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QL5 > EO 10.01 > Flashcards

EO 10.01 Flashcards

1
Q

Varicose veins
S/S
(10)

A
  1. Tense and palpable veins but not necessarily visible
  2. Sense of fullness
  3. Fatigue
  4. Pressure
  5. Superficial pain
  6. Hyperesthesia in the leg
  7. Muscle cramps
  8. Edema
  9. Burning
  10. Itching
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2
Q

Varicose veins Causes

A
  1. Venous insufficiency from faulty valves
  2. Valvular dysfunction causes venous reflux leading to venous hypertension
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3
Q

What is Raynaud’s Syndrome

A

Vasospasm of parts of the hand in response to cold or emotional stress, causing reversible discomfort and colour changes in one or more digits

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4
Q

Raynaud’s Syndrome Signs/Symptoms

A
  1. Sensation of burning
  2. coldness
  3. Paresthesia
  4. Intermittent colour changes
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5
Q

Difference between Raynaud’s Syndrome Primary and Secondary

A
  1. Primary: 80% of cases occur without symptoms or signs of other disorders
  2. Secondary: 20% of cases have a causative underlying disease
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6
Q

Causes of Secondary Raynaud’s

A
  1. Connective tissue disorders
  2. Endocrine disorders
  3. Hematologic disorders
  4. Neoplastic disorders
  5. Neurologic disorders
  6. Trauma
  7. Vascular disorders
  8. Drugs
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7
Q

Risk factors for Raynaud’s Syndrome

A
  1. Autoimmune disorders
  2. Connective tissue disorders
  3. Smoking
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8
Q

Raynaud’s Syndrome Treatments

A
  1. Trigger avoidance
  2. Medication
  3. Treatment of secondary causes
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9
Q

Raynaud’s Syndrome Education

A
  1. Stop smoking
  2. Avoid aggravating factors
  3. Dress appropriately for climate
  4. Use relaxation techniques
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10
Q

Myocardial Infarction Patho

A

Acute obstruction of a coronary artery causing decreased blood flow leading to myocardial necrosis of the

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11
Q

Myocardial Infarction Causes

A
  1. Coronary thrombosis
  2. Coronary artery spasm
  3. Arteritis
  4. Embolic infarction
  5. Congenital coronary anomalies
  6. Oxygen supply - demand imbalance;
  7. carbon monoxide poisoning
  8. Cocaine-induced vasospasm
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12
Q

Most common Myocardial Infarction Cause

A

Coronary thrombosis

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13
Q

(AMI) After total occlusion, how long does myocardial necrosis take before it is complete

A

4-6 hrs

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14
Q

AMI

Flow to ischemic area must remain above what % of pre-occlusion levels for area to survive.

A

40%

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15
Q
  1. Total occlusion of what main coronary artery is catastrophic and results in death in minutes
    &
  2. What does it supply/how much
A
  1. Left main coronary artery
  2. Supplies 70% of Left Ventricular mass
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16
Q
  1. AMI predominantly affect where
    &
  2. Where can damage extend to
A
  1. Left Ventricle
  2. Right ventricle & Atria
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17
Q

RV infarction usually results from what obstructed arteries

A
  1. Right coronary
  2. Dominant left circumflex artery
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18
Q

What infarcts tend to be larger and result in a worse prognosis

A

Anterior infarcts

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19
Q

What infarcts involve the whole thickness of myocardium from epicardium to endocardium

A

Transmural Infarcts

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20
Q

What are Transmural infarcts usually characterized by

A

Abnormal Q waves on ECG

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21
Q
  1. Where do Nontransmural or subendocardial infarcts affect
  2. How do they present on ECGs
A
  1. Do not extend through the ventricular wall
  2. ST-segment and T-wave (ST-T) abnormalities
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22
Q

What infarcts usually involve the inner one third of myocardium

A

Subendocardial infarcts

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23
Q

AMI Risk Factors

A
  1. Dyslipidemia
  2. Family History
  3. Tobacco Use
  4. Diabetes
  5. Hypertension
  6. Age
  7. Lifestyle
  8. Obesity
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24
Q

ST-T abnormalities of ischemia include what

A
  1. ST-segment depression
  2. T-wave inversion
  3. ST-segment elevation
  4. Peaked T waves
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25
Q

Name some of the S/S of AMI
(There 19 in the slides)

A
  1. Pain(arm, back, jaw, epigastrum, neck, chest)
  2. Anxiety
  3. Lightheadedness
  4. pallor
  5. weakness
  6. syncope
  7. Nausea
  8. Vomiting
  9. Diaphoresis
  10. Chest heaviness/tightness
  11. Cough
  12. Dyspnea
  13. Rales
  14. Wheezing
  15. S4 heart sound
  16. Arrhythmias
  17. Hypertension
  18. Hypotension
  19. Jugular venous distension
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26
Q

Cardiac Markers

A
  1. CK
  2. CK-MB
  3. Troponin I
  4. Troponin T
  5. Myoglobin
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27
Q

