Midterm conditions Flashcards
Discomfort induced by exertion and relieved with rest or nitroglycerin.
Due to ischemia of the heart or obstruction of coronary arteries.
Angina Pectoris:
Anginal symptomatology that occurs with the same degree of exertion and resolves with the same decree of rest and same dosage and strength of nitroglycerine
Stable Angina:
Angina that occurs with more frequent occurrence of angina episodes, longer lived ones, or more easily proved not relieved by nitroglycerine
Unstable Angina:
Angina at rest not relieved by Nitroglycerine
Prientz Metal/ Atypical
Symptoms that suggest high risk
*pressure/squeezing quality, pain similar to prior mi or angina, radiation to neck, shoulders, jaw or left arm, associated dyspnea and could have nausea and sweating
Most often due to endothelial injury and plaque formation and rupture
Acute Coronary Syndrome:
Pesent when there is significant impairment of respiration and/or blood circulation.
Emergency!!
PE: Broncophony will be diminished and it will be hyper-resonant on percussion. Increased heart rate, rapid breathing and displacement of windpipe away from affected side
Tension Pneumothorax
Unequal pulses, radiating pain to the back, new onset murmur
Aortic Dissection:
Consider in any patient who presents with chest pain that is pleuritic in nature or dyspnea that is not explained by: *Clinical evaluation
- Radiograph
- Electrocardiogram.
- JVD w/lungs clear to auscultation->Pulmonary embolism, Cardiac Tamponade, RCHF
- SX: Dyspnea, anxiety, pleuritic chest pain, cough, hemoptysis. Low pulse ox and arterial gasses
- Tests: CT pulmonary angiography, D-dimer testing & conventional pulmonary angiography.
- D-dimer also used with suspicion of Deep Vein Thrombosis, Pulmonary Embolism and intravascular coagulation
Pulmonary Embolism:
SX: Becks Triad= Low BP, JVD, Decreased Heart Sounds
*JVD w/lungs clear to auscultation->Cardiac Tamponade, RCHF, Pulmonary embolism
Occurs as a result of chest trauma, cancer, uremia, pericarditis or cardiac surgery
Cardiac Tamponade:
Any swelling of the aorta greater than 1.5 x normal, representing an underlying weakness in the wall of the aorta at that location.
Sx: pain radiating to the mid back, hoarse voice and left due to left recurrent laryngeal nerve being stretched *Matching of where pain goes
Aortic Aneurysm:
Sx onset is usually gradual over minutes and chest pain is the mc sx. Sensation of tightness, squeezing, pressure.
Nitric Oxide is given to increase oxygen load to the heart and by dilating the vessels.
Myocardial Infarction
“crackling or wheezing sounds, cyanosis, blood tinged sputum”
Sx: dyspnea, rapid labored breathing, crackling or wheezing sounds, cyanosis, blood tinged sputum, dstended jugular vein, rapid pulse, cool, clammy skin, restlessness and anxiety.
TX: high flow O2, keep patients head and shoulder elevated, and keep them call while 911 arrives.
Acute Pulmonary Edema:
Respiratory alkalosis and can pass out. They are common and begin abruptly and last for a long time. Chest pain and shortness of breath are common.
Panic Attack/Hyperventillation
- Extremely dilated sub-mucosal veins in the lower third of the esophagus
- MC DT Portal hypertension dt cirrhosis
- Strong tendency to bleed and perforate
- TX: stop blood, maintain plasma volume, correct disorders in coagulation and use antibiotics if gram-negative
therapeutic endoscopy is gold standard treatment - Be careful because resuscitation of all lost blood volume can lead to increase in portal pressure and lead to more bleeding.
- Therapeutic approaching to stoping the bleeding include:
A. Vatical ligation and sclerotherapy you could also use balloon tamponade for refractory bleeding.
Esophageal Varices:
Adenocarcinoma is third M/C cancer in US
Occult bleeding b/c mucosal ulceration =>Common
Microcytic Hypochromic Anemia
Colorectal cancer:
