Screening for the Chest, Breast and Ribs Flashcards
What are 4 most common chest pain issues that are medical?
- oncology
- Cardiac
- Pulmonary
- GI
What is important to remember about chest pain in general?
it is usually not a primary complaint but must figure out if it is cardiac or not
What are three things to look for if chest pain is oncology related?
- PMH- pts with previous cancer hx at greater risk like lung or breast
- Lung- will present on shoulder pain, cough, DOE but this means its well advanced
- Breast- recent mammogram, life long estrogen exposure
What are the 3 P’s that are not MI related?
- pleuritic- increased with deep breathing
- pain on palpation- MS
- pain with changes of position- MS
What is cardiac pain patterns with males?
pressure, discomfort substernal, pain-jaw down to arm
What is cardiac pain pattern with females?
more subtle, likely will get more DOE, fatigue than pain
What are two risk factors for breast cancer?
- genetics- 5-10% of cases
2. Estrogen exposure- biggest risk factor
What are 4 types of estrogen exposure?
- Menarche under 12- first period
- menopause over 55
- Nulliparous- no children
- first birth over 35 y.o
What are age ranges for greatest risk of breast cancer?
peak age 45-70
men- 60-66
women 60-61
What are clinical signs and symptoms for breast cancer?
lump (breast or axilla), unusual discharge from nipple, dimpling of skin over breast
What are two types of screens for breast cancer?
- mammography- begins at 40
- CBE- every 3 years 20-39
annually after 40
What are two other less common reasons for non- MI chest pain?
- anxiety/panic attack
2. cocaine use
What are signs and symptoms of a panic attack?
SOB, diaphoretic, chest pain very similar to MI
risk factors- extreme stress, mental health issues, OTC decongestants, caffine
What are cardiotoxic effects of cocaine?
can cause MI or arrthymia, tachy, HTN
chest pain most common c/o with cocaine use
What is PP for pts who take anabolic steroids?
young pt with chest pain and DOE, hypertensive
What are side effects of anabolic steroids?
fractures heal slower, muscles and tendons injured faster and take longer to heal
What are S and S of anabolic steroid use?
chest pain, HTN, 10-15 weight gain in 2 weeks, acne, swollen face, stretch marks, male baldness, mood changes
What are differences between costochondritis and Tietze’s?
C- more common, no swelling, folks over 40, more women, 2-5th joints
T- less common, more swelling, younger folks, single level
both have pain with DB and cough
What is slipping rib syndrome?
clicking ribs, hyper mobility of lower ribs (7-9), pain worse with slumped posture or side bend towards
rib mob with decrease sx
What is intercostal neuritis?
herpes zoster or shingles,
affects college age kids or over 70, must have had chicken poxs
triggered by stress or immune triggered
What are symptoms of shingles?
follows cranial nerve or spinal nerve pattern bc it hides in nerves
extreme pain for 4-6 weeks, contagious skin rash lasts about 2 weeks
What is dorsal root irritation?
lateral/anterior chest pain, hx of back pain, similar to spinal stenosis, LE mvmt will not increase pain
make sure to r/o cardiac by asking how stairs are