Immediate AMI Treatment

A

MONA
1. Morphine (painrelief)
2. O2
3. Nitroglycerine
4. ASA

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28
Q

General AMI Treatment

A
  1. Relieve stress
  2. Interrupt thrombosis
  3. Reverse ischemia
  4. Limit infarct size
  5. Reduce cardiac workload
  6. Prevent
  7. Treat complications
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29
Q

QL5 Med Tech Chest Pain Protocol

A
  1. Notify MO/PA/NP
  2. Place position in semi-fowlers position
  3. Oxygen via NRBM
  4. IV TKVO – NS
  5. 12-Lead ECG
  6. Continuous monitoring
  7. ASA 325-650mg
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30
Q

Rehabilitation and Post discharge Treatment (Dissecting Aortic Aneurysm)

A
  1. Functional evaluation
  2. Changes in lifestyle
  3. Drugs
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31
Q

Rehabilitation and Post discharge Drugs
(Dissecting Aortic Aneurysm)

A
  1. Aspirin
  2. β-blockers
  3. ACE inhibitors
  4. Statins
32
Q

Rehabilitation and Post discharge Lifestyle Changes
(Dissecting Aortic Aneurysm)

A
  1. Regular exercise
  2. Diet modification
  3. Weight loss
  4. Smoking cessation
33
Q

What is DISSECTING AORTIC ANEURYSM

A

Surging of blood through a tear in the aortic intima causing a separation of the intima and media leading to creation of a false lumen

34
Q

What is Deep Venous Thrombosis?

A

Development of single or multiple blood clots within deep veins of extremeties or pelvis.

Slide 18 EO 010.01

35
Q

Where can a Aortic Dissection occur

A

most commonly proximal ascending aorta or descending thoracic aorta
But can also occur anywhere

36
Q

What are the S/S of deep venous thrombosis?

A
  1. Leg pain/cramps
  2. Tenderness on palpation
  3. Edema + erythema

Can be asymptomatic.

Extra credit:

  1. Homan Sign (pain on dorsiflexion)
  2. Lisker’s sign (pain on percussion of medial tibia)
  3. Bancroft/Moses Sign (pain on compression of calf against tibia)

Slide 20, 21 EO 010.01

37
Q

Aortic Dissection S/S

A
  1. Abrupt, sharp or tearing pain
  2. Shearing anterior chest pain radiating to interscapular region
  3. Back pain
  4. Syncope
  5. Stroke
  6. Abdominal pain
  7. AcuteMI/angina
  8. Hypo/hypertension
  9. Wide pulse pressure
  10. Murmur
  11. Pulse deficits or asymmetry
38
Q

Aortic Dissection Diagnosis

A

Transesophageal echocardiogram (TEE)
CT angiography
MRA
Chest x-ray
ECG
Routine labs

39
Q

Aortic dissection Treatment

A

Surgery
Medications to decrease blood pressure
Admission to ICU

40
Q

What are some diagnostic tests for deep venous thrombosis?

A
  1. D-Dimer
  2. Constrast venography
  3. Ultrasound

Slide 22 EO 010.01

41
Q

Aortic dissection Pt education

A

Activity
Medications
Surgical wound management

42
Q

Tmt of deep venous thrombosis?

A
  1. Bed rest (ha)
  2. Medications like thrombolytics and anticoagulators
  3. Surgical intervention

Slide 24 EO 010.01

43
Q

What is angina?

A

A condition that occurs when cardiac workload and myocardial oxygen demand exceends capacity of coronary arteries to supply oxygenated blood.

Heart needs more oxygen than what is supplied, but no true blockage is present.

Slide 61 EO 010.01

44
Q

What are some causes of angina?

A
  1. Atherosclerosis
  2. Coronary artery spasm
  3. Aortic stenosis
  4. hypertrophic cardiomyopathy
  5. Severe hypertension
  6. Aortic insufficiency
  7. Primary pulmonary hypertension

Slide 62 EO 010.01

45
Q

What are the 3 types of angina?

A
  1. Classic
  2. Variant
  3. Unstable

Slide 62 EO 010.01

46
Q

S/S of angina?

A
  1. Precordial pressure/heaviness
  2. Discomfort up to crushing sensation on sternum
  3. Dyspnea/choking sensation on exertion
  4. Radiating pain

Slide 63, 64 EO 010.01

47
Q

What are some diagnostic tests for angina?

A
  1. Monitoring
  2. Imaging
  3. Labs
  4. Coronary arteriography
  5. ECG

Slide 65 EO 010.01

48
Q

CAD Risk factors

A

High LDL, low HDL
Type 2 diabetes
Smoking
Obesity
Physical inactivity
Poor power supply
Poor stress management

49
Q

CAD S/S

A

Chest pain below the sternum
Exertional dyspnea
Orthopnea
Paroxysmal nocturnal dyspnea
Cardiac arrhythmias
Systolic murmur
Cardiomegaly
Pedal edema

50
Q

What is costocondritis?

A

Anterior chest wall pain associated with inflammation of the costochondral and costosternal regions

Slide 98 EO 010.01

51
Q

What are some causes of costochondritis?

A
  1. Trauma
  2. Overuse (over/unusual physical activity, URTI (coughing))
  3. Unknown

Slide 99 EO 010.01

52
Q

S/S of costochondritis?

