsion
twisting of spermatic cord
202
testicular torsion chief complaint
pain
203
testicular torsion diagnosed by
US scrotum
204
Upper respiratory infection
URI
205
URI chief complaint
cough, congestion
206
URI assoc. sx
fever, sore throat, headache, myalgias
207
PE of URI
rhinorrhea, boggy turbinates, pharyngeal erythema
208
URI diagnosed by
clinically
209
Pay special attention to any complaints of __ or __ for URI patients
CP
| SOB
210
middle ear infection
oititis media
211
otitis media chief complaint
ear pain, ear pulling
212
oititis media assoc. sx
fever, sore throat, dry cough, congestion
213
PE of otitis media
erythema, effusion, dullness, or bulging of the tympanic membrate (TM)
214
otitis media diagnosed
clinically
215
strep throat
streotococcal pharyngitis
216
strep throat chief complaint
sore throat
217
PE of strep throat
pharyngeal erythema
tonsillar hypertrophy
tonsillar exudates
218
strep throat diagnosed by
rapid strep
219
pink eye
conjunctivitis
220
pink eye chief complaint
eye redness
irritation
pain
221
pink eye assoc sx
eyelid matting, eye discharge, fever
222
PE of pink eye
```
conjunctival injection (redness)
edema, exudates
```
223
pink eye diagnosed by
clinically
224
Nosebleed
epistaxis
225
nosebleed risk factors
blood thinners (coumadin/warfarin ASA, plavix) or HTN
226
PE of nosebleed
anterior, posterior, or septal source
227
nosebleed diagnosed by
clinically
228
patients on blood thinners who have a nosebleed will have __ to make sure blood isn't too thin
coagulation labs (PT/INR) drawn
229
Musculoskeletal back pain chief complaint
back pain
230
Musculoskeletal back pain assoc sx
shooting posterior lower extremity pain
231
Musculoskeletal back pain pert. negs.
No LE weakness
| No incontinence
232
PE of Musculoskeletal back pain
paraspinal tenderness
| positive straight leg raise (+SLR diagnoses sciatica)
233
Extremity injury chief complaint
pain
234
extremity injury pert negs
no motor weakness, no numbness or tingling
235
PE of extremity injury
distal CSMT intact (circulation, sensory, motor, tendon)
no tendon or ligament laxity
ROM limited secondary to pain
236
Hemoglobin
red blood cell
237
Abdominal Aortic aneurysm
AAA
238
AAA PE
midline pulsatile abdominal mass, abdominal bruit, unequal femoral pulses, hypotension
239
AAA diagnosed by
CT A/P with IV contrast dye
240
Aortic dissection
separation of the muscular wall from the membrane of the artery, putting the pt at risk of aortic rupture and death
241
Aortic dissection diagnosed by
CT Chest with IV dye
242
Deep vein thrombosis
DVT
243
DVT risk factors
PMHx of DVt pr PE, FHx, recent surgery, cancer, immobility, preg, BCP, smoking LE trauma, LE casts
244
DVT chief complaint
extremity pain and swelling (atraumatic)
| usually located in a lower extremity
245
DVT diagnosed by
US/doppler of extremity
246
Cellulitis chief complaint
red, swolen, painful and sometimes warm area of skin
247
PE of cellulitis
erythema, edema, increased warmth (calor) inducration
248
cellulitis diagnosed by
clinically
249
Abscess
cellulitis with fluctuance
250
abscess chief complaint
red, swollen, painful lump
251
PE of abscess
fluctuance, induration, purulent drainage
252
abscess diagnosed
clinically
253
rash
change in skins appearance due to reaction
254
PE of rash
urticaria (hives or wheals), macules (flat), papules (raised bumps), vesicles, blanching, petechaie (dangerous rash), purpura (dangerous rash)
255
Rash diagnosed by
clinically
256
PE of allergic reaction
edema, facial angioedema, urticaria (hives, wheals)
257
ED concern of allergic reaction is
anaphylaxis
258
allergic reaction
rash
itching
swelling
SOB due to airway swelling
259
adverse reaction
nausea/vomiting
abdominal pain
diarrhead
260
Diabetic ketoacidosis
DKA
261
DKA chief complaint
persistent vomiting with a hx of DM
262
DKA assoc. sx
SOB, polydipsia, polyuria
263
PE of DKA
ketotic odor, dry mucous membranes, tachypnea
264
DKA diagnosed by
arterial blood gas (ABG or VBG) showing low pH or positive serum ketones
265
DKA treated with
hydration/insulin
266
PE of Psych disorder
flat affect, SI, HI, tangential or pressured speech
267
Psych patients should clear the patient __ first.
medically
268
Trauma
physical injury
269
Mechanism of injury
MOI
270
PE of trauma
glasgow coma scale (GCS)
271
Trauma diagnosed by
trauma protocol depending on MOI: CT or XR
272
Neurological injury trauma (scribe alerts)
```
LOC (loss of consciousness)
confusion
numbness
weakness
HA
neck/back pain
internal organ injury
SOB
chest pain
abdominal pain
```
273
MOI MVA
head on
tbone
rear impact
rollover
274
MOI urgent MVA
ejection
motorcycle/atv
auto/pedestrian
275
MOI rapid vertical deceleration
severe: greater than 3x pt height
276
MOI penetrating trauma
location, depth, angle
