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Scribe america > Course 2: Pathophysiology > Flashcards

Course 2: Pathophysiology Flashcards

1
Q

Example Pathophysiology (ED Flow)

A
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2
Q

Differential Diagnosis

A

1. Differential Diagnosis: the different diseases the physician comes up with to explain the true source of the pc’s chief complaint

  1. associated symptoms, associated meds, PE findings, and diagnosis of diseases are all methods used to condirm the differential diagnosis
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3
Q

Pertinent Positives

A

specific symptoms that raise the physician’s suspicion for a particular disease

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4
Q

Pertinent Negatives

A

specific symptoms that are not present which cause teh physician to doubt certain diagnosis

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5
Q
A
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6
Q

Coronary Artery Disease

(Etiology)

A

CAD

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7
Q

Myocardial Infarction

(Etiology)

A
  1. MI:
    1. ​STEMI—» ST elevation present (EKG)
    2. non-STEMI—» happened recently but non-ST elevated MI (troponin lvls)
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8
Q

Congestive Heart Faliure

(Etiology)

A
  1. CHF
  2. heart becomes enlarged, inefficient, and congested with excess fluid
  3. PE:

A) rales (snap, crackle, pop sound in lungs upon breathing),

B) Jugular Vein Distention (JVD) in neck,

C) pitting pedal edema ( Observable swelling of body tissues due to fluid accumulation that may be demonstrated by applying pressure to the swollen area)

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9
Q

Atrial Fibrillation

(Etiology)

A
  1. AFIB
  2. electrical abnormalities in the “wiring” of the heart causes the top of the heart (atria) to quiver abnormally
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10
Q

what are 3 Shortness of Breath (SOB) Symptoms associated with CHF?

A
  1. worse with lying flat (Orthopnea)
  2. paroxysmal nocturnal dyspnea (PND)
  3. Dyspnea on Exertion (DOE)
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11
Q

inflammation of the sac surrounding the heart causing CP (chest pain)

A

Pericarditis

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12
Q

inflammation of the sac surrounding the lungs causing pleuritic CP

A

Pleurisy

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13
Q

irritation of the ribs causing CP worsened by pressing on the sternum

A

Costochondritis

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14
Q

irritation of the chest wall causing pain with palpation of the chest

A

Chest Wall Pain

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15
Q

fluid collecting around the lungs causing SOB or CP

A

Pleural Effusion

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16
Q

Cardiovascular Summary Slide

  1. Diagnosis
  2. What is it?
  3. Diagnosed by what tests?
A
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17
Q

Pulmonary Embolism

(Etiology)

A
  1. PE
  2. a blood clot disloges from pulmonary artery and blocks blood flow to the lungs
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18
Q

Pneumonia

(Etiology)

A
  1. PNA
  2. infiltrate (bacterial infection) and inflammation within the lung
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19
Q

Pneumothorax

(Etiology)

A
  1. PTX
  2. collapsed lung due to trauma or a spontaneous small rupture of the lung
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20
Q

Chronic Obstructive Pulmonary Disease

(Etiology)

A
  1. COPD
  2. long-term damage to lung’s alveoli (emphysema) along w/inflammation and mucus production (chronic bronchitis)
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21
Q

Asthma (Reactive Airway Disease)

(Etiology)

A
  1. Asthma
  2. constricting of the airway due to inflammation and muscular contraction of the bronchioles (i.e. bronchospasm)
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22
Q

Pulmonary Summary

  1. Diagnosis
  2. catch phrase?
  3. Diagnosed by…?
A
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23
Q

Ischemic Cerebrovascular Accident

(Etiology)

A
  1. CVA
  2. blockage of the arteries supplying blood to the brain resulting in permanent brain damage
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24
Q

Transient Ischemic Attack

(Etiology)

A
  1. TIA
  2. vascular changes temporarily deprive part of the brain from oxygen—»symptoms generally last less than 1 hr
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25
Q

Hemorrhagic Cerebrovascular Accident

A
  1. CVA (brain bleed)
  2. traumatic or spontaneous rupture of blood vessels in the head leads to bleeding in brain
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26
Q