A
  1. Sharp pain in multiple locations, worse on mvmt
  2. Chest tightness
  3. Non-supportive edema and tenderness at rib articulations
  4. Erythema and warmth at tender spots

Slide 100 EO 010.01

53
Q

What are some diagnostic tests for costochondritis?

A

None specifically, must rule out cardiac chest pain. Imaging might not be helpful. Get a thorough history.

Slide 101 EO 010.01

54
Q

Tmt of costochondritis?

A
  1. NSAIDs
  2. Oral Analgesics
  3. Lidocaine/corticosteroid injections into joints

Slide 103 EO 010.01

55
Q

CAD Diagnostic Tools

A

ECG
Exercise test
Laboratory
Triglycerides
Complete cholesterol
Low-density lipoproteins (LDL)
High-density lipoproteins (HDL)
Imaging
Angiography
Echocardiography

56
Q

What is hypertension?

A

Sustained elevation of resting systolic blood pressure greater than or equal to 140/90

Slide 33 EO 010.01

57
Q

CAD DDX

A

Angina
Thromboangiitis obliterans
Cardiomyopathy
Myocarditis
Pulmonary embolism
Pericarditis

58
Q

What are primary vs secondary hypertension?

A

Primary is hypertension with no known cause, hemodynamic and physiological compenonents varying and unlikely to have singular cause.

Secondary hypertension is hypertension caused by other pathologies such as kdiney disease, Cushing’s syndrome, hyperthyroidism, etc

Slide 34 EO 010.01

59
Q

What is Acute Pericarditis

A

Acute pericarditis develops rapidly, provoking an inflammatory reaction

60
Q

What can hypertension lead to?

A
  1. Coronary artery disease
  2. MI
  3. Stroke
  4. Renal failure
  5. Cardiomyopathy
  6. Heart failure
  7. Aortic dissection

Slide 36 EO 010.01

61
Q

What is Chronic Pericarditis

A

Chronic pericarditis (defined as persisting > 6 months) develops slowly; its main feature is effusion. Acute disease can become chronic.

62
Q

What is Constrictive Pericarditis

A

Constrictive pericarditis, which is not common, results from marked inflammation and fibrous thickening of the pericardium.
Thick, rigid pericardium markedly disrupts ventricular filling, reducing stroke volume and cardiac output.

63
Q

What are risk factors of hypertension?

A
  1. Fx
  2. Obesity
  3. EtOH
  4. Excess Na+
  5. Stress
  6. Physical inactivity

Slide 37 EO 010.01

64
Q

S/S of hypertension?

A
  1. Dizziness
  2. Flushed face
  3. Retinopathy
  4. Increase S2
  5. Headaches

Slide 38 EO 010.01

65
Q

Pericarditis can also be caused by? (2 things)

A

Pericardial Effusion
Cardiac Tamponade

66
Q

What causes pericarditis?

A

Infection
Autoimmune disease
Inflammatory disorder
Uremia
Trauma
MI
Medicines

67
Q

Tmt of hypertension?

A
  1. Weight loss/exercise
  2. Smoking cessation
  3. Dietary changes
  4. Biofeedback and relaxation
  5. Drug therapy for primary or secondary

Slide 41 EO 010.01

68
Q

Acute Pericarditis S/S

A

Chest pain
Pericardial friction
Dyspnea
Chest pain can be relieved by sitting with the upper body bent forward
Chest pain may be aggravated by torso movements
Coughing, breathing, swallowing food

69
Q

Diffuse Esophageal Spasm S/S

A

Substernal chest pain, accompanied by dysphagia for liquids and solids.
Very hot or very cold liquids can exacerbate pain.
In the absence of dysphagia, a sharp pain may also occur, similar to that of angina pectoris.
This pain is often described as a twinge in the substernal region and may be associated with exercise.

70
Q

Diffuse Esophageal Spasm Diagnostics

A

Barium X-rays
Esophageal scintigraphy
Esophageal manometry

71
Q

Diffuse Esophageal Spasm DDX

A

Angina
MI
Hiatal hernia
Esophagitis
Esophageal perforation
Aortic dissection
Pericarditis

72
Q

Diffuse Esphageal Spasm Tx

A

Calcium channel blockers
Pneumatic expansion and bottlenecking
Narcotic analgesics
Surgical myotomy along the entire length of the esophagus.
Botulinum toxin injections in the lower esophageal sphincter: a new approach

73
Q

Diffuse Esophageal Spasm Patient Edu

A

Patient education will vary depending on how the disorder is managed.
May include information on medications
Surgery information

74
Q

What is classic angina?

A

Sense of choking/pressure in the precordium, brought on by exertion or anxiety.

75
Q

What is variant angina?

A

Angina occuring at rest after exercise or at night.

Known as Pinzmetal’s.

76
Q

What is unstable angina

A

Angina that is new or changing in character, or both. Can signal impending MI.

77
Q

What are some risk factors for angina?

A
  1. Hypercholesterolemia
  2. Hypertension
  3. Tobacco abuse
  4. Diabetes
  5. Male
  6. Age
  7. Obesity

QL5 (13 decks)

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