Day 2: Pathophysiology

Question 1

What is CAD?

Answer 1

Coronary Artery Disease. Where there is a narrowing of the coronary arteries that limits blood supply to the heart muscle causing angina (chest pain specifically due to heart-muscle ischemia).

Question 2

What are the past histories that suggest CAD?

Answer 2

Angina, MI, CABG, Angioplasty, and Cardiac Stents

Question 3

Does a PSHx of Angioplasty mean that the patient has CAD?

Answer 3

Yes

Question 4

Does a PMHx of CVA mean that the patient has CAD?

Answer 4

No

Question 5

What is the difference between MI and CAD?

Answer 5

CAD is a risk factor for MI because CAD is the narrowing of the heart arteries while an MI is the acute blockage of these arteries.

Question 6

Does a pt with AFib and CHF have CAD?

Answer 6

No

Question 7

What are the cardiac risk factors?

Answer 7

HTN, HLD, FHx of CAD <55 y.o., CAD, DM, smoker, Paroxysmal AFib, and Chronic AFib

Question 8

How is CAD diagnosed?

Answer 8

Through cardiac catheterization

Question 9

CAD affects which part of the heart?

Answer 9

The arteries

Question 10

How is an MI diagnosed?

Answer 10

Through EKG (STEMI) or through elevated Troponin levels (non-STEMI)

Question 11

What are the associated sx’s of MI other than CP?

Answer 11

SOB, Diaphoresis, N/V

Question 12

What are the associated sx’s of CHF?

Answer 12

SOB that worsens with lying flat (Orthopnea), Paroxysmal Nocturnal Dyspnea (PND), and Dyspnea on exertion (DOE). Also, pedal edema

Question 13

What diagnoses CHF?

Answer 13

CXR and elevated BNP (B-Type Natriuretic Peptide)

Question 14

What is A-Fib?

Answer 14

Atrial Fibrillation. Where there are electrical abnormalities in the “wiring” of the heart that cause the top of the heart (atria) to quiver abnormally

Question 15

What might someone with A-Fib feel?

Answer 15

Heart palpitations (fast, irregular, pounding heart beats)

Question 16

How is A-Fib diagnosed?

Answer 16

EKG

Question 17

What might someone with a Pulmonary Embolism’s CC be?

Answer 17

SOB or Pleuritic chest pain (CP that worsens with deep breathing)

Question 18

What are the risk factors for a Pulmonary Embolism?

Answer 18

known DVT, PMHx of DVT or Pulmonary Embolism, BCP, Smoking, CA, A-Fib, Immobility, pregnancy, FHx, Recent history of surgery

Question 19

What study diagnoses a Pulmonary Embolism?

Answer 19

CTA (CT Chest w/ IV contrast) or VQ scan

Question 20

Can a CT chest w/o IV contrast dx a Pulmonary Embolism? Why or Why not?

Answer 20

No, because the contrast allows the doctor to see the clot.

Question 21

What is PTX?

Answer 21

Pneumothorax. Where a lung collapses due to trauma or spontaneous rupture.

Question 22

What is the most common cause of PTX?

Answer 22

Trauma

Question 23

What dx’s a PTX?

Answer 23

CXR

Question 24

What do COPD pt’s usually have a SHx of?

Answer 24

Smoking

Question 25

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

Answer 25

A nebulizer is a machine while an inhaler is a handheld device.

Question 26

What is Asthma?

Answer 26

RAD or Reactive Airway Disorder. The constricting of the airway due to inflammation and muscular contraction of the bronchioles, known as a “bronchospasm”.

Question 27

What is the PE finding closely associated to Asthma?

Answer 27

Wheezing