MDTS--- CARDIO-RESP--NEURO

Question 1

Absent/diminished breath sounds
Tall/Young 20-40 Y/O
smoker
Can happen at rest
Possible trauma
Sharp/stabbing on inspiration pain
decreased tactile fremitus

Answer 1

Spontaneous Pneumothorax

Question 2

Trauma/injury chest wall
hypotension
FLATTENED NECK VEINS
pulse pressure low
Respiratory distress
Tachypnea, hypoxia
dullness to percussion
decreased breath sounds

Answer 2

Hemothorax

Question 3

Heart rate 150-240
Regular Rate/Rhythm
Palpations
Mild chest pain
SOB/Syncope
EKG:
   1.Narrow QRS no P wave

Answer 3

SVT

Question 4

Stressed/Caffeinated
heavy TAB/ETOH
Physical discomfort, delirium, pain, uremia
depression, bipolar

Answer 4

Sleep disorder

Question 5

Fever, HA, NECK PAIN,
Nuchal rigidity,
Mental status changes
POS brudzinsky
Petechia palpable purpura
photophobia

Answer 5

Meningitis

Question 6

Fever, HA, Nuchal rigidity altered mental status
BEHAVIORAL CHANGES
motor/sensory deficits
speech/movement disorder

Answer 6

Encephalitis

Question 7

head pain
Women>men
daily bilateral
vise like
neck and back of head

Answer 7

Tension HA

Question 8

head pain
middle age men
Men> women
Pain around eye/temple
comes and goes
happens in groups and disappears

Answer 8

Cluster HA

Question 9

head pain
gradual build up
AURA
focal disturbances
stars, flashes, zigzag,
throbbing unilateral

Answer 9

Migraines

Question 10

head pain
lasts min or less
patient sometimes has URI

Answer 10

Cough HA

Question 11

Head pain
History of chronic pain from various injuries/illness
HEADACHE UNRESPONSIVE TO MEDICATION

Answer 11

Medication overuse

Question 12

> in adolescents
MVA, falls, assaults
skull fractures 75-95 %
Headache pain increase
Decrease Neuro exam

Answer 12

Epidural hemorrhage

Question 13

More common elderly, ETOH abusers
1-2 days after trauma with LUCID INTERVALS
HA, vomiting, anisocoria
dysphagia, CRANIAL NERVE CHANGES

Answer 13

Subdural

Question 14

Trauma/exercise
drugs (cocaine/amphetamine)
Severe headache
WORST HA OF LIFE
altered mental status, LOC
seizure, Nausea,
meningeal signs

Answer 14

Subarachnoid

Question 15

Patient history of back pain: herniated disc,
leg weakness “foot drop”
cannot hold foot up
PROBLEM BOWEL/BLADDER
numbness tingling in lower back 1 or both

Answer 15

Cuada equina syndrome

Question 16

blurry vision
Seeing stars/spots
POS tilt test
MURMUR- S3/S4

Answer 16

Cardiac Syncope

Question 17

Chest pain, tachypnea, tachycardia,
hypotension unresponsive to fluid
BECKS TRIAD:
HYPOTENSION,JVD, MUFFLED HEART SOUNDS

Answer 17

Pericardial tamponade

Question 18

Substernal chest pain
caused by coxsackievirus /echo virus
Auscultation= RUB sound
Fever, recent viral sickness
PAIN WORS SUPINE BTTER WITH SITTING FORWARD

Answer 18

Pericarditis

Question 19

New Murmur + Temp
Petechia palate
splinter hemorrhage
osler nodes
Janeway lesions
roth spots
IV drug use
Dental surgery

Answer 19

Infectious endocarditis

Question 20

retrosternal chest pain
S3/S4 gallop
Insect bites/snake
viral infection
cocaine/ETOH, PCN
SINUS TACHY OUT OF PORPOTTION TO TEMP

Answer 20

Acute myocarditis

Question 21

Sudden/severe chest pain
RIPPING/TEARING RADIATING TO BACK
hypertensive, syncope
DIMINISHED unequal peripheral pulses

Answer 21

Dissecting Aortic Aneurysm

Question 22

dyspnea, orthopnea (SOB laying down)
dyspnea on exertion, pulmonary edema, Chronic NON-Productive cough, exercise intolerance, fatigue
expiratory wheezing or rhonchi, decreased S1, Murmurs S3 overload

Answer 22

Left Sided CHF

Question 23

Peripheral edema, hepatic congestion, abdominal ascites

JVD, Elevated JVP, Hepatomegaly, Ascites (fluid wave on ABD exam) Peripheral pitting edema

Answer 23

Right sided CHF

Question 24

>smokers
air pollution, airway infection, allergies
Midline burning chest pain 
RHONCHI CLEARS WITH COUGHING
hemoptysis, wheezing
Dry cough becomes wet

Answer 24

Acute Bronchitis

Question 25

Tachypnea, cyanotic
unable to speak in full sentences
Accessory muscle usage,
fever, cough,
Decreased O2 Sat

Answer 25

Hemoptysis

Question 26

Fever, chills, sweats, chest discomfort,
dyspnea, rales, cough-W-W/O mucus
Rales-Sounds
dullness to percussion
--CXR--
   1. parenchymal infiltrates

Answer 26

Pneumonia

Question 27

Nocturnal asthma
mechanical obstruction of airway
Depressed CNS by diseases
Drug/ETOH usage
Fever, wt. loss, malaise
Poor Dentin
FOUL SMELLING PURULENT SPUTUM

Answer 27

Aspiration Pneumonia/lung abscess

Question 28

A fib- Most common
Due to Emboli/ Thombi
sudden loss/reduction of pulses extremities
numbness/paralysis
Pain
pallor
Pulseless
paresthesia
poikilothermic

Answer 28

Acute Arterial Occlusion of Limb

Question 29

Sudden onset of intermittent (fleeting) chest pain
secondary to URI/trauma
Fever, myalgia, HA, nasal congestion
Ipsilateral shoulder pain
FRICTION RUB ON AUSCULTATION

Answer 29

Pleuritic/pleurisy

Question 30

Acute onset or worsening of dyspnea at rest
rales/rhonchi, expiratory wheezing
PINK FROTHY SPUTUM
—-CXR—
Butterfly patter of distribution of alveolar edema

Answer 30

Pulmonary Edema

Question 31

Abrupt onset
dyspnea, cough, anxiety
chest pain
low grade fever, hypotension, tachycardia, hemoptysis, DVT signs, pleural friction

Answer 31

Pulmonary Embolism

Question 32

Cough > 2-3 weeks
fatigue, Wt loss, night sweats
decreased, tactile fremitus
Crackles on inspiration pr after cough
CINNAMEN BREATH
Recent Travel

Answer 32

Tuberculosis

Question 33

Clear Rhinorrhea, hyposmia, nasal congestion
Fever, HA, malaise, cough
Scratchy throat
Engorged nasal mucosa
symptoms typically <4days and last less than 4wks

Answer 33

Upper respiratory infection

Question 34

Abrupt onset
Pain in the ear
Face feels stiff and pulled to one side
cannot close 1 eye
UNABLE TO GENERATE FOREHEAD WRINKLES

Answer 34

Bell’s Palsy