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EMERGENCY MEDICINE > CHEST PAIN AND SENSORIUM > Flashcards

CHEST PAIN AND SENSORIUM Flashcards

1
Q

recent onset of pain, pressure, or tightness in the anterior thorax between the xiphoid, suprasternal notch and both midaxillary lines

A

chest pain

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2
Q

________ includes:
Acute myocardial infarction
acute ischemia/unstable angina

A

acute coronary syndrome

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3
Q

type of chest pain

retrosternal left anterior chest crushing, squeezing, tightness or pressure

classic features of ACS
Radiation to the neck, arms or jaw
diaphoresis
dyspnea
nausea and vomiting

A

classic cardiac pain

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4
Q

chest pains lasting for 12-24 hours or more without waxing and waning intensity or pain worsened by specific body movements or positions

A

non-classic cardiac pain

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5
Q

innervates the chest wall from the dermis to the parietal pleura

pain from somatic fibers is usually easily described, precisely located and often experienced as a sharp sensation

A

somatic pain fibers

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6
Q

found in the internal organs such as the heart, esophagus and visceral pleura

patients with visceral pain are more likely to use terms such as discomfort, heaviness, pressure, tightness or aching

visceral pain is often referred to an area of the body corresponding to adjacent somatic nerves

A

visceral pain fibers

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7
Q

angina occurring at rest and that is prolonged usually >20 minutes

A

rest angina

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8
Q

new onset angina that markedly limits ordinary physical activity

A

new onset angina

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9
Q

previously diagnosed angina that has become distinct more frequent has a longer duration or is lower in threshold, limiting ability to walk 1-2 blocks or climb 1 flight of stairs

A

increasing angina

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10
Q

_________ occurs when there is an imbalance of oxygen demand and oxygen supply

A

ischemia

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11
Q

influenced by the oxygen carrying capacity of the blood and the coronary artery blood flow

A

oxygen supply

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12
Q

determined by the amount of hemoglobin present and oxygen saturation

A

oxygen carrying capacityuni

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13
Q

universal sign of ischemic chest pain

defines as an individual holding a clenched fist over the chest that has low sensitivity but is a relatively specific ischemia

A

levine sign

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14
Q

ST segment elevations in V1, V2 and possibly V3

A

anteroseptal

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15
Q

ST segment elevations in V1, V2, V3, and V4

A

anterior

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16
Q

ST segment elevations in V1-V6, I, and aVL

A

anterolateral

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17
Q

ST segment elevations in I and aVL

A

Lateral

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18
Q

ST segment elevations in II, III, and aVF

A

inferior

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19
Q

ST Segment elevations in II, III, aVF, and V5 and V6

A

inferolateral

20
Q

medications for ST segment elevation or ischemic ECG

A, C, N, beta, anti-

A

aspirin
clopidogrel
nitroglycerin
beta blockers
antithrombin

21
Q

___________ is indicated for patients with STEMI (as a reperfusion option) if time to treatment is <6 to 12 hours from symptom onset and the ECG has at least 1 mm of ST segment elevation in two or more contiguous leads

A

fibrinolytic therapy

22
Q

__________ encompass a number of life threatening aortic emergencies

includes:
aortic dissection, penetrating atherosclerotic ulcer, intramural hematoma and aortic aneurysmal leakages

A

acute aortic syndromes

23
Q

__________ occurs after a violation of the intima, allows blood to enter the media and dissect between the intimal and adventitial layers

A

aortic dissection

24
Q

stanford classification
involvement of the ascending aorta

A

type A dissection

25
Q

standford classification
restricted only to descending aorta

A

type B dissection

26
Q

debakey

simultaneously involve the ascending aorta, arch and descending aorta

A

type 1 dissection

27
Q

debakey

involves only the ascending aorta

A

type 2 dissection

28
Q

debakey

involve only the descending aorta

A

type 3 dissection

29
Q

a plain _________- may provide important clues for diagnosis

A

a plain chest xray

30
Q

imaging modality of choice for diagnosis of dissection

can reliably identify a false lumen and can provide additional details such as anatomy of the dissection, the location of the dissection flap, extension of the flap into great vessels, signs of aortic rupture and signs of end organ damage

A

ct scan

31
Q

sensitive and specific as CT

procedure generally has to be performed under moderate sedation or even general anesthesia

A

transesophageal echocardiography

32
Q

P wave

A

atrial depolarization

33
Q

distant between the onset of P wave to the onset of QRS

A

PR interval

34
Q

ventricular depolarization

A

QRS complex

35
Q

plateau phase, phase 2 of cardiomyocyte action potential

A

ST segment

36
Q

point where ST segment starts

A

J point

37
Q

rapid depolarization of contractile sacs

A

T wave

38
Q

duration of ventricular depolarization and repolarization

A

QT interval

39
Q

______- are not designed to shock flatline (asystole patterns)

A

defibrillators

40
Q

the _____ is a test of sensation and if positive may distinguish sensory from motor ataxia

A

romberg test

41
Q

the _____- response is the toe that moves upward in response to a mildly noxious stimulation applied to the lateral plantar or lateral aspect of the foot

A

babinski response

42
Q

a ____— is an episode of abnormal neurologic function caused by inappropriate electrical discharge of neurons

A

seizure

43
Q

_________ is a clinical condition in which an individual is a subject to recurrent seizures

A

epilepsy

44
Q

___________ are those in which no evident cause can be identified (type of seizure)

A

idiopathic seizure

45
Q

______ are seizures that are a consequence of an identifiable neurologic condition such as mass lesion, previous head injury or stroke

A

symptomatic seizure

46
Q

in a typical attack the patient suddenly becomes rigid (tonic phase), trunk and extremities are extended, and patient falls to the ground

A

generalized tonic clonic seizures

47
Q
A

EMERGENCY MEDICINE (8 decks)

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