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ScribeAmerica VCRT > Course 2: Pathophysiology > Flashcards

Course 2: Pathophysiology Flashcards

1
Q

CAD diagnosed by

A

Cardaic catheterization

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2
Q

CAD assoc. meds

A

Aspirin (ASA) 324mp PO

Nitroglycerin (NTG) 0.4mg SL

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3
Q

Aspirin

A

ASA

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4
Q

Nitroglycerin

A

NTG

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5
Q

CAD chief complaint

A

chest pain - worse with exertion

chest pressure

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6
Q

CAD is the single greatest risk factor for ___

A

an MI

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7
Q

Stress tests or _____ assess the severity of CAD.

A

Cardiac Catheritization

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8
Q

A patient has CAD if they have a PMHx of ____

A

Angia, MI, CABG, Cardiac stents, angioplasty

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9
Q

Risk factors of MI

A

CAD, HTN, HLD, DM, smoker, FHx of CAD

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10
Q

MI diagnosed by

A

EKG (STEMI) or elevated Troponin (non-STEMI)

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11
Q

MI assoc. meds

A

ASA, NTG, B-Blocker, Thrombolytic (Heparin)

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12
Q

Acute MI patients must receive ___ ASAP

A

ASA 324mg

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13
Q

STEMI patients must get to ___ within 90 minutes of arrival.

A

Cath-lab

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14
Q

STEMI MI

A

ST elevated MI

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15
Q

NON-STEMI

A

Non-STEMI

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16
Q

CHF chief complaint

A

shortness of breath

worse lying flat

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17
Q

Paroxysmal Nocturnal syspnea

A

PND

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18
Q

Dyspnea on exertion

A

DOE

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19
Q

CHF PE

A

Rales in lungs, JVD in neck, pitting pedal edema

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20
Q

Jugular Vein distension

A

JVD

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21
Q

Rales

A

Crackles

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22
Q

CHF diagnosed by

A

CXR or elevated BNP

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23
Q

B-type Natriuretic Peptide

A

BNP, released by cardiac tissue in the heart when exerted/stretched

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24
Q

CHF can be thought of as __ in the heart, fluid gets backed up in the __ and down the legs (__)

A

fluid jam
JVD
Pedal edema

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25
Q

CHF assoc. meds

A

Diuretics (lasix, furosemide)

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26
Q

AFIB chief complaint

A

palpitations (fast, pounding, irregular)

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27
Q

AFIB risk factors

A

Paroxysmal A Fib, Chronic A Fib

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28
Q

AFIB PE

A

Irregulary irregular rhythm, tachycardia

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29
Q

AFIB diagnosed by

A

EKG

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30
Q

AFIB assoc. meds

A

Coumadin (Warfarin): blood thinner

Digoxin: slows heart rate

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31
Q

RVR

A

rapid ventricular response

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32
Q

NSR

A

Natural sinus rhythm

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33
Q

Cardiovert

A

Restarting the heart to get it to normal rhythm

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34
Q

Pericarditis

A

Inflammation of the sac surrounding the heart causing CP

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35
Q

Pleurisy

A

Inflammation of the sac surrounding the lungs causing pleuritic CP

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36
Q

Costochondritis

A

Irritation of the ribs causing CP worsened by pressing on the sternum

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37
Q

Chest Wall Pain

A

Irritation of the chest wall causing pain with palpation of the chest

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38
Q

Pleural Effusion

A

Fluid collecting around the lungs causing SOB or CP

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39
Q

Angina

A

Chest pain when the heart isn’t getting enough blood during exertion

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40
Q

PE risk factors

A

Known DVT, PMHx of DVT or PE, FHx, recent surgery, cancer, AFIB, immobility, pregnancy, BCP, smoking

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41
Q

Cheif complaint of PE

A

SOB or pleuritic chest pain (worse with deep breaths)

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42
Q

PE diagnosed by

A

CTA Chest or VQ scan

D-dimer (aids in detecting clots, but cannot diagnose)

