B P3 C13 History and Physical Examination: An Evidence-Based Approach Flashcards
(178 cards)
Typical angina should satisfy three characteristics:
(1) substernal discomfort
(2) initiated by exertion or stress
(3) relieved with rest or sublingual nitroglycerin.
__________ more commonly present with a less typical clinical picture.
Women, elderly persons, and patients with diabetes
Dyspnea may occur with exertion or in recumbency (orthopnea) or even on standing (_____________).
Platypnea
_______________ of cardiac origin usually occurs 2 to 4 hours after onset of sleep; the dyspnea is sufficiently severe to compel the patient to sit upright or stand and then subsides gradually over several minutes.
Paroxysmal nocturnal dyspnea
A report of a regular, rapid-pounding sensation in the neck or visible neck pulsations associated with palpitations increases the likelihood of this arrhythmia
Atrioventricular nodal reentrant tachycardia (AVNRT)
______________ occurs suddenly, with rapid restoration of full consciousness thereafter.
Cardiac syncope
Patients with ___________________ may experience early warning signs (nausea, yawning), appear ashen and diaphoretic, and revive more slowly, albeit without signs of seizure or a prolonged postictal state.
Neurocardiogenic syncope
__________ is defined as a state of decreased physiologic reserve and vulnerability to stressors.
Frailty
____________ is present with significant right-to-left shunting at the level of the heart or lungs. It also is a feature of hereditary methemoglobinemia
Central cyanosis
________________ of the fingers, toes, nose; characteristic of the reduced blood flow that accompanies small-vessel constriction seen in severe heart failure, shock, or peripheral vascular disease.
Peripheral cyanosis or acrocyanosis
_____________ cyanosis affecting the lower but not the upper extremities occurs with a patent ductus arteriosus (PDA) and pulmonary artery hypertension with ______________ at the level of the great vessel
Differential cyanosis
Right-to-left shunting
Hereditary telangiectases on the lips, tongue, and mucous membranes seen in what syndrome
Osler-Weber-Rendu syndrome
A lace-like purplish dislocation of the skin that imparts a mottled or reticulated appearance
Livedo reticularis
Tanned or bronze discoloration of the skin in unexposed areas can suggest iron overload and _____________.
Hemochromatosis
_______________ often occur with either anticoagulant and/or antiplatelet use, whereas _____________ characterize thrombocytopenia, and _______________ can be seen with infective endocarditis and other causes of leukocytoclastic vasculitis.
Ecchymoses
Petechiae
Purpuric skin lesions
Various lipid disorders can manifest with ___________, located subcutaneously, along tendon sheaths, or over the extensor surfaces of the extremities.
Xanthomas
Xanthomas within the palmar creases are specific for _______________
Type III hyperlipoproteinemia
The leathery, cobblestone, “plucked chicken” appearance of the skin in the axillae and skinfolds of a young person is characteristic of ______________________, a disease with multiple cardiovascular manifestations, including premature atherosclerosis.
Pseudoxanthoma elasticum
Extensive lentiginoses (freckle-like brown macules and café-au-lait spots over the trunk and neck) may be part of developmental delay associated cardiovascular syndromes (_________, ___________, ______________) with multiple atrial myxomas, atrial septal defect (ASD), hypertrophic cardiomyopathy, and valvular stenoses.
LEOPARD, LAMB, and Carney
___________ should be suspected in the presence of lupus pernio, erythema nodosum, or granuloma annulare.
Cardiovascular sarcoid
A high-arched palate is a feature of ________________ disease syndromes.
Marfan and other connective tissue
A large protruding tongue with parotid enlargement may suggest ______________.
Amyloidosis
Patients with _________________ characteristically have a bifid uvula.
Loeys-Dietz syndrome
Orange tonsils are typical of ________________
Tangier disease