Meningitis: Bacterial vs. Viral

(Etiology)

A

inflammation and infection of the meninges; the sac surrounding the brain and spinal cord

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27
Q

Spinal Chord Injury

(Etiology)

A

injury to the spinal cord = weakness/numbness in the extremeties, past the site of injury

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28
Q

Seizure

(Etiology)

A
  1. SZ
  2. abnormal electrical activity in the brain = abnormal physical manifestations
  3. common causes = epilepsy, ETOH withdrawl, febrile SZ in pediatric pts
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29
Q

Bell’s Palsy

(Etiology)

A

inflammation or viral infection of facial nerve causes one-sided weakness of the entire face

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30
Q

Headache (Cephalgia)

(Etiology)

A
  1. HA
  2. anything from hypertensive headaches (high BP), recurrent diagnosed migraines, sinusitis, etc,
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31
Q

Altered Mental Status

(Etiology)

A
  1. AMS
  2. multiple causes: hypoglycemia, infection, intoxication, and neurological causes
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32
Q

syncope

(Etiology)

A
  1. temporary loss of blood supply to the brain = loss of consciousness
  2. common causes = vasovagal & low blood volume (dehydration/hypovolemia), and rarely due to cardia/neurologic causes
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33
Q

Vertigo (Dizziness)

(Etiology)

A

caused by 1 of 2 etiologies…

  1. vertigo may be from a harmless problem of inner ear (benign positional vertigo)
  2. due to camage in a specific center of the brain (i.e. possible CVA)
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34
Q

Neurological Summary

  1. diagnosis
  2. important things to document
A
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35
Q

Abdominal Quandrants & Associated Disorders

A
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36
Q

Appendicitis

(Etiology)

A
  1. APPY

2, infection of appendix causes inflammation and blockage, sometimes leading to rupture

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37
Q

Small Bowel Obstruction

A
  1. SBO
  2. physical blockage of the small intestine
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38
Q

Gallstones

A
  1. Cholelithiasis / Cholecyctitis
  2. minerals from liver’s bile condense to form gallstones –» irritate, inflame, or obstruct gallbladder
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39
Q

Gastrointestinal Bleed

A
  1. GI Bleed
  2. hemorrhage in upper/lower GI tract leads to anemia
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40
Q

Hematemesis

A
  1. vommiting of blood (usually from the GI tract)

(A) brighter blood = upper GI tract

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41
Q

Coffee ground emesis

A
  1. vommiting of blood (usually from the GI tract)

(A) darker blood = lower part of GI tract

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42
Q

Hematochezia

A
  1. passage of blood through stool (usually from the GI tract)

(A) brighter blood = lower GI tract

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43
Q

Melena

A
  1. passage of blood though stool (usually from the GI tract)

(A) darker blood = upper GI tract

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44
Q

Diverticulitis

A

acute inflammation and infection of abnormal pockets of the large intestine (i.e. diverticula)

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45
Q

Pancreatitis

A

inflammation of the pancreas

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46
Q

Gastroesophageal Reflux Disease

A
  1. GERD
  2. stomach acid regurgitating into the esophagus
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47
Q

C. Diff Colitis

A

opportunistic bacteria that causes persistent diarrhea (Stool therapy)

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48
Q

gastroenteritis

A
  1. vomiting and diarrhea
  2. “GI Bug” often viral or bacterial
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49
Q

Crohn’s Disease

A

immune disorder causing diarrhea and abdominal pain

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50
Q

Irritable Bowel Syndrome

A

chronically sensitive bowels prone to diarrhea

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51
Q

Gastritis

A
  1. irritated stomach w/vomiting
  2. “somach ache”
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52
Q

GI Tract Summary

  1. diagnosis
  2. abdominal region
  3. diagnosed with…?
A
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53
Q

Urinary Tract Infection

A
  1. UTI
  2. infection in the urinary tract (bladder or urethra)
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54
Q

(1) NEPHROLITHIASIS

vs.

(2) Renal Calculi

vs.

