Illness script - week 3

Question 1

Coronary heart disease (CHD)

Leading cause of _____ and _____ in Australia, __ - __ times higher for _____ and _____ _____ _____, also remote communities and low _____ population

Answer 1

Coronary heart disease (CHD)

Leading cause of deaths and hospitalisation in Australia, 2 - 3.1 times higher for Aboriginal and Torres strait islander, also remote communities and low socioeconomics population

Question 2

Hypertension

__ - __% primary hypertension is diagnosed when there is absence to _____ cause, __ - __% of cases of secondary causes are from _____ _____ _____, _____, _____ disease, _____ of aorta, primary _____ or _____

Answer 2

Hypertension

90 - 95% primary hypertension is diagnosed when there is absence to secondary cause, 5 - 10% of cases of secondary cause are from kidney artery stenosis, glomerulonephritis, polycystic disease, coarctation of aorta, primary aldosternism or pheochromocytoma

Question 3

Diagnosing hypertension

Patient needs to come visit __ more times in a span of __ months with a greater reading of >__/__ mmHg

Answer 3

Diagnosing hypertension

Patient needs to come visit 2 more times in a span of 3 months with a greater reading of >140/90 mmHg

Question 4

Classification of hypertension

__ - __ - >__ = Grade 3 (_____)
>140 - <90 = _____ _____ _____

Answer 4

classification of hypertension

120 - <80 = Normal
120 - 139 (-) 80 - 90 = High normal
140 - 159 (-) 90 - 99 = Grade 1 (mild)
160 - 179 (-) 100 - 109 = Grade 2 (moderate)
>180 - >110 = Grade 3 (Severe)
>140 - <90 = Isolated systolic hypertension

Question 5

Risk factors of CAD

1) _____
2) _____, _____ > _____ until 60 years told
3) _____
4) _____ _____
5) _____ _____ of heart disease

Answer 5

risk factors of CAD

1) Age
2) Gender, Males > females until 60 years old
3) Ethnicity
4) Genetic predisposition
5) Family history of heart disease

Question 6

Chronic stable angina (CSA)

A reversible _____ _____, caused when oxygen supply doesn’t meet demand due to the narrowing of the _____ _____ by _____

For _____ to occur, the artery has to be __% or more _____

Answer 6

chronic stable angina (CSA)

A reversible myocardial ischaemia, caused when oxygen supply doesn’t meet demand due to the narrowing of the coronary arteries by atherosclerosis

For ischaemia to occur, the artery has to be 75% or more stenosed

Question 7

Manifestations of CSA

1) _____ _____ occurring over a long period of time with same pattern on _____, _____ and _____ of symptoms
2) Pain usually last __ - __ minutes
3) _____ at rest is unusual
4) __% of cases with myocardial ischaemia are _____
5) Associated with _____ and _____

Answer 7

manifestations of CSA

1) Intermittent angina occurring over a long period of time with same pattern of onset, duration and intesity of symptoms
2) Pain usually last 3 - 5 minutes
3) Pain at rest is unusual
4) 80% of cases with myocardial ischaemia are asymptomatic
5) Associated with diabetes and hypertension

Question 8

Prinzmetal’s angina

Occurs at _____ in response to spasms of major _____ _____, patients with history of _____ _____ and _____ _____

Spasms may occur in the absence of CAD, occurs during _____ _____ and may be relived with moderate _____

Answer 8

Prinzmetal’s angina

Occurs at rest in response to spasms of major coronary artery, patients with history of migraine headaches and raynaud’s phenomenon

Spasms may occur in the absence of CAD, occurs during REM sleep and may be relieved with moderate exercise

Question 9

Acute coronary syndrome (ACS)

deterioration of once a _____ _____: _____ turns into _____ _____ into _____

Answer 9

acute coronary syndrome (ACS)

Deterioration of once a stable plaque: rupture turns into platelet aggregation into thrombus

Question 10

Partial occlusion of the coronary artery can lead to _____ (UA), _____ (NSEACS) or _____ (NSTEMI)

Total occlusion of the coronary artery can lead to _____ STEMI

Answer 10

Partial occlusion of the coronary artery can lead to unstable angina, Non ST segment elevation acute coronary syndrome, non ST segment elevation myocardial infarction

Total occlusion of the coronary artery can lead to ST segment elevation myocardial infarction

Question 11

Manifestations of unstable angina

1) _____ in onset
2) occurs at _____
3) has a worsening pattern
4) It is _____, a _____ _____

Answer 11

manifestations of unstable angina

1) New in onset
2) Occurs at rest
3) has a worsening pattern
4) It is unpredictable, a medical emergency