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43
Q

PNA risk factors

A

elderly, bedridden, recent chest injury, recent surgery

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44
Q

PNA chief complaint

A

SOB or productive cough

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45
Q

PNA assoc. Sx

A

Cough with sputum, fever, chest pain

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46
Q

PNA assoc. meds

A

Rocephin and Zithromax

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47
Q

PE of PNA shows

A

Rhonchi

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48
Q

PNA diagnozed by

A

CXR

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49
Q

Community acquired pneumonia

A

CAP

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50
Q

CAP protocol requires documenting of

A

Abx, vitals, mental status, and blood cultures

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51
Q

Pneumothorax

A

PTX, lung collapse

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52
Q

PTX chief complaint

A

SOB and one-sided chest pain

sudden onset, often trauma patients

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53
Q

PE of PTX

A

Absent breath sounds unilaterally

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54
Q

PTX diagnosed by

A

CXR

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55
Q

Percentage of lung collapsed must be ___

A

documented

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56
Q

Chronic obstructive pulmonary disease

A

COPD

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57
Q

COPD risk factors

A

smoking

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58
Q

COPD chief complaint

A

SOB

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59
Q

PE of COPD

A

decreased breath sounds, wheezes, rales

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60
Q

COPD assoc. meds

A

Home 02

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61
Q

COPD diagnosed by

A

CXR and HX of smoking

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62
Q

Reactive airway disease

A

RAD

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63
Q

RAD chief complaint

A

SOB/Wheezing

improved by nebulizer (bronchodilators)

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64
Q

PE of RAD

A

Wheezes

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65
Q

RAD assoc. meds

A

Inhalers, nebulizers, corticosteroids

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66
Q

RAD diagnosed by

A

clinically

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67
Q

Ischemic cerebral vascular accident

A

CVA

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68
Q

CVA chief complaint

A

unilateral focal neurologic deficits
one sided weakness, numbness
changes in speech/vision

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69
Q

CVA risk factors

A

HTN, HLD, DM, hx TIA,CVA, smoking, FHx CVA, AFIB

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70
Q

PE of CVA

A

Neuro deficits

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71
Q

CVA diagnosed

A

clinically

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72
Q

Always document the ___ of the time a CVA pt was last known well

A

date and time

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73
Q

tPA

A

powerful blood thinner that can reverse a CVA

(if stroke occures

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74
Q

brain bleed chief complaint

A

headache, sudden onset

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75
Q

HCVA assoc. sx

A

changes in speech, perception, motor strength, AMS, seizure, headache

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76
Q

PE of HCVA

A

unilateral neurological deficits

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77
Q

Hemorrhagic CVA

A

HCVA, stroke

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78
Q

HCVA diagnosed by

A

CT hear, LP (lumbar puncture)

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79
Q

If HCVA, document tPA not indicated due to __.

A

hemorrhage

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80
Q

Transient Ischemic Attack

A

TIA

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81
Q

TIA chief complaint

A

transient focal neuro deficit

changes in speech, vision, strength, or sensation

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82
Q

TIA diagnosed by

A

clinically

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83
Q

TIAs are known as ____

A

mini-strokes

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84
Q

TIAs usually last

A
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85
Q

With TIA document tPA considered and no indicated due to __

A

issue resolved

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86
Q

Meningitis chief complaint

A

headache and neck pain

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87
Q

Meningitis assoc. sx

A

fever, neck pain, neck stiffness, AMS

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88
Q

PE of meningitis

A

meningismus, nuchal rigidity

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89
Q

Meningitis diagnosed by

A

lumbar puncture

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90
Q

Spinal Cord Injury chief complaint

A

neck pain, back pain, bilateral extremity weakness

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91
Q

PE of Spinal Cord Injury

A

Midline bony tenderness, deformities, or step-offs

bilateral extremity weakness, numbness, decreased rectal tone

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92
Q

Spinal cord injury diagnosed by

A

CT cervical/thoratic/lumbar spine

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93
Q

PE of a spinal cord injury immobilized with a ___

A

C-collar and backboard

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94
Q

Seizure

A

SZ

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95
Q

SZ chief complaint

A

seizure activity, syncope

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96
Q

SX assoc. sx

A

injuries (tongue bite), confusion, headache, incontinence

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97
Q

PE of SZ

A

somnolent, confused (post-ictal: aggitation, confusion after SZ)

