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Flashcards in Chest Pain & Respiratory Distress Deck (21):
1

*Differences between STABLE, UNSTABLE, and ATYPICAL ANGINA

- Stable: chest pain w exertion, relative to amt of exertion, improves w rest and nitroglycerin
- Unstable: sxs are worse... an MI waiting to happen. pain more easily provoked by exertion, occurs more requently, longer lived, required more rest and NTG for relief. EMERGENCY- go to hospital to get tx.
- Atypical: occurs at rest

2

*#1 cause of MI

plaque rupture leading to thrombosis of A

3

*MONA is used for?

tx of MI
- morphine
- oxygen
- nitroglycerin
- chewable aspirin

4

*STEMI in V1-V6 means...

Anterolateral L Ventricle MI (most common)

5

*Q waves are affected more so in...

transmural inferior MI's
(not NSTEMI)

6

*Prior to cardiac Troponins, the cardiac marker used was...

CK-MB, creatine kinase MB iso-enzyme
(was there injury to the HT?)

7

*CPR compression-ventilation Ratio

30:2 w/1 -2 rescuers
(tx fibrillation w electricity)

8

*Aortic Arch Aneurysm/Dissection presents w pain to...

tearing pain between scapula

9

2 Aortic Dissection acute complications mentioned in class...

----> Acute Renal Failure dt decreased blood to the KDs
----> Acute Aortic Valve Regurg. if tear is near there

10

An MI can cause _______ which is the MC eti of death after an MI.

Ventricular Fibrillation Arrhythmia

11

MI Sxs

- chest pain
- dyspnea (SOB)
- diaphoresis
- HALF ARE CLINICALLY SILENT or non-classic presentation (FEMALES, DIABETES)

12

*Beck's Triad is what and used for what?

PE findings in Cardiac Tamponade
1. low BP (can't return blood to HT efficiently)
2. JVD, acute onset
3. muffled HT sounds

13

*What is Pulsus Paradoxus?
- conditions

nothing to do w PULSE!!
- decreased systolic on inspiration (at least 10mmHg)
- cardiac tamponade, PE, Pericardial Effusion, R Ventricular Failure/Infarction, respiratory failure in asthma

14

Electrical Alternans

alternating shape of QRS complex in amplitude
- seen in cardiac tamponade, pericardial effusion
- wobbling heart in fluid sac

15

*What is Virchow's Triad?

group of causes that lead to thrombosis and thus PE:
1. alteration in blood flow (bed rest, injury, pregN, obesity, CA)
2. factors within vessel wall (surgery, catheterization)
3. factors affecting coag. of blood (hormones, genetics, deficiencies, smoking, CA)

16

*Differences and Similarities between Well's Score for PE and DVT:

- PE: clinically suspected DVT, tachycardia, prior Hx of DVT or PE, hemopysis
- DVT: pitting edema, tenderness, swollen leg/calf, superficial veins
- PE and DVT: alt. dx less likely, immobilization/surgery, prior Hx of DVT, CA

17

MC SXS of PE

- feeling of dread
- dyspnea/SOB
- pleuritic chest pain
- cough
- hemoptysis

18

3 D's (Sxs) in children w Epiglottitis

1. dysphagia
2. drooling
3. distress
... sitting position w trunk leaning forward, neck hyperextending w chin thrust forward "tripod" position and HOT POTATO voice

19

*Stages of Acute Asthma

1. FEV1 50-80% of norm.; MILD
2. FEV1 50% or less; MODERATE, wheezing, respiratory distress at rest
3. FEV1 25-11%; SEVERE; marked wheezes OR absent breath sounds; mb pulsus paradoxus, SCM contraction
4. FEV1 10% or less; RESPIRATORY FAILURE, lethargy, confusion

20

*During Anaphylactic Shock, are there C/I to Epi? How much?

NO!
IM EPI 0.3-0.5 mg of a 1mg/mL prep

21

*What type of reaction is Anaphylaxis? How is this different from Anaphylactoid?

IgE... loss of vascular integrity, edema of throat/neck, closes airway.. fluid in LU.. decreased vol. in blood --> shock
- Anaphylactoid is non-IgE mediated but resembles anaphylaxis.... often occurs w 1st exposure to certain drugs. Asthma pts at high risk! .. (remember Samter's Triad: nasal polyps, sens. to ASA, NSAIDS, hay fever)