Question 12

NSTEACS

All patients with NSTEACS should have _____ _____ to direct _____ decisions

Usually given _____ unless contraindicated

Answer 12

NSTEACS

All patients with NSEACS should have risk stratified to direct management decisions

Usually given aspirin unless contraindicated

Question 13

Myocardial infarction (MI)

__ - __% of acute MI are secondary to _____ formation, results of sustained _____ causes _____ _____ cell _____

Necrosis of entire thickened _____ takes about __ - __ hours, the degree of altered function is dependent on the _____ and _____, most commonly the _____ _____

Answer 13

myocardial infarction (MI)

80 - 90% of acute MI are secondary to thrombus formation, results of sustained ischaemia causes irreversible myocardial cell death

Necrosis of entire thickened myocardium takes about 4 - 6 hours, the degree of altered function is dependent on the location and size, most commonly the left ventricle

Question 14

Symptoms of MI (HEPPP)

1) _____
2) _____
3) _____
4) _____
5) _____

Answer 14

Symptoms of MI (HEPPP)

1) Hot
2) Exhuastion
3) Pain
4) Pale
5) Puke

Question 15

Signs of MI

1) _____
2) _____ _____
3) _____ _____
4) _____ _____ _____
5) _____ _____
6) _____
7) _____ _____

Answer 15

Signs of MI

1) Arrhythmias
2) Heart failure
3) Cardiogenic shock
4) Papillary muscle dysfunction
5) Ventricular aneurysm
6) Pericarditis
7) Dressler syndrome

Question 16

Diagnosing MI

1) _____ (ECG)
2) _____ _____ _____
3) _____ _____
4) _____ _____ test
5) _____

Answer 16

Diagnosing MI

1) Electrocardiograph (ECG)
2) Serum cardiac matter
3) Coronary angiography
4) Exercise stress test
5) Echocadiograms

Question 17

Manifestations of heart failure

1) _____ _____ _____ _____ (ADHF): _____ _____ and life threatening
2) Early: increase in _____ _____, decrease in _____
3) Later: _____ and _____ _____

Answer 17

manifestations of heart failure

1) Acute decompensated heart failure (ADHF): pulmonary oedema and life threatening
2) Early: increase in respiratory rate, decrease in PaO2
3) Later: Tachypnea and respiratory acidemia

Question 18

Chronic heart failure

1) _____
2) _____
3) _____ and _____ pain
4) _____
5) _____
6) _____, _____ and _____ changes

Answer 18

chronic heart failure

1) Fatigue
2) Dyspnea
3) Tachycardia and Chest pain
4) Oedema
5) Nocturia
6) Skin, weight and behavioural changes

Question 19

Complications of heart failure

1) _____ _____
2) _____
3) _____ _____ _____
4) _____
5) _____ failure

Answer 19

complications of heart failure

1) pleural effusion
2) Arrhythmias
3) Left ventricle thrombus
4) Hepatomegaly
5) Renal failure

Question 20

Classification of heart failure

Based on a person's \_\_\_\_\_ to \_\_\_\_\_ \_\_\_\_\_
Class 1: \_\_\_\_\_ \_\_\_\_\_
Class 2: \_\_\_\_\_ \_\_\_\_\_
Class 3: \_\_\_\_\_ \_\_\_\_\_
Class 4: Inability to carry out any \_\_\_\_\_ \_\_\_\_\_ without discomfort

Answer 20

classification of heart failure

Based on a person’s tolerance to physical activity
Class 1: no limitation
Class 2: Slight limitation
Class 3: Marked limitation
Class 4: Inability to carry out any physical activity without discomfort

Question 21

Diagnosing heart failure

1) _____ _____ and _____ _____
2) Chest X-ray
3) _____ (ECG)
4) _____ assessment
5) _____
6) _____ _____ test

Answer 21

diagnosing heart failure

1) Patient history and physical exam
2) Chest X-ray
3) Electrocardiograph (ECG)
4) Haemodynamic assessment
5) Echocardiogram
6) Exercise stress test

Question 22

Management of chronic heart failure

1) _____
2) _____ _____
3) _____ _____
4) _____ _____
5) _____ _____

Answer 22

management of chronic heart failure

1) Assessment
2) Overall goals
3) Health promotion
4) Patient teaching
5) Home nursing

Question 23

Acute intervention of chronic heart failure

1) _____ _____ _____ goals
2) _____ _____ tools
3) _____ _____ restrictions
4) _____ _____
5) _____ _____

Answer 23

acute intervention of chronic heart failure

1) Quality of life goals
2) Self management tools
3) Salt dietary restrictions
4) Energy conservation
5) Support systems