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98
Q

SZ assoc. meds

A

Dilantin, Tegretol, Kreppa, Depakote, Neurontin

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99
Q

Bells Palsy Cheif complaint

A

Facial Droop

sudden onset

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100
Q

Bells Palsy assoc. sx

A

jaw or ear pain

increased tear flow from one eye

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101
Q

Bells Palsy pert. neg

A

no extremity weakness

no changes in speech or vision

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102
Q

Bells Palsy diagnosed

A

clinically

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103
Q

PE of bells palsy

A

unilateral weakness of upper and lower face

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104
Q

____ is the most common cause of facial droop in young patients who do not have CVA risk factors

A

Bells Palsy

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105
Q

Headache

A

HA (cephalgia)

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106
Q

HA chief complaint

A

headache (gradual onset)

pressure, throbbing

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107
Q

HA pertinent negatives

A

no fever, no neck stiffness, no numbness/weakness

no changes in speech of vision

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108
Q

Altered mental status

A

AMS

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109
Q

AMS risk factors

A

diabetic, elderly, demented, ETOH use, drug use

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110
Q

AMS chief complaint

A

confusion, decreased responsiveness, unresponsive

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111
Q

AMS diagnosed by

A

case dependent

112
Q

AMS causes

A

hypoglycemia, infection, intoxication, neurlogical

113
Q

AMS is generalized and is typically caused by things that affect ____

A

the whole brain

114
Q

Focal neuro deficits are localized weakness/numbness in one specific area, corresponding with ___

A

damage at one specific site in the brain

115
Q

Most common cause of AMS for patients without a hx of dementia is from ___, most often caused by a ___.

A

infection

UTI

116
Q

Fainting, passing out

A

Syncope

117
Q

syncope

A

temporary loss of blood supply to the brain resuling in loss of consciousness, due most commonly to vasovagal and low blood volume. other causes are cardiac/neurologic.

118
Q

syncope chief complaint

A

passing-out (not “about” to pass-out)

119
Q

Document what happened prior, during and after the syncopal episode in order to ___.

A

rule out possible dx

120
Q

Vertigo

A

caused by inner ear (benign) or damage to center of brain

121
Q

vertigo chief complaint

A

room spinning, off balance

122
Q

vertigo assoc. sx

A

N/V, tinnitus

123
Q

PE of vertigo

A

horizontal nystagmus, + romberg, + dix-hallpike test

124
Q

vertigo assoc. meds

A

Meclizine (antivert)

125
Q

Vertigo diagnozed by

A

clinically

126
Q

Diseases associated with epigastric region

A

GERD, MI

127
Q

Diseases associated with RUQ

A

cholecystitis

128
Q

Diseases associated with LUQ

A

pancreatitis

129
Q

Diseases associated with Periumbillical region

A

SBO

130
Q

Diseases associated with RLQ

A

Appendicitis

131
Q

Diseases associated with LLQ

A

Diverticulitis

132
Q

Diseases associated with Suprapubic region

A

ovarian torsion
ovarian cyst
UTI

133
Q

Diseases associated with Flanks

A

Pyelonephritis

Renal Calculi

134
Q

Appendicitis

A

APPY

135
Q

APPY chief complaint

A 
RLQ pain (gradual onset)
constant pain
pain worsened by movement
136
Q

APPY assoc. sx

A

decreased appetite (anorexia)
fever
N/V

137
Q

PE of APPY

A

McBurney’s point tenderness

RLQ tenderness

138
Q

Small bowel obstruction

A

SBO

139
Q

SBO risk factor

A

elderly, infants, abdominal surgery, narcotic pain meds

140
Q

SBO chief complaint

A

abdominal pain, vomiting, constipation

141
Q

SBO assoc. sx

A

abdominal distension
bloating
no BMs

142
Q

PE of SBO

A

Abdominal tenderness, guarding, rebound
abdominal bowel sounds
abdominal distension, tympany (tightness)

