[2] Cardinal Symptoms of Heart Disease

Question 1

Attributes of Pain

Answer 1

O: Other Associated Symptoms
P: Provocative/Palliative
Q: Quality
R: Radiation/Region
S: Severity
T: Time
(Onset, Duration, Frequency)

Question 2

[Classic Angina vs. Atypical vs. MVP]

Provocative

Answer 2

C: During Effort
A: Spontaneous
M: Spontaneous

Question 3

[Classic Angina vs. Atypical vs. MVP]

Palliative

Answer 3

C: Rest/Nitrates
A: Nitrates
M: Spontaneous

Question 4

[Classic Angina vs. Atypical vs. MVP]

Quality

Answer 4

C: Variable
A: Variable
M: Variable

Question 5

[Classic Angina vs. Atypical vs. MVP]

Radiation

Answer 5

C: Retrosternal
A: Retrosternal
M: Left Anterior

Question 6

[Classic Angina vs. Atypical vs. MVP]

Severity

Answer 6

C: Mild
A: Mild
M: Mild-Severe

Question 7

[Classic Angina vs. Atypical vs. MVP]

Timing

Answer 7

C: 1-30 Minutes
A: 1-30 Minutes
M: Minutes - Hours

Recent data shows that Angina attacks should last less than 15-20 minutes

Question 8

[Classic Angina vs. Atypical vs. MVP]

Other Factors

Answer 8

C: Risk Factors
A: Also w/ CSAP
M: Young Female

Question 9

When does Variant Angina? or Vasospastic Angina occur?

What is typical of it?

Answer 9

Occurs at Rest
ST Segment Elevation

(Typical myocardial problems cause ST Segment Depression)

Question 10

What can usually cause Atypical Angina?

Answer 10

Coldness

Question 11

Diagnose: Patient is a 40F with chest pain on exertion, usually after washing clothes

Answer 11

Upper Extremity Effort

Question 12

Diagnose: The pain usually occurs during exertion but sometimes at rest or after fatty meals. It is relieved by nitrates or rest, or sometimes by belching…

Answer 12

Multiple Etiologies

Biliary, GERD, Atypical Angina

Question 13

How do you differentiate Cardiac and Pulmonary Dyspnea?

Answer 13

Cough: Late symptom in Cardiac
Orthopnea: Late symptom in Cardiac
PND: Relieved by standing in Cardiac, Expectorates in Pulmonary

Question 14

Define: Trepopnea

Answer 14

Difficulty of breathing on one side or another

Question 15

Define: Platypnea

Answer 15

Dyspnea when upright

Question 16

How can you alleviate symptoms of Trepopnea?

Answer 16

Lie on the side of the unaffected lung

Question 17

Diagnose: “Doc, madali po akong mapagod..”

Answer 17

(Easy Fatigue vs. Exertional Dyspnea)

Question 18

Define: Heart Palpitations

Answer 18

Being aware of your heartbeat

Question 19

Diagnose: 74F Bilateral Ankle Swelling for the past month, she can hardly walk

Answer 19

Ankle Arthritis

Edemas are not painful

Question 20

What concentration cause cyanosis?

Normal
Met-Hb
Sulf-Hb

Answer 20

Normal: 5g/dL

Met-Hb: 1.5g/dL

Sulf-Hb: 0.5g/dL

Question 21

What causes Central Cyanosis?

Answer 21

Arterial Desaturation Centrally

Question 22

What causes Peripheral Cyanosis?

Answer 22

Vasoconstriction in the Cold
Venostasis

General peripheral problems

Question 23

Define: Toes were cyanotic but her fingers were not?

Answer 23

Reversed Patent Ductus Arteriosus

Blood goes from right-left instead of the usual way around due to Pulmonary Hypertrophy over time

Question 24

Define: Syncope

Answer 24

Sudden transient loss of consciousness with no neurologic deficit

Question 25

Define: Stokes-Adams Syncope

Answer 25

Sudden cessation of cardiac function and effective CO and complete heart block causing loss of consciousness

Question 26

What is being tested when the doctor asks "What level of effort triggers the pain?"? a. provocative b. quality c. palliative d. region e. associated symptoms (c/o Leland Lukban)

Answer 26

A

Question 27

Under Canadian cardiovascular grading of angina: Angina with strenuous or rapid or prolonged exertion at work or recreation. a. grade 1 b. grade 2 c. grade 3 d. grade 4 (c/o Leland Lukban)

Answer 27

A

Question 28

Region where esophageal non-cardiac associated chest pain is usually observed a. Retrosternal b. Left anterior c. Substernal d. midclavicular (c/o Leland Lukban)

Answer 28

C

Question 29

Which one of these fall under Functional non-cardiac associated chest pain? a. Tietze’s syndrome b. Da Costa’s syndrome c. Prinzemetal’s Angina d. Kobayashi’s Syndrome (c/o Leland Lukban)

Answer 29

B

Question 30

Referred to as a supply type of angina. a. Classic Angina b. Atypical Angina c. Mitral valve prolapse Angina d. Esophageal Angina (c/o Leland Lukban)

Answer 30

B

Question 31

This causes Descending Edema

Answer 31

Renal Cause

Question 32

This causes Centrifugal Edema

Answer 32

Hepatic Cause

Question 33

This causes Ascending Edema

Answer 33

Cardiac/Pulmonary Cause