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Chest Pain Flashcards

(52 cards)

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1
Q

Symptoms of PE

A

Pleuritic chest pain worse on inspiration
Breathlessness
Haemoptysis

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2
Q

Signs of saddle or large PE

A

Dizziness
Syncope / pre-syncope
Haemodynamic instability

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3
Q

PE on examination

A

Tachycardia
Tachypnoea
Hypoxia
Clear chest

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4
Q

Sudden onset SOB and pleuritic chest pain, haemoptysis, raised RR

A

PE

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5
Q

Investigations for PE

A

Wells score
D-Dimer
FBC
U&Es
LFTs
CRP
ABG
ECG

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6
Q

What will a CXR show in PE?

A

Normal, small wedge, small effusions

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7
Q

ECG findings in PE

A

Sinus tach
If large, right heart strain (S1 Q3 T3) RBBB R axis deviation

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8
Q

When don’t you do a CTPA?

A

Pregnancy - consider V/Q scan

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9
Q

What wells score makes u do CTPA

A

Over 4

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10
Q

What do u do wells score 3?

A

Do D-dimer

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11
Q

How do you manage a normal PE?

A

Oxygen
Anaelgesia
Anticoagulation - LMWH or apixaban

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12
Q

How do you manage massive PE

A

Consider thrombolysis

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13
Q

What is Virchows triad?

A

Hypercoagulability
Stasis blood flow
Endothelial injury

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14
Q

Is pneumothorax type 1 or 2 respiratory failure

A

Type 1

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15
Q

Symptoms of pleurisy

A

Sudden onset
Sharp pain
Worse on inspiration
Recent viral symptoms

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16
Q

Lung sounds in pleurisy

A

Pleural rub

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17
Q

Is it a PE or pleurisy?

A

Pleurisy - infective symptoms and pleural rub

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18
Q

What does CXR show in pleurisy?

A

Consolidation

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19
Q

How do you treat pneumothorax less than 2cm?

A

Oxygen and observe

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20
Q

How do you treat pneumothorax over 2cm?

A

Aspirate, chest drain

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21
Q

What is pleurisy?

Study These Flashcards
A

Inflammation of the pleura due to viral infection

22
Q

Symptoms of CAP

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A

Fever
Rigours
Breathlessness
Cough green sputum
Chest pain

23
Q

Exam findings in CAP

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A

Increased RR
Tachycardia
Course crackles
Bronchial breathing

24
Q

Investigations for CAP

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A

FBC
U&Es
LFTs
CRP
WCC
CRP
Elevated neutrophils
Sputum cultures
ABG
CXR

25
What does CXR and ABG show in CAP
Type 1 resp failure Consolidation
26
What does CURB 65 mean?
For predicting mortality in CAP
27
Symptoms of lung cancer
Breathlessness Chest pain Haemoptysis Weight loss Cough
28
Signs of lung cancer on exam
Clubbing Hypoxia Cachectic Lobar collapse Pleural effusion
29
Pancoast tumour
Horner syndrome Weakness and muscle wasting in the hand of affected side
30
Horner syndrome
Flushing on one side of face Not sweating on affected side of face Constricted pupil and droopy eyelid on affected side
31
Risk factors for MI
HTN, diabetes, previous IHD, high cholesterol, smoking
32
Bloods to do in MI
FBC Lipids U&Es HbA1c LFTs Troponins
33
Immediate drug treatment for MI
Aspirin 300mg Clopidogrel 300mg or Tecligor
34
Ongoing drug treatment following MI
Beta blockers, CCBs, ACEi, statin, aspirin or Clopidogrel
35
Why take beta blockers or CCBs after MI?
Reduce cardiac work
36
Why take ACEi or CCB after MI?
Reduce blood pressure
37
Drug treatment for angina
GTN Opioids Beta blockers CCBs ACEi Statins
38
Symptoms of aortic dissection
Sudden onset severe central ripping chest pain Radiates through to back and neck Rapid collapse
39
Examination in aortic dissection
Hypotension Hypovolaemic shock Different BP in each arm New early diastolic murmur Wide pulse pressure
40
What do we do about aortic dissection?
Group and save, crossmatch Fluid resus Surgery
41
Symptoms of pericarditis
Sharp anterior chest pain Acute onset, often following viral illness Can have fever or viral symptoms
42
Quality of pain in pericarditis
Sharp Anterior Relieved by leaning forwards Worse on deep inspiration or lying down
43
Symptoms of cardiac tamponade
Reduced cardiac output Low blood pressure Raised JVP muffled heart sounds
44
Can cardiac tamponade occurs in pericarditis?
Yes
45
Treatment for pericarditis
Pericardiocentesis
46
How to diagnose cardiac tamponade
Echo
47
ECG changes with pericarditis
Widespread saddle ST elevation, later T wave inversion
48
What is Dressler’s syndrome
When you get a pericarditis following an MI
49
How do you know if it’s an MI or pericarditis?
Sometimes viral stuff in pericarditis Pericarditis pain relieved leaning forwards, worse lying down or coughing/breathing deeply
50
Cancer Red flags with GORD
Dysphasia Upper abdo pain Dyspepsia Haematemesis
51
Consequences of prolonged GORD
Barrett’s oesophagus Oesophageal cancer Oesophagitis Ulcers Structures
52
How do you know if the chest pain in MSK?
Anywhere Worse with movement Worse breathing in Clear cause or trigger Tender to touch

Illness Scripts (5 decks)

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