143
Q

SBO diagnosed by

A

CT A/P with PO contrast

Acute abdominal series (AAS, type of xray)

144
Q

Gallstones

A

Choleithiasis (stones)

cholecystis (inflammation or infection)

145
Q

gallstones catchphrase

A

RUQ abd pain after eating fatty foods

146
Q

gallstones chief complaint

A

RUQ pain (sharp, worsened with eating/palpation)

147
Q

PE of gallstones

A

RUQ tenderness, murphy’s sign

148
Q

Gallstones diagnosed by

A

abdominal US (ultrasound), RUQ

149
Q

Gastrointestinal bleed

A

GI bleed

150
Q

GI bleed chief complaint

A

hematemesis (upper)
coffe ground emesis (lower)
hematochezia (lower)
melena (upper)

151
Q

GI bleed assoc. sx

A

generalized weakness, lightheadedness, SOB, abdominal pain, rectal pain

152
Q

PE of GI bleed

A

pale conjunctiva, pallor, tachycardia

153
Q

Rectal exam of GI bleed

A

melena, grossly bloody stool

154
Q

GI bleed diagnosed by

A

Heme positive stool (guaiac positive) during a rectal exam

155
Q

ED Concern

A

the need for a possible blood transfusion due to significant blood loss

156
Q

Diverticulitis

A

acute inflammation of abdominal pockets of the large intestine

157
Q

Diverticulitis risk factors

A

diverticulosis, advanced age

158
Q

diverticulitis chief complaint

A

LLQ pain

159
Q

diverticulitis assoc. sx

A

nausea, fever, diarrhea

160
Q

diverticulitis diagnosed by

A

CT A/P with PO contrast

161
Q

pancreatitis risk factors

A

ETOH abuse
Cholecystitis
specific meds

162
Q

pancreatitis chief complaint

A

LUQ, epigastric pain

163
Q

pancreatitis assoc. sx

A

N/V

164
Q

PE of pancreatitis

A

epigastric tenderness

165
Q

Pancreatitis diagnosed by

A

elecated lipase lab test

166
Q

Acid Reflux

A

GERD

167
Q

GERD chief complaint

A

epigastric pain
burning
improved with antacids

168
Q

PE of GERD

A

epigastric tenderness

169
Q

GERD assoc. meds

A

GI cocktail (numbs and sooths the esophagus and stomach)

170
Q

Patients with cardiac risk factors and epigastric pain will always get a ____

A

cardiac workup

171
Q

Abdominal pain - C. Diff. colitis

A

opportunistic baceria that causes persistent diarrhea

172
Q

Abdominal pain - Gastroenteritis

A

vomiting and diarrhea “GI bug” often viral or bacterial

173
Q

Abdominal pain - Chron’s disease

A

immune disorder causing diarrhea and abdominal pain

174
Q

Abdominal pain - IBS

A

chronically sensitive bowels prone to diarrhea

175
Q

Abdominal pain - Gastritis

A

irritated stomach with vomiting “stomach ache”

176
Q

Urinary tract infection

A

UTI

177
Q

UTI risk factors

A

female

178
Q

UTI chief complaint

A

dysuria (painful urination)

179
Q

UTI assoc. sx

A

frequency, urgency, malodorous urine, AMS (elderly)

180
Q

PE of UTI

A

suprapubic tenderness

181
Q

UTI diagnosed by

A

urine dip

urinalysis (test for nitrite, WBC)