(3) URETEROLITHIASIS

A
  1. NEPHROLITHIASIS: the process of forming a kidney stone
  2. Renal Calculi: term for physicial kidney stone
  3. URETEROLITHIASIS: process of stones traveling through ureter
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55
Q

Kidney Stone

A

Nephrolithiasis / Renal Calculi / Ureterolithiasis

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56
Q

Ectopic Pregnancy (Tubal Pregnancy)

A

fertilizzed egg develops outside the utereus (usually in fallopian tube) —» high risk for rupture/death

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57
Q

Testicular Torsion

A

Male

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58
Q

Ovarian Torsion

A

Female

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59
Q

Genitourinary Summary

A
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60
Q

Abdominal Aortic Aneurysm

A
  1. AAA
  2. widened and weakened arterial wall at risk of rupture
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61
Q

Aortic Dissection

A

separation of muscular wall from membrane of the artery, putting the pt at risk for aortic rupture and death

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62
Q

Deep Vein Thrombosis

A
  1. DVT
  2. slow filling blood in the straight veins of extremities can lead to clotting, which can eventually block the vein
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63
Q

Sepsis

A
  • chemicals in the immune system that release into the blood to fight infection, cause inflammation throughout the body instead
  • severe cases can lead to septic shock (medical emergency)
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64
Q

Upper Respiratory Infection

A
  1. URI
  2. most often viral infection causing congestion, cough, and inflammation of upper airway
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65
Q

Otitis Media

A
  1. Middle Ear Infection
  2. viral/bacterial infection of tympanic membrane (TM) causing ear pain and pressure
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66
Q

Strep Throat

A
  1. STREPTOCOCCAL PHARYNGITIS
  2. bacterial infection of the tonsils and pharync causing a sore throat and frequently swollen lymph nodes
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67
Q

Musculoskeletal Back Pain

A
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68
Q

Extreme Injury

A
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69
Q

Allergic Reaction

A
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70
Q

Allergic vs. Adverse Reactions

A
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71
Q

Cellulitis

A

infection of the skin cells

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72
Q

Abscess (Cellulitis w/Fluctuance)

A

skin infection with an underlying collection of pus

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73
Q

Rash

A
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74
Q

Diabetic Ketoacidosis

A
  1. DKA
  2. shortage of insulin resulting in hyperglycemia and production of ketones
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75
Q

Trauma (Physical Injury)

A
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76
Q

Trauma: Mechanism of Injury [MOI]

A
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77
Q

Psychological Disorders

A
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78
Q

what other past histories would suggest that a patient has CAD?

(5)

A
  1. MI,
  2. Angina (CP due to heart-muscle ischemia)
  3. CABG,
  4. Stent,
  5. Angioplasty (ballon)
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79
Q
  1. Does a PMHx of CVA mean the patient has CAD?
  2. Does a surgical history of angioplasty mean the patient has CAD?
A
  1. NO
  2. YES
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80
Q

Explain the difference between CAD and an MI

A

CAD is a broad term for heart disease. MI is included in CAD —» It’s an active heart attack.

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81
Q

If someone has a PMHx of A-Fib or CHF, do they also have CAD?

A

NO

82
Q

What are the “cardiac risk factors?”

(6)

A
  1. HTN,
  2. DM,
  3. HLD,
  4. CAD,
  5. Smoking,
  6. FHx CAD < 55 y/o
83
Q

How is CAD diagnosed?

A

By a cardiologist during a cardiac catheterization (Not done in the ED)

84
Q

Name two ways that an MI can be diagnosed?

A
  1. STEMI —» EKG
  2. Non-STEMI —» Troponin
85
Q

What are some associated symptoms of an MI other than CP?

A
  1. N/V,
  2. SOB,
  3. Diaphoresis (sweating)
86
Q

Diaphoresis

A

sweating —» especially to an unusual degree as a symptom of disease or a side effect of a drug

87
Q

What are some associated symptoms for CHF?

A
  1. SOB (Orthopnea, PND, DOE)
  2. pedal edema
88
Q

What 2 studies would diagnose CHF?

