Chest Px Differential Dx Flashcards
(34 cards)
Px described as ripping or tearing suggests what condition?
Aortic Dissection
Pleuritic or dull pain is most likely associated with what condition?
Pneumothorax
Px that is worse lying down and better when leaning forward leads you to suspect…
A pericardial effusion
Px worsened upon inspiration clues you into what condition?
Pulmonary Embolism (PE)
Substernal Px described as burning may indicate what kind of condition?
GI or Cardiac
An abrupt and acute onset of chest Px should include what conditions in your initial DDx?
Aortic Dissection
Esophageal Perforation
Pneumothorax
Pulmonary Embolism
Px radiating to the patients abdominal region could indicate what Dz pathophysiology?
Esophageal rupture
Pain that radiates across the chest and/or to the back should raise suspicion of what condition?
Aortic Dissection
T/F Chest Px can radiate to the... Arm Neck Jaw Shoulders Abdomen Back Chest?
True
T/F
You can rule out cardiac origin of Px if a PT has had a recently negative stress test.
False
You can only r/o Cardiac origin in PT’s who have recently had negative results with CARDIAC CATH and CORONARY CT ANGIOGRAM
Acute Coronary Syndrome
What are some risk factors?
More common in women or men?
Men
Smoking, HTN, Diabetes
Cocaine
Family Hx of MI <55y.o.
Obesity, hyperlipidemia, inactivity
Marfan’s syndrome is associated with which particular Cardiac condition?
Acute Aortic Dissection
Pregnancy, cocaine abuse, HTN, and congenital bicuspid aortic valve also risk factors
Risk factors for a pneumothorax include?
"HESS" HIV infxn (P. jirovecii) Endometriosis SCUBA Diving Smoking
Trauma, hemostasis, pregnancy, oral contraceptives, and hypercoagulable states are associated risk factors with what condition?
PE
What is the Modified Wells Criteria used for?
What are some of the criteria?
Clinical signs of DVT (+3) DVT most likely Dx (+3) Recent surg (+1.5) Hx of DVT or PE (+1.5) Recent surg/immobilization (+1.5) Hemoptysis (+1) Cancer (+1)
Greater than 6 is high risk
Pulmonary Embolism Rule out Criteria (PERC)
BREATHSS pneumonic device…
What criteria must be met to r/o PE?
B- Blood in sputum (hemoptysis) R- Room air O2 < 95% E- ESTROGEN USE A- Age >50y.o. T- Thromb. Hx i.e. DVT/PE H- HR >100bpm S- Surg/ w.in last 4wks S- Swollen leg (UNILATERAL)
If an oncology patient presents to you with uremia and low TSH values and a recent Hx of radiation therapy; what condition should remain at the top of your Dx/DDx?
Pericardial Tamponade
Risk factors: Hypothyroid Autoimmune Dz Cancer Uremia Injury during procedures Radiation therapy Tb
Unilateral breath sounds should always raise suspicion of…
Pneumothorax
Asymmetrical leg swelling, focal wheezing… You must r/o what condition?
Pulmonary embolism
A diaphoretic patient presents to your clinic with difficulty breathing and is extremely anxious. Your physical exam should revolve around r/o what cause/origin?
CARDIAC
Your PT presents with a >20mmHg difference in BP and the radial and carotid pulses are only palpable unilaterally… The patient is also displaying confusion and other neurologic findings; what remains your most likely cause of their S/Sx?
Aortic Dissection
POINT TENDERNESS in the chest indicates what condition? The pain/TTP is reproducible.
Musculoskeletal origin.
Your PT’s hemoccult card comes back positive for blood in the stool and they have epigastric tenderness. Your exam MUST include this ROS….
Gastrointestinal b/c it is the most likely etiology/origin of PT S/Sx
When reviewing an EKG you note several abnormalities… There is a prominent S wave in lead I, a prominent Q wave in lead III, and an INVERTED T wave in lead III…
What condition does this lead you to suspect your PT has?
Right Heart strain or PE
S1Q3T3