182
Q

Pyelonephritis

A

infection of the tissue in the kidneys, usually spread from a UTI

183
Q

pyelo risk factors

A

female, frequent UTIs

184
Q

pyelo chief complaint

A

flank pain with dysuria

185
Q

pyelo assoc. sx

A

fever, N/V

186
Q

Pyelo diagnosed by

A

CT abdomina/pelvis

187
Q

Kidney stones

A

nephrolithiasis, renal calculi, urolithiasis

188
Q

Kidney stones chief complaint

A

flank pain
sudden onset
radiating to groin

189
Q

kidney stones assoc. sx

A

hematuria, N/V, unable to void

190
Q

PE of kidney stones

A

CVA tenderness

191
Q

kidney stones diagnosed by

A

CT abd/pelvis

RBC in UA may be a clue

192
Q

Ectopic pregnancy

A

tubal pregnancy

193
Q

tubal pregnancy

A

fertilized egg develops outside uterus, usually in the fallopian tube, high risk for rupture and death

194
Q

tubal preg risk factors

A

preg female, STDs

195
Q

tubal preg chief complaint

A

lower abdominal pain

vaginal bleeding while pregnant

196
Q

tubal preg diagnosed by

A

US Pelvis (determine location)

197
Q

Ovarian torsion

A

twisting of an ovarian artery reducing blood flow

198
Q

ovarian torsion chief complaint

A

lower abdonminal pain

199
Q

PE of ovarian torsion

A

adnexal tenderness, lower abdominal pain

200
Q

Ovarian orsion diagnosed by

A

US pelvis

201
Q

testicular torsion

A

twisting of spermatic cord

202
Q

testicular torsion chief complaint

A

pain

203
Q

testicular torsion diagnosed by

A

US scrotum

204
Q

Upper respiratory infection

A

URI

205
Q

URI chief complaint

A

cough, congestion

206
Q

URI assoc. sx

A

fever, sore throat, headache, myalgias

207
Q

PE of URI

A

rhinorrhea, boggy turbinates, pharyngeal erythema

208
Q

URI diagnosed by

A

clinically

209
Q

Pay special attention to any complaints of __ or __ for URI patients

A

CP

SOB

210
Q

middle ear infection

A

oititis media

211
Q

otitis media chief complaint

A

ear pain, ear pulling

212
Q

oititis media assoc. sx

A

fever, sore throat, dry cough, congestion

213
Q

PE of otitis media

A

erythema, effusion, dullness, or bulging of the tympanic membrate (TM)

214
Q

otitis media diagnosed

A

clinically

215
Q

strep throat

A

streotococcal pharyngitis

216
Q

strep throat chief complaint

A

sore throat

217
Q

PE of strep throat

A

pharyngeal erythema
tonsillar hypertrophy
tonsillar exudates

218
Q

strep throat diagnosed by

A

rapid strep

219
Q

pink eye

A

conjunctivitis

220
Q

pink eye chief complaint

A

eye redness
irritation
pain

221
Q

pink eye assoc sx

A

eyelid matting, eye discharge, fever

222
Q

PE of pink eye

A 
conjunctival injection (redness)
edema, exudates
223
Q

pink eye diagnosed by

A

clinically

224
Q

Nosebleed

A

epistaxis

225
Q

nosebleed risk factors

A

blood thinners (coumadin/warfarin ASA, plavix) or HTN

226
Q

PE of nosebleed

A

anterior, posterior, or septal source

227
Q

nosebleed diagnosed by

A

clinically

228
Q

patients on blood thinners who have a nosebleed will have __ to make sure blood isn’t too thin

A

coagulation labs (PT/INR) drawn

229
Q

Musculoskeletal back pain chief complaint

A

back pain

230
Q

Musculoskeletal back pain assoc sx

A

shooting posterior lower extremity pain

231
Q

Musculoskeletal back pain pert. negs.

