Cardiovascular

Question 1

What are red flags of chest pain?

Answer 1

Abdominal vital signs (tachycardia (fast heart beat), bradycardia(slow, very), tachypnea, hypotension)
Signs of hypoperfusion (confusion, ashen colour, disphoresis),
Dysponea
Asymmetric breath sounds or pulses
Nw heart murmurs
Pulses paradoxical (pulse change upon breathe)

Question 2

What are the characteristic features of angina ?

Answer 2

Dyspnea upon exertion, heavy or tight chest discomfort that radiates to the left, right arm or jaw or neck.

Question 3

Characteristic features of myocardial infarction?

Answer 3

Pain is more severe than angina but similar. Does not require exertion can also occur at rest. Dyspnea, sweating, vomiting and nausea.

Question 4

Pericarditis characteristics?

Answer 4

Pain felt is SHARP or RaaW. Made worse by lying down or flat and upon respiration. The pain is eased by lying forwards. Causes dyspnea, and fever.

Question 5

What are the characteristics of aortic dissection?

Answer 5

Pain is TEaRInG and severe. Interscapular pain associated with stroke/abdominal pain/paraplegia from ischemia.

Question 6

Chest discomfort in respiration can be attributed to and what is the quality of this and exonerated by

Answer 6

Pleuritic pain. Presents as sharp/stabbing pain, exacerbated by inspiration

Question 7

Gastrointestinal pain has two possible causes what are these?

Answer 7

Gastro oesophageal reflux and oesophageal spasm

Question 8

Gastro osaephageal reflux characteristics?

Answer 8

Burning, discomfort that may arise after eating a meal. Made worse by bending over, lying down or straining.

Question 9

Oesophageal spasm characteristics ?

Answer 9

Central chest discomfort that is similar to that of angina, not related to exercusion and can occur at rest.

Question 10

Chest pain arising from musculoskeletal issues present with what characteristics and what may this be?

Answer 10

Costochrondritis or Rib fracture. Pain is localised, often dull, achy,sudden or gradual or even chronic. Usually made worse by movement.

Question 11

Dermalogical characteristics and what may this be?

Answer 11

Shingles in a dermlogical pattern. Usually unilateral nerve root distribution

Question 12

Angina and mi may be felt where?

Answer 12

Retro sternly with pain radiating to the left, right arm or neck or jaw,

Question 13

Gastrointestinal chest pain felt where?

Answer 13

Retro sternly

Question 14

Pain arising from aortic dissection is felt where?

Answer 14

Inter scapula and abdominal and maybe chest.

Question 15

Pleuritic pain and mskeletal felt where?

Answer 15

Localised.

Question 16

What is tearing, tight/heavy/crushing, sharp/stabbing, sharp/raw, sharp/stabbing/dull pains seen in?

Answer 16

Aortic dissection, MI&Angina, pleuritic, pericarditis, mskeletal.

Question 17

If chest pain lasts longer than ten minutes or less than ten minutes what is it likely to be ?

Answer 17

Longer than ten, MI and less than ten ANGINA,

Question 18

Sudden onset pain is seen in what conditions ?

Answer 18

Pleuritic and aortic dissection

Question 19

Sudden or gradual pain seen in

Answer 19

Musculoskeletal

Question 20

Exercise will make _____ worse but not affect ______

Answer 20

Angina and MI

Question 21

If pt lying flat or pain on inspiration and relieved by sitting upright or leaning forward what might b the case

Answer 21

Pericarditis

Question 22

Pleuritic pain made worse when

Answer 22

Inspiration or coughing

Question 23

Msk is worsened by

Answer 23

Movement

Question 24

When would you see breathlessness

Answer 24

Angina, MI, pericarditis, pneumonia, pulmonary embolism,melt sided heart failure

Question 25

Exertion, febrile illness, hypnoxic state, severe anaemia or severe metabolism can lead to breathlessness because....

