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MedY3 > Screening And Investigations CHEST > Flashcards

Screening And Investigations CHEST Flashcards

1
Q

Investigation and management of STEMI

A

Suggested: central pain, continuous, NOT relieved by rest, lasting >30 min
Ix: ST 1mm rise in limb, 2mm in chest on serial ECG
Mgt: O2, aspirin nitrate infusion, BB, statin, LMWH, ACEi, angioplasty/ thrombolysis urgently

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2
Q

Investigation and management of NSTEMi

A

Suggested: central pain, continuous, NOT relieved by rest, lasting >30 min
Ix: Increase troponin over 12 hr, no change on ECG
Mgt: O2, aspirin nitrate infusion, BB, statin, LMWH, ACEi, angioplasty/ thrombolysis urgently

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3
Q

Investigation and management of PE

A

Suggested: sudden Dyspnoea, pleural rub, cyanosis, tachycardia, risk factors
Ix: CTPA (gold) or V/Q
Mgt: LMWH, warfarin, thrombolysis if saddle clot on echo

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4
Q

Investigation and management of pneumothorax

A

Ix: expiration CXR
Mgt: if tension insert Venflon into 2nd ICS MCL. Oxygen, analgesia

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5
Q

Investigation and management of Aortic dissection

A

Suggested: tearing pain radiating to back, absent peripheral pulse, low BP, wide mediastinum on CXR

Ix: loss of clear lumen on CT scan or MRI

Mgt: oxygen analgesia, large bore IV access, cross match 6 units, sugery

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6
Q

Investigation and management of gastro-oesophageal

A

Dx: central or epi gastric burning pain, onset over hours, dyspepsia, worse lying, worsened by food alcohol NSAID
Ix: negative ECG, troponin. Oesophagitis on endoscopy. Improve on antacids.
Mgt: antacid, PPI

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7
Q

Investigation and management of Pulmonary oedema

A

Background fatigue, CDV RFx, displaced apex, bilateral basal fine crackles. Raised jvp, leg swelling.
Ix: CXR fluffy opacities near hila, loss costophrenic angle, impaired left v Fxn on echo (

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8
Q

Investigation and management of COPD

A

Sugg: long hx cough/sputum, >10yph, recurrent exacerbations, CXR radiolucent lungs.
Ix: spirometry, FEV1

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9
Q

Investigation and management of Asthma

A

Wheeze, chronic cough worse at night/ early morn, triggers, atopy hx, F hx.
Ix: reduced peak flow, FEV1 improve >15% with treatment
Mgt: high flow O2, prednisolone,nebulised salbutamol and ipratropium, smoking cessation,

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10
Q

Investigation and management of angina.

A

Suggested: central pain, relieved by rest, lasting

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11
Q

Management acronyms for immediate and long term management for STEMI

A

Morphine/ oxygen/ nitrate/ anti-platelet therapy/ stent or streptokinase / heparin

Statin/ ACEi or ARB/ Anticoagulation/ Beta blocker/ Clopidogrel

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12
Q

Criteria for starting warfarin/ new oral anticoagulant
OR
Risk of stroke with Atrial fibrillation

A 
CCF
Hypertension
Age >75
DM
Stroke (2)
Vascular disease
Age >65
Sex Category (2)

0=lifestyle management
1= aspirin or warfarin
2= warfarin or doac (direct)

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13
Q

Light’s criteria for exudates

A

Determines presence of exudate with protein and LDH levels.
Pleural protein : serum protein >0.5
Pleural LDH : Serum LDH > 0.6
Pleural LDH > 2/3 of upper value serum LDH

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14
Q

Well’s score

A

Likeliness of DVT

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15
Q

Criteria for pneumonia severity

A

Confusion
Urea>9?
Respiratory rate >20
BP

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16
Q

NYHF criteria

A

1 asymptomatic
2 Dyspnoea on slight exertion (up one flight)
3. Dyspnoea on DAL
4. Dyspnoea at rest

17
Q

ECOG

A

5 dead

18
Q

Complications post MI

A 
CRASHPAD - 
CCF
Rupture
Arrhythmia 
Shock
HTN
Pericarditis 
Aneurysm (ventricular)
DVT/ Dressler's pericarditis

Most commonly CCF, arrhythmia, recurrent MI and shock.

19
Q

Management and acronyms for short-term and long term management for NSTEMI

A

Anti coagulation, dual anti platelet therapy (clopidogrel + aspirin), ACEi, beta blocker. GTN / morphine symptom control.

Statin, ACEi, BETA BLOCKER, anti platelet

20
Q

First line management for preventing episodes of unstable angina

A

Beta blocker, CCB- central acting diltiazem/verapamil- if contraindicated

21
Q

What is the classification for diagnosing Infective endocarditis ?

A

Duke’s Criteria: two major / 1 major or two minor /

Major criteria =

  1. +ve blood cultures from separate locations
  2. Positive Transoesophageal echocardiogram
22
Q

Chest XRay signs of APO

A 
Alveolar oedema - (bat wing sign)
B lines (Kerley)
Cardiomegaly
Diversion of upper love vessels
Effusion of pleura
23
Q

What is the severity criteria for pneumonia?

A

Confusion
Urea>7mmol/L
Respiratory rate >30 /min
BP 65

0-1 home
2 hospital therapy
3 consider ICU

24
Q

What is the severity criteria for pneumonia?

A

Confusion
Urea>7mmol/L
Respiratory rate >30 /min
BP 65

0-1 home
2 hospital therapy
3 consider ICU

MedY3 (16 decks)

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