A
  1. CXR
  2. Elevated BNP
89
Q

What is A-Fib?

A

Electrical abnormality of the heart causing the top of the heart to quiver

90
Q

What might someone feel with A-Fib?

A

Palpitations, fast, pounding, irregular heartbeat

91
Q

How is A-Fib diagnosed?

A

EKG

92
Q

What could be the CC of someone with a PE?

A

Pleuritic CP or SOB

93
Q

What are 10 risk factors for a PE?

A
  1. Known DVT,
  2. PMHx of DVT or PE,
  3. FHx of DVT or PE,
  4. recent surgery,
  5. CA,
  6. Afib,
  7. immobility,
  8. pregnancy,
  9. BCP,
  10. smoking
94
Q

What study would diagnose a PE?

A
  1. CTA Chest/VQ Scan —» (D-Dimer can only rule it out)
95
Q

What part of the heart does CAD affect; Arteries, Veins, or Nerves?

A

Arteries

96
Q

Can a CT Chest without IV contrast diagnose a PE? Why or why not?

A

No. Contrast in the vessels(IV) helps clearly see a blockage.

97
Q

What is the most common cause of a PTX?

A

trauma

98
Q

How is a PTX diagnosed?

A

CXR

99
Q

What social history will most COPD patients also have?

A

smoking

100
Q

What is the difference between an inhaler and a nebulizer for asthma?

A
  • An inhaler is portable and gives a one time dose and provides a rapid release of medication.
  • A nebulizer is a home machine that delivers continuous treatment over a period of time.
101
Q

What is asthma?

A

Constricting of the airway due to inflammation and muscular contraction of the bronchioles. Also called Reactive Airway Disease

102
Q

What physical exam finding is closely associated with asthma?

A

Wheezes/ing

103
Q

What are the CC for a person with PNA?

A

Productive cough and fever

104
Q

How is PNA diagnosed?

A

CXR

105
Q

Name all 7 areas of the abdomen.

A
  1. Epigastric,
  2. RUQ,
  3. LUQ,
  4. RLQ,
  5. LLQ,
  6. Suprapubic,
  7. Periumbilical (Right/ Left flank)
106
Q

What is the layman’s name for GERD?

A

“Heartburn” or Acid Reflux

107
Q

What might someone with GERD complain of?

A

Epigastric pain “burning”

108
Q

For older patients with GERD symptoms, what life-threatening disease may also need to be ruled

out?

A

MI

109
Q

What does bile do? Where is it stored?

A
  1. Bile emulsifies the fats in foods.
  2. It is stored in the gallbladder and made in the liver
110
Q

What is the difference between Cholelithiasis and Cholecystitis?

A
  1. Cholelithiasis is gallstones.
  2. Cholecystitis is acute gallbladder inflammation/infection.
111
Q

What might be the chief complaint of a person with gallstones?

A

RUQ abdominal pain

112
Q

What physical exam finding is closely associated with Cholecystitis?

A

Murphy’s Signs

113
Q

How are gallstones diagnosed?

A

Abdominal Ultrasound of the RUQ

114
Q

Name associated symptoms of appendicitis.

A
  1. Fever
  2. N/V
  3. decreased appetite (anorexia)
  4. Note: RLQ pain —» gradual, constant, worse w/ movements is the CC (not associated sx)
115
Q

How is appendicitis diagnosed?

A

CT A/P with PO contrast

116
Q

What would someone with pancreatitis c/o?

A
  1. LUQ or epigastric abdominal pain
  2. N/V
  3. fever
117
Q

How is pancreatitis diagnosed?

A

Elevated Lipase (or Amylase which is less specific)

118
Q

Name four possible CC’s for a GI bleed pt.

A
  1. hematemesis
  2. coffee ground emesis
  3. hematochezia
  4. melena
119
Q

How is a GI bleed diagnosed in the ED?

A
  1. Guaiac positive or heme + stool
  2. gastroccult
120
Q

What are we worried about for someone with a GI bleed?

A

Anemia—»too much blood loss

121
Q

What is the pre-existing condition you must have before you can get diverticulitis?