Answer 25

Increased ventilary demand

Question 26

Pleural effusion, pneumothorax. Intra thoracic mass, rib injury or muscle weakness leads to dyspnoea because..

Answer 26

Decreased ventilary capacity

Question 27

Asthma or copd leads to dyspnoea because..

Answer 27

Increased airway resistance.

Question 28

Interstitial fibrosis and pulmonary oedema lead to dyspnoea because

Answer 28

Decreased pulmonary compliance

Question 29

What is Orthopnea ?

Answer 29

Shortness of breath when lying flat. Seen in late manifestation of heart failure. When lying down venous return is increased leading to redistribution of oedema through the lungs

Question 30

What are the red flags of Dyspnea ?

Answer 30

At rest during examination, decreased level of consciousness, accessory muscle use,chest pain, crackles, weight loss, night sweats, palpitations.

Question 31

Palpitations are?

Answer 31

The awareness of the heart beat

Question 32

For palpitations what do you need to focus on?

Answer 32

Is the beat regular or irregular, fast or slow, frequency/duration, rest exercise or both, sudden or gradual, triggers or relieving factors.

Question 33

What are common presenting complaints of cardiovascular heart issues?

Answer 33

Chest pain, breathlessness, palpitations, syncope, presyncope, peripheral oedema

Question 34

Palpitation red flags, what are they

Answer 34

Light headed ness or syncope, chest pain, dyspnea, new onset of irregularly irregular heart Rythm, tachy and bradycardia, underlying heart disease, family history sudden death

Question 35

What are common arrhythmias? With regularities.

Answer 35

Ectopic (missed beats), atrial fibrillation (irregularly irregular), atrial flutter (usually regular), supra ventricular tachycardia (reg) and ventricular tachycardia (reg)

Question 36

So what is syncope exactly and what are common causes of it?

Answer 36

A sudden brief loss of consciousness with full recovery. Cerebral hypo fusion. Most are caused by decreased cardiac output as a result of Cardiac disorders that obstruct outflow (aortic stenosis, hypertrophic cardiomyopathy), cardiac disorders of systolic or diastolic dysfunction, arrhythmias, deceased venous return (loss of sympathetic tone, increased vagus tone)

Question 37

Red flags for syncope?

Answer 37

Syncope during exertion, multiple recurrences in short time, heart murmur, older age, significant injury during syncope, f.history of unexpected death

Question 38

Orthodontic hypotension, is? And take into account what in clinic?

Answer 38

Inability of body to cope with the change in pressure dynamics on standing. If pt has severe hypotension going from lying to standing may cause syncope.

Question 39

Vbi! What might you see if somebody had it?

Answer 39

``` Visual disturbances (diplopia, blurred, transient hemianopsia) Dysarthria, dysphagia, drop attacks, nasua, vomiting, lightheadedness, fainting, disorientation or anxiety, hearing disturbances, facial or oral paraesthia, pallor, tremors, sweating, other neurological symptoms. ```

Question 40

Different types of odema, why, and what are reasons ?

Answer 40

Pitting, having excess fluid that is unbound Non pitting, excess protein in interstitium They can occur due to increased venous pressure or reduced oncotic pressure Unilateral suggests a local cause whereas bilateral suggests a systemic issue

Question 41

List some causes of pitting odema

Answer 41

Congestive heart failure, pericarditis, dvt, venous insufficiency, hypoalbuminsrmia, cirrhosis, immobility, calcium channel blockers

Question 42

Non pitting, less comm than pitting where seen most likely

Answer 42

Hypothyroidism and lymphedema,

Question 43

What are the red flags for oedema?

Answer 43

Sudden onset, significant pain, dyspnoea, history of heart disease, pleural friction rub, hepatomeagly, unilateral leg swelling with tenderness.

Question 44

Modifiable vs non modifiable risk factors, cardiac,

Answer 44

Hypertension, diabetes mellitus, hyperlipidemia, smoking, diet, exercise. Vs age, gender, f. History, hypertrophic cardiomyopathy, mar fans syndrome,