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cardio pulm exam 2 > physical diagnosis-16-landeen > Flashcards

physical diagnosis-16-landeen Flashcards

1
Q

group of people who may not feel any discomfort from MI

A

diABETIES

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2
Q

Most important factor in assessing ;ossible MI

A

History!

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3
Q

Chest discomfort during MI versus angina

A

MI pain lacks any clear physical clinical cause like angina does

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4
Q

most specific clinical manifestion indicating MI

A

Pain radiating to neck and arms

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5
Q

1st sign of HF/ elevated venous pressure

A

non productive cough

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6
Q

ass features of acute MI

A

unrelieved by nitro, duration symptoms grerater 30 min

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7
Q

ass. features aortic stenosis

A

systolic murmor

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8
Q

Ass. features pericarditis

A

relieved by sitting up and leaning forwards, pericardial frictio rub, sharp quality, and lasts hours to days

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9
Q

Aortic dissection

A

abrupt onset terribble pain, knife like burning, location is ant chest radiating to back, ass with hypertension, marfan syndrome

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10
Q

Spontaneous phnemothorax

A

smoking!

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11
Q

esophogeal spasm

A

can be confused for angina

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12
Q

patient sleeps with 6 pillows and preferes to sleep in a recliner, whats going on?

A

orthopnea, strongly suggests pul edema HF

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13
Q

hepato pulmonary syndrome

A

common sign is platypnea, dyspnea is alleviated when laying down, worse while sdtanding

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14
Q

syncope in medicated elderly

A

elderly exp syncope commonly especially when on many bp meds, make them hypotensive and pass out, alweays measure orthostatic vitals or can miss it.

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15
Q

disorders in which hemoptysis is a common sign

A

PE, pulmonary edema, mitral stenosis, malignancies

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16
Q

one of the common fiordt signs of HF/ increasedvenous pressure

A

non productive cough

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17
Q

dry cough

A

common with PE, can produce a frothy pink sputum

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18
Q

First thing to do when seeing patient for cardiac distress

A

ABC, airway brerathing circulation, then bp in both arms 1 leg

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19
Q

pulsating uvula

A

aortic stenosis

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20
Q

most comming sign in fundoscopic exam for peeps with diabetes, endocarditis, hypertension

A

roth spots

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21
Q

Best art to measure jugular venous pressure (JVP)

A

inner carotid, cononected to right heart direct, outer ok not as good

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22
Q

JVD def

A

engorgement of the IJ more than 5 cm above the sternal angle at 45 degrees

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23
Q

how to measure JVP

A

Measured by adding 5 cm to the height of the observed jugular venous distention above the sternal angle of Louis at 45 degrees

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24
Q

carotid pulses

A

use bell

25
Q

patients with a higher stroke volume (aortic regurgitation, arteriovenous fistula, hyperthyroidism, fever, or anemia findings from carotid pulse

A

inc frequency and intensity

26
Q

aortic stenosis findings with carotid pulse

A

pulse is delayed

27
Q

barrel chest

A

1:1 ratio, chronic lung disease

28
Q

pectus excavatum

A

excavated chest, sinks in funnel shape

29
Q

pectus carinatum

A

pigeon chest, protrude

30
Q

What are bruite suggestive of?

A

plaque accumulation

31
Q

aortic stenosis and bruits

A

aortic stenosis can radiate to caratid too, dont confuse

32
Q

common location pace maker

A

top left chest, can palpate small box, can get infected

33
Q

best way to detect pleural effusion

A

tactile fremitus and percussion

34
Q

lung crakles

A

suggests pulmonary edema, pneumonia or pleuritis.

35
Q

left ventricle apex beat

A

best heard left 5th space

36
Q

patient position for heart palp

A

patient in supine position at 30 degrees and enhanced by placing the patient in the left lateral decubitus

37
Q

PMI

A

Point of maximal impulse is less than 2 cm and it moves quickly away from the fingers. Size, amplitude and rate of force can be noted

38
Q

S1

A

MITRAL AND TRICUSPID VALVE CLOSURE

39
Q

S2

A

aortic and pulmonic valve closure

40
Q

ventricular systole

A

tween s1 s2

41
Q

ventricular dystole

A

tween s2 s1

42
Q

s3

A

Rapid filling phase of ventricular diastole. Can be normal and children and young adults.
> 40 yrs: Heart failure, MR (mitral regurg), s3 is close to s2, comes right after s2

43
Q

s4

A

late ventricular diastole.

CAD, HTN, HF , can be normal in athletes, comes closer to s1 right b4

44
Q

systolic murmors

A

Mitral and Tricuspid Regurgitation, Aortic and Pulmonic Stenosis

45
Q

diastolic murmors

A

Aortic and Pulmonic Regurgitation, Mitral and Tricuspid Stenosis

46
Q

continuous murmors

A

patent ductus arteriosis

47
Q

grading systolic murmor

A

closer apex sound is to s2 or even in s2 more severeSystolic murmor is

48
Q

pericardial friction rub

A

100% specific for diagnosis acute pericarditis

49
Q

pericardial disease echo characteristic

A

ST elevation looks like inversted smily face not tombstone

50
Q

liver enlargement from ab palp

A

indicative of HF

51
Q

Hepatojugular reflux

A

licited by pressing on the liver and showing an increase in the jugular venous pressure

52
Q

spleen enlargemnt from ab palp

A

advanced HF

53
Q

ausc abs

A

Assess for abdominal aortic or renal artery bruit

54
Q

peripheral vasc disease

A

muscular atropy and lack of hair

55
Q

delayed pulses

A

diss/coarctation aorta

56
Q

clubbing advanced

A

> 180 deg

57
Q

normal nail bed angle

A

160 deg

58
Q

early clubbing

A

180 deg flat

cardio pulm exam 2 (4 decks)

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