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CMN574 > unit 1 noncardiac CP > Flashcards

unit 1 noncardiac CP Flashcards

1
Q

timing of mitral valve prolapse murmur?

A

pansystolic

or late systolic

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2
Q

what extra sound does mitral valve prolapse have? and what is the timing?

A

mid-systolic click

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3
Q

s/s of mitral valve prolapse? (3)

A
  • CP
  • dyspnea
  • palpitations
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4
Q

if you see a patient with pectus excavatum what valvular disorder should you think of?

A

mitral valve prolapse

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5
Q

mitral valve prolapse effects men or women more?

A

women

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6
Q

physical characteristics AW pts at risk for mitral valve prolapse?

A
  • healthy & thin
  • marfan’s
  • eherls danlos
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7
Q

psych hx AW mitral valve prolapse?

A

anxiety & depression

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8
Q

mitral valve repair is indicated if _______ is present

A

regurg

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9
Q

description of chest pain AW AA dissection?

A
  • abrupt onset
  • severe
  • tearing/ripping
  • radiate to back
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10
Q

risk factors for AA dissection (6)

A
  • smoking
  • cocaine
  • inflammatory or collagen disease
  • pregnancy
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11
Q

s/s AW AA dissection?

A
  • ANXIETY
  • BP higher 15+ pts R>L
  • ABSENT UE PULSES
  • HOLOSYSTOLIC MURMUR
  • dyspnea
  • hypo or hypertensive
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12
Q

timing of murmur AW AA dissection?

A

holosytolic (ST aortic insufficiency)

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13
Q

pericarditis CP location

A
  • pleuritic, substernal

* radiates to epigastrium, shoulders, back

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14
Q

which non ischemic cause of CP is worse when supine?

A

pericarditis

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15
Q

what might you hear with pericarditis?

A

pericardial friction rub

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16
Q

s/s pericarditis

A
  • fever
  • dyspnea
  • pain worse when supine
  • pericardial friction rub
  • pleuritic substernal CP radiates to epigastrium, shoulders, back
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17
Q

causes of pericarditis (5)

A
  • VIRAL INFECTION
  • POST-MI
  • SLE/RA
  • uremia
  • CA
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18
Q

respiratory causes of CP (6)

A
  • bronchitis
  • PNA
  • asthma
  • COPD
  • pleurisy
  • PE
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19
Q

CP AW PNA & treatment of PNA

A

*dull or NO PAIN

20
Q

CP and s/s AW PE

A
  • pleuritic
  • sharp
  • stabbing
  • UNILATERAL
  • worse w deep breath or cough
  • tachycardic
21
Q

well score criteria is for?

A

PE

22
Q

low wells score?

A

<2

23
Q

criteria for wells score?

A
  • clinical s/s of PE/DVT (3pts)
  • PE #1 dx or equally likely (3pts)
  • HR > 100 (1.5pts)
  • immobilized x3d OR surg w/i past month (1.5pts)
  • previous PE/DVT (1.5pts)
  • hemoptysis (1pt)
  • malignancy w treatment w/i 6mo OR palliative care (1pt)
24
Q

high wells score?

A

> 6 = high suspicion- get CT & anticoagulate

25
Q

s/s AW asthma CP presentation?

A
  • fever
  • cough
  • wheezing
  • dyspnea
26
Q

what to assess in a pt w respiratory chest pain?

A
  • fever
  • egophony
  • rales
  • wheezes
  • friction rub
27
Q

top 3 noncardiac causes of CP

A
  1. MS
  2. GI
  3. psych
28
Q

psych causes of CP

A
  • stress
  • panic attack
  • somatization can aggravate GERD, asthma, angina
29
Q

location of anxiety associated CP?

A

precordial

30
Q

chest pain associated with depression?

A
  • constant or intermittent
  • HEAVINESS
  • unrelated to meals/activity
  • SUDDEN OR GRADUAL
31
Q

associated symptoms with CP caused by psych

A
  • anxiety
  • dyspnea
  • hyperventilation
  • tingling/numbness in BILATERAL extremities
  • dizziness
32
Q

2 questions to screen pscyh associated CP

A

in the last 6mo have you

  1. had a spell or attack of feeling anxious?
  2. felt heart racing or felt faint?
33
Q

GI disorders AW CP

A
  • GERD
  • esophagitis/spasm
  • PUD
  • hiatal hernia
  • gallbladder
34
Q

risk factors associated with GI related CP

A
  • hx of ulcers
  • smoking
  • ETOH
  • NSAIDS/asa
  • always ask about OTCs
35
Q

CP description of GI related pain

A

*substernal BURNING

36
Q

s/s esophageal spasm related CP

A
  • squeezing

* pressure

37
Q

PUD associated pain location and timing

A
  • epigastric radiating to back
  • worse w meals
  • worse when supine
38
Q

epigastric pain with palpation would indicate what type of non cardiac cause of CP

A

GI

39
Q

tests to run for GI related pain?

A
  • H.pylori

* EGD

40
Q

treatment of GI related CP

A
  • PPI
  • Abx if h.pylori
  • dietary changes
  • elevated HOB
41
Q

causes of musculoskeletal related CP

A
  • muscle strain
  • costochonrditis
  • broken rib
  • herpes zoster
  • fibro
  • SSC (what??)
  • chest wall contusion
  • protracted vomiting
42
Q

risk factors for MS related CP

A
  • young, active
  • trauma
  • overuse
  • hx chicken pox
43
Q

location of MS related CP

A
  • LOCALIZED

* pt can point to w one finger

44
Q

s/s of MS related CP

A
  • gradual onset
  • sharp or dull
  • localized
  • worse w arm movement/deep inspiration
45
Q

diagnostic testing for musc CP

A

none unless trauma

46
Q

tx for musc CP

A

rest, NSAIDS, ice x24h then heat

CMN574 (6 decks)

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