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UF COM ClinDx Unit 4 > L3 - Chest Pain > Flashcards

L3 - Chest Pain Flashcards

1
Q

What does HBP stand for?

A

High blood pressure

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2
Q

What does GTN stand for?

A

Glycerinetrinitrate

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3
Q

How often is chest pain diagnosed?

A

Chest pain is not a diagnosis. It is a symptom

Diagnosis = chest pain due to X

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4
Q

What is Levine’s Sign?

A

When a person grips their chest with a fist during chest pain

It suggests cardiac involvement

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5
Q

When do you do ECG?

A

Once during chest pain & once after

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6
Q

How does the ECG appear during cardiac related chest pain?

A

ST segment elevation or depression

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7
Q

How to decrease HR & BP?

A

Beta Blockers

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8
Q

How to decrease LV stiffness & LVEDP?

A

Nitro –> decreased venous return to heart

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9
Q

Sharp chest pain would suggest what?

A

Non-cardiac

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10
Q

Squeezing/pressing chest pain would suggest what?

A

Cardiac

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11
Q

Aching chest pain would suggest what?

A

Cardiac

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12
Q

Dull chest pain would suggest what?

A

Cardiac

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13
Q

Burning chest pain would suggest what?

A

Cardiac (exception = GERD)

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14
Q

Visceral/deep chest pain would suggest what?

A

Cardiac (exception = GERD)

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15
Q

Superficial chest pain would suggest what?

A

Non-cardiac

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16
Q

Substernal chest pain would suggest what?

A

Cardiac (exception = GERD)

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17
Q

Severe chest pain would suggest what?

A

Cardiac more likely but not a certainty

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18
Q

Mild chest pain would suggest what?

A

Non-cardiac but not a certainty

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19
Q

Chest pain for seconds would suggest what?

A

Non-cardiac

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20
Q

Chest pain for minutes would suggest what?

A

Cardiac

21
Q

Chest pain for hours would suggest what?

A

Non-cardiac, but MI can present with this long of pain

22
Q

Chest pain associated with movement of the neck, arm or shoulder would suggest what?

A

Non-cardiac but not a certainty

23
Q

What would random (no precipitating factor) chest pain suggest?

A

Doesn’t fit the classic picture of cardiac chest pain, but doesn’t really point strongly one way or the other

24
Q

Chest pain that follows exertion would suggest what?

A

Cardiac

25
Q

<p>

| Chest pain following a meal would suggest what?</p>

A 
<p>
	Cardiac </p>
<p>
	or</p>
<p>
	Esophogeal Spasm</p>
26
Q

Chest pain following exposure to heat or cold would suggest what?

A

Cardiac

27
Q

Chest pain following an emotional situation would suggest what?

A

Cardiac

Adrenaline rush

28
Q

Chest pain relieved by nitrates would suggest what?

A

Cardiac

29
Q

Chest pain that is alleviated by eating suggests what?

A

Non-cardiac

30
Q

Chest pain alleviated by antacids suggest what?

A

Non-cardiac

31
Q

Chest pain with breathlessness would suggest what?

A

Cardiac (high pressure builds up into pulmonary HTN)

32
Q

Chest pain that occurs while sleeping suggests what?

A

Cardiac more likely

More venous return when lie down

33
Q

Chest pain that occurs early in the morning suggests what?

A

Cardiac more likely

Platelets stickier during morning

34
Q

How to decrease platelet adhesion?

A

Baby aspirin

35
Q

How do you do an ECG if the patient isn’t having chest pain at that moment?

A

Stress test (treadmill) —> try to induce cardiac event

36
Q

ST elevation on an ECG suggests what?

A

MI

37
Q

Visceral substernal epigastric pain that lasts 30 minutes. Does not radiate. Exacerbated by not eating & recumbency (resting). Alleviated with antacids. Diagnosis?

A

GERD

38
Q

What non-cardiac cause mimics cardiac angina most closely?

A

Esophogeal spasm

39
Q

Visceral substernal epigastric pain & burning for hours. Brought on by certain foods or not eating. Alleviated by antacids. Diagnosis?

A

Peptic Ulcer

40
Q

Superficial arm, neck & chest pain that is not relieved by rest. Alleviated by analgesia. Pain worsens with head, arm or shoulder movement. Pain worsens due to palpation. Diagnosis?

A

Cervical disk problem & nerve compression

41
Q

Superficial tenderness exacerbated by movement or palpation located on the chest. Alleviated with time or analgesia. Diagnosis?

A

Musculoskeletal

42
Q

Visceral substernal pain that lasts for a few minutes following an emotion situation. Facial paresthesia (tingling). Alleviated by removing emotional stimulus. Diagnosis?

A

Emotional hyperventilation

43
Q

Severe visceral substernal chest pain lasting hours to days. Spontaneous provocation & relief by nitro. Diagnosis?

A

MI

44
Q

When do you give morphine for chest pain?

A

Not first. It will alleviate any pain so it gives you no info.

Give nitro first, then IV analgesics

45
Q

Substernal poorly localized and radiating chest pain that is brought on by effort or emotion lasting 5-15 minutes. Alleviated with nitro or rest. Diagnosis?

A

Effort Angina

46
Q

When is effort angina the worst?

A

First episode is most vivid

47
Q

Poorly localized substernal visceral pain that radiates and arises spontaneously. Lasts 5-15 minutes. Alleviated by nitro. Diagnosis?

A

Rest angina

48
Q

Visceral substernal radiating pain that lasts 5-60 minutes. Arises spontaneously or in relation to exercise, food or cold. Alleviated by nitro. Diagnosis?

A

Esophogeal spasm but really similar to cardiac cause

49
Q

How to differentiate GERD and Peptic ulcers?

A

Peptic ulcers pain generally last hours while GERD generally lasts for about a half hour

UF COM ClinDx Unit 4 (10 decks)

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