A

No LE weakness

No incontinence

232
Q

PE of Musculoskeletal back pain

A

paraspinal tenderness

positive straight leg raise (+SLR diagnoses sciatica)

233
Q

Extremity injury chief complaint

A

pain

234
Q

extremity injury pert negs

A

no motor weakness, no numbness or tingling

235
Q

PE of extremity injury

A

distal CSMT intact (circulation, sensory, motor, tendon)
no tendon or ligament laxity
ROM limited secondary to pain

236
Q

Hemoglobin

A

red blood cell

237
Q

Abdominal Aortic aneurysm

A

AAA

238
Q

AAA PE

A

midline pulsatile abdominal mass, abdominal bruit, unequal femoral pulses, hypotension

239
Q

AAA diagnosed by

A

CT A/P with IV contrast dye

240
Q

Aortic dissection

A

separation of the muscular wall from the membrane of the artery, putting the pt at risk of aortic rupture and death

241
Q

Aortic dissection diagnosed by

A

CT Chest with IV dye

242
Q

Deep vein thrombosis

A

DVT

243
Q

DVT risk factors

A

PMHx of DVt pr PE, FHx, recent surgery, cancer, immobility, preg, BCP, smoking LE trauma, LE casts

244
Q

DVT chief complaint

A

extremity pain and swelling (atraumatic)

usually located in a lower extremity

245
Q

DVT diagnosed by

A

US/doppler of extremity

246
Q

Cellulitis chief complaint

A

red, swolen, painful and sometimes warm area of skin

247
Q

PE of cellulitis

A

erythema, edema, increased warmth (calor) inducration

248
Q

cellulitis diagnosed by

A

clinically

249
Q

Abscess

A

cellulitis with fluctuance

250
Q

abscess chief complaint

A

red, swollen, painful lump

251
Q

PE of abscess

A

fluctuance, induration, purulent drainage

252
Q

abscess diagnosed

A

clinically

253
Q

rash

A

change in skins appearance due to reaction

254
Q

PE of rash

A

urticaria (hives or wheals), macules (flat), papules (raised bumps), vesicles, blanching, petechaie (dangerous rash), purpura (dangerous rash)

255
Q

Rash diagnosed by

A

clinically

256
Q

PE of allergic reaction

A

edema, facial angioedema, urticaria (hives, wheals)

257
Q

ED concern of allergic reaction is

A

anaphylaxis

258
Q

allergic reaction

A

rash
itching
swelling
SOB due to airway swelling

259
Q

adverse reaction

A

nausea/vomiting
abdominal pain
diarrhead

260
Q

Diabetic ketoacidosis

A

DKA

261
Q

DKA chief complaint

A

persistent vomiting with a hx of DM

262
Q

DKA assoc. sx

A

SOB, polydipsia, polyuria

263
Q

PE of DKA

A

ketotic odor, dry mucous membranes, tachypnea

264
Q

DKA diagnosed by

A

arterial blood gas (ABG or VBG) showing low pH or positive serum ketones

265
Q

DKA treated with

A

hydration/insulin

266
Q

PE of Psych disorder

A

flat affect, SI, HI, tangential or pressured speech

267
Q

Psych patients should clear the patient __ first.

A

medically

268
Q

Trauma

A

physical injury

269
Q

Mechanism of injury

A

MOI

270
Q

PE of trauma

A

glasgow coma scale (GCS)

271
Q

Trauma diagnosed by

A

trauma protocol depending on MOI: CT or XR

272
Q

Neurological injury trauma (scribe alerts)

A 
LOC (loss of consciousness)
confusion
numbness
weakness
HA
neck/back pain
internal organ injury
SOB
chest pain
abdominal pain
273
Q

MOI MVA

A

head on
tbone
rear impact
rollover

274
Q

MOI urgent MVA

A

ejection
motorcycle/atv
auto/pedestrian

275
Q

MOI rapid vertical deceleration

A

severe: greater than 3x pt height

276
Q

MOI penetrating trauma

A

location, depth, angle

ScribeAmerica VCRT (5 decks)

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