exam 2

Question 1

how common is chest pain in PCP

Answer 1

10% of all visits

Question 2

what is the most common symptoms associated with coronary heart disease

Answer 2

chest pain

Question 3

classic chest pain sympmtoms

Answer 3

with exertion…

pain, pressure, tightness

Question 4

atypical symptoms

Answer 4

cramping, grinding, tearing, ripping, jaw/tooth/arm/neck pain

Question 5

what is a paplitation

Answer 5

awareness of heartbeat

pounding, skipping, racing, fluttering

Question 6

differential diagnosis for palpitations

Answer 6

anxiety, arrhythmia (afib/pac/pvc) hyperthyroidism

Question 7

dysnpnea

Answer 7

uncomfortable awareness of breathing that is innaprpriate for level of exertion

Question 8

orthopnea

Answer 8

dyspnea that occurs when supine and improves with sitting up

Question 9

paroxysmal noctural dyspnea

Answer 9

sudden dyspnea and orthopnea that awake patient from sleep

Question 10

differential diagnosis for SOB

Answer 10

anxiety, pulmonary, GI, cardiac

Question 11

swelling

Answer 11

accumulation of fluid in extravascular interstial space

Question 12

how many liters of fluid can be absorbed before pitting eema appears

Answer 12

5L

Question 13

syncope

Answer 13

transient LOC followed by rcovery

Question 14

what is the most common cause of syncope

Answer 14

neruo cardiogenic

Question 15

vasovagal reflex

Answer 15

loss of sns tone increases vagal tone which drops BP and heart rate

Question 16

angina pectoris

Answer 16

temprary myocardial ischemia

Question 17

associted symptoms wirh angina pectoris

Answer 17

chest pain worse with exertion or stress, diaphoresis, dyspnea, ausea

Question 18

MI

Answer 18

prolonged ischemia to the heart that results in irreversible muscle damage

Question 19

symptoms of MI

Answer 19

diaphoresis, nausea, chest pain, fatigue, not revlieaved by rest

Question 20

CHF

Answer 20

heart failure or ventricular dysfunction

Question 21

symptoms of right heart failure

Answer 21

edema/leg swelling

Question 22

symptoms of left heart failure

Answer 22

dyspnea, cough, wheezing

Question 23

pericarditis

Answer 23

irritation of parietal pleura adjacent to pericardium

Question 24

location of discomfrot with pericarditis

Answer 24

retrosternal or precordial

Question 25

characterisitc of pericarditis

Answer 25

pain worse with breatthing, changing positions, coughing, swlaoowing. better when sitting foreward

Question 26

aortic dissection

Answer 26

splitting within layers of aortic wall

Question 27

symptoms of aortic dissection

Answer 27

anterior/posterior chets pain radiating to neck/back, ripping or tearing

Question 28

what might crackles in the lungs indicate

Answer 28

pulmonary edema (left heart failure)

Question 29

what might congestion of the liver indicate

Answer 29

right heart failure

Question 30

hepatojugular reflex

Answer 30

push down on the liver and fluid pooled in the hepatic venous system is forced back upward toward the heart causing JVD

Question 31

what do abdominal bruits indicate

Answer 31

turbulent blood flow in the aorta, renal arteries or splenic artery

Question 32

0 pulse

Answer 32

absent

Question 33

1 pulse

Answer 33

weak, thready

Question 34

2 plulse

Answer 34

normal

Question 35

3 pulse

Answer 35

full, bounding

Question 36

allen test

Answer 36

tests patency of ulnar and radial arteries

Question 37

what is important to check prior to checking abg

Answer 37

allen test

Question 38

palpable abdominal pulses

Answer 38

aorta

Question 39

non palpable abdominal pulses

Answer 39

celiac, SMA, IMA

Question 40

pulsus alternans

Answer 40

regular pulse with alternating strength of pulse

Question 41

pitting edema

Answer 41

palpable swelling, accumulation of fluid in interstitial space

Question 42

1+ pitting edema

Answer 42

2 mm

Question 43

2+ pitting edema

Answer 43

4 mm

Question 44

3+ pitting edema

Answer 44

6 mm

Question 45

4+ pitting edema

Answer 45

8 mm

Question 46

PAD

Answer 46

pain claudications worse with exertion and leg elevation

Question 47

risk factors for PAD

Answer 47

older than 65, older than 50 woth history of smoking/DM, hx of CAD, black, fam hx of AAA

Question 48

symptoms of PAD

Answer 48

pain with exertion and non healing wounds

Question 49

aorto-iliac

Answer 49

butt, hip, thigh

Question 50

illiac-pudental

Answer 50

ED

Question 51

common femoral

Answer 51

thigh

Question 52

superficial femoral

Answer 52

upper calf

Question 53

politeal

Answer 53

lower calf

Question 54

tibial or peroneal

Answer 54

foot

Question 55

celiac or mesenteric

Answer 55

abdominal

Question 56

what would lead to a strong suspicion of PAD

Answer 56

delayed response and diminished or absent peripheral pulses

Question 57

what causes varicose veins

Answer 57

incompentancy of valves and weakness of the walls of the veins

Question 58

causes of varicose veins

Answer 58

``` pregnancy obesity constipation tumor hereditary ```

Question 59

risk factors varicose veins

Answer 59

age, sitting/standing long periods of time, sedentary, obesit, preg, fam hx

Question 60

venous stasis

Answer 60

chronic permanent skin changes that are associated with chronic venous insufficiency

Question 61

primary raynauds

Answer 61

no definable cause

Question 62

secondary raynauds

Answer 62

related to autoimmune disease

Question 63

arterial ulcerations

Answer 63

diastal location or traumatic

Question 64

venous ulcerations

Answer 64

around ankles

Question 65

neuropathic ulcers

Answer 65

pressure points

Question 66

why is DVT concerning

Answer 66

carrys 90% of blood back to the heheart

Question 67

symptoms of DVT

Answer 67

pain, swelling, red

Question 68

hoffmans sign

Answer 68

discomfort in leg with forced dorsiflexion of the foot

Question 69

superficial thrombophlebitis

Answer 69

inflammation, thrombosis in superficial veins, lower prob of traveling to heart

Question 70

doppler studies

Answer 70

used to evaluate for competency of veins

Question 71

abi

Answer 71

less than 0.9 normal | low sens, high spec