A

Diverticulosis —» the condition of having diverticula, small outpouchings from the large intestine

122
Q

What will be the CC for someone with diverticulitis?

A

LLQ abdominal pain

123
Q

What studies would diagnose diverticulitis?

A

CT A/P with PO contrast

124
Q

What might a person with a SBO complain of?

A
  1. Abd pain/bloating
  2. vomiting
  3. abdominal distention (occurs when substances, such as air (gas) or fluid, accumulate in the abdomen causing its expansion)
  4. no BM’s —» constipation
125
Q

How is an SBO diagnosed?

A
  1. CT A/P w/ PO contrast
  2. AAS (acute abd series) X-ray
126
Q

What is pyelo?

A
  1. Pyelonephritis —» Kidney infection (different and worse than a UTI)

(A) usually spread from an UTI

127
Q

What will be the CC of someone with a UTI?

A

painful urination (dysuria)—» frequency, burning, hesitancy, and malodorous urine

128
Q

Where would a patient feel pain if they had pyelo?

A
  1. flank pain
  2. fever
  3. Dysuria (painful/difficult urination)
129
Q

How is a UTI diagnosed?

A

Urine dip or urinalysis (UA) showing white blood cells, bacteria and nitrites

130
Q

What might a person with kidney stones c/o?

A
  1. Flank pain
  2. sudden onset
  3. radiating to groin
131
Q

How are kidney stones diagnosed?

A
  1. CT A/P
  2. RBC in UA
132
Q

How is an ectopic pregnancy diagnosed?

A

US of the pelvis

133
Q

How is ovarian torsion diagnosed?

A

US Pelvis

134
Q

What sx might a person with a brain bleed c/o?

A
  1. HA- sudden (“thunderclap”) onset + worst HA of their life,
  2. changes in speech, vision, motor (weakness), sensation (numbness),
  3. AMS
135
Q

What study would diagnose a brain bleed?

A

CT Head or Lumbar Puncture

136
Q

What sx might a person with an ischemic CVA c/o?

A

Focal Neurological Deficit (FND): changes in speech, changes in vision, one-sided motor changes (weakness), one-sided sensation changes (numbness)

137
Q

How is an ischemic CVA diagnosed?

A

Clinically —» potentially normal CT head

138
Q

How does a TIA differ from a CVA?

A

TIA - mini stroke, symptoms usually resolve in less than a hour.

CVA - Stroke, symptoms last longer, and potentially may not go away

139
Q

What is a common cause for seizures in children?

A

fevers

140
Q

What is the name of the state after a seizure?

A

Post-ictal

141
Q

What are 3 symptoms of meningitis?

A
  1. fever
  2. neck pain/stiffness
  3. headache
142
Q

What study would diagnose meningitis?

A

LP - lumbar puncture

143
Q

What are 4 important things to document for syncopal episodes?

A
  1. how they felt before
  2. how they felt during
  3. how they felt after
  4. and how they currently feel
144
Q

Name 4 causes of altered mental status.

A
  1. hypoglycemia
  2. infection
  3. intoxication
  4. neurological
145
Q

How is AMS different from a focal neuro deficit?

A
  • AMS is generalized and typically caused by something that can affect the whole brain (drugs, low BS).
  • FND are localized (weakness/numbness/speech/vision) to one specific area and corresponds with damage to specific spot in the brain
146
Q

What are the risk factors for a DVT?

A
  1. Known DVT,
  2. PMHx of DVT or PE,
  3. FHx of DVT or PE,
  4. recent surgery,
  5. CA,
  6. Afib,
  7. immobility + pregnancy,
  8. BCP,
  9. smoking
147
Q

What are common signs of a DVT?

A
  1. extremity pain
  2. swelling —» atraumatic (minimal tissue injury)
148
Q

What is an aortic dissection?

A

The separation of the muscular wall from the membrane of the artery, putting the pt at risk for aortic rupture and death.

149
Q

What are 3 symptoms of cellulitis?

A
  1. Redness,
  2. swelling
  3. pain to an area of the skin
150
Q

How is an abscess different from cellulitis?

A

Abscess is cellulitis with fluctuance (pus pocket)

151
Q

What procedure will be performed for every abscess?

A

Incision and drainage

I&D

152
Q

What is the main concern with an allergic reaction?

A

Anaphylaxis or respiratory failure

153
Q

What are the ONLY three symptoms of a true allergic reaction?

A
  1. Rash,
  2. itching,
  3. swelling —» SOB due to airway swelling
154
Q

How can Diabetic Ketoacidosis (DKA) be diagnosed?

A
  1. Arterial Blood Gas showing low pH
  2. Positive Serum Ketones
155
Q

What is the Emergency Physician’s main responsibility for psychiatric patients?

A

medical clearance

156
Q

Name three important things to document for any trauma patient.

A
  1. LOC,
  2. head injury,
  3. neck pain,
  4. back pain,
  5. numbness,
  6. weakness
157
Q

Dysuria

A

painful or difficult urination.

158
Q
A
159
Q
A
160
Q
A
161
Q
A
162
Q
A
163
Q
A

Aortic Dissection

164
Q
A

CHF

165
Q
A

Testicular Torsion

166
Q
A

DVT traveled to the lungs causing a PE

167
Q
A
168
Q
A
169
Q
A

Sepsis

170
Q
A
171
Q
A

Fever

172
Q
A
  1. Nitroglycerin
  2. Acetylsalicylic acid
173
Q

Edema

A

medical term for swelling

174
Q

Facial Angioedema

A

swelling of the face often secondary to an allergic rxn

175
Q

Nystagmus

A
  • Involuntary “shaking” eye movements, rather than normal continuous smooth motion
  • sx of vertigo
176
Q

Incontinence

A

lack of voluntary control over urination or defecation

177
Q

Pale conjunctiva

A

Pale inner aspect of the eyelid most often due to anemia

178
Q

Pallor

A

paleness

179
Q

what is used to diagnosis a GI bleed?

A

Heme positive stool (Guaiac positive) during rectal exam

180
Q

what are the pertinent negatives for musculoskeletal back pain?

A
  1. No LE weakness
  2. no incontinence
181
Q

Dysuria

A

painful urination

182
Q

Adnexal Tenderness

A

tenrerness of the ovaries during the pelvic exam indicative of ovarian cyst or torsion

183
Q

effusion

A

escape of fluid into a cavity

184
Q

Paroxysmal Afib

A

occasional, sporadic, transient Afib

185
Q

PE Catch Phrase

A

Pleuritic CP w/tachycardia and hypoxia

186
Q

Tonsillar hypertrophy & tonsillar exudates

A

hypertrophy: enlargement

Exudates: pus

187
Q

CSMT

A

Circulation, sensory, motor, tendon

188
Q

pruritic

A

itchiness/ defined as an unpleasant sensation of the skin that provokes the urge to scratch

189
Q

CVA Tenderness

A

Costo‐vertebral Angle tenderness; tenderness over the kidney’s

190
Q

Dyspnea

A

Difficult and labored breathing, shortness of breath

191
Q

Guarding

A
  1. Tensing of abdominal wall muscles as to guard the internal organs indicative of true abdominal disease
  2. Listed in PE of pt w/SBO
192
Q

Rebound

A
  1. Pain when releasing hand from abdominal palpation
  2. Listed in PE of SBO
193
Q

Tympany

A
  1. A bell‐like noise when tapping the abdomen
  2. List in PE for pt w/SBO
194
Q

Angina

A

CP due to heart-muscle ischemia (narrowing of coronary artery)

195
Q

PTA

A

prior to arrival

196
Q

CHF catch phrase

A

SOB w/pedal edema and orthopnea

197
Q

CHF assoc. sx

A
  1. Rales (crackles) in lungs
  2. Jugular vein distention (JVD) in neck
  3. pitting pedal edema
198
Q

PE findings for critical injury

A
199
Q

Ischemic CVA

Risk Factors & PE?

A
200
Q

CHF

Catch Phrase, CC, & PE Findings

A

Scribe america (8 decks)

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