Course 2 Pathophys Review Questions

Question 1

What other past histories would suggest that a pt has CAD?

Answer 1

PMHx of Angina, MI, CABG, Cardiac stents, or Angioplasty

Question 2

Does a PMHx a A-Fib or CHF, do they also have CAD?

Answer 2

No

Question 3

Does a PMHx of CVA mean the pt has CAD?

Answer 3

No

Question 4

Does a surgical history of angioplasty mean the pt has CAD

Answer 4

Yes

Question 5

Explain the difference between CAD and MI.

Answer 5

MI is acute, CAD is chronic

Question 6

If someone has a PMHx of A-fib or CHF, do they also have CAD?

Answer 6

No

Question 7

What are the “cardiac risk factors?”

Answer 7

CAD, HTN, HLD, MD, Smoker, FHx of CAD

Question 8

How is CAD diagnosed?

Answer 8

Cardiac Catheterization (Not in the ED)

Question 9

Name two ways that an MI can be diagnosed?

Answer 9

EKG (STEMI) or elevated Troponin (Non-STEMI)

Question 10

What are some associated symptoms of an MI other than CP?

Answer 10

Diaphoresis, N/V and SOB

Question 11

What are some associated symptoms of CHF?

Answer 11

SOB with pedal edema and orthopnea

Question 12

What 2 studies would diagnose CHF

Answer 12

CXR or BNP (B-type Natriuretic Peptide)

CHF Lab

Question 13

What is A-Fib?

Answer 13

Atrial Fibrillation

Question 14

What might someone feel with A-Fib?

Answer 14

Palpitations (Fast, Pounding, Irregular)

Question 15

How is an A-Fib diagnosed?

Answer 15

EKG (ECG)

Question 16

What could the CC of someone with a PE?

Answer 16

SOB or Pleuritic chest pain (CP worse with deep breaths)

Question 17

What are risk factors for a PE?

Answer 17

Known DVT, PMHx of DVT or PE, FHx, Recent surgery, Cancer, A-Fib, immobility (from traveling) , Pregnancy, BCP, Smoking.

Question 18

What study would diagnose a PE

Answer 18

CTA Chest (CT with IV contrast) or VQ scan. D-Dimer aids in detecting lots but doesn’t dx a PE

Question 19

What part of the heart does CAD affect; Arteries, Veins, or Nerves?

Answer 19

Arteries

Question 20

Can a CT Chest without IV contrast diagnose a PE? Why or Why not?

Answer 20

No because you need to see where the blockage is.

Question 21

What is a PTX?

Answer 21

Pneumothorax

Question 22

What is the most common cause of PTX?

Answer 22

Trauma or a spontaneous small rupture of the lung

Question 23

How is a PTX diagnosed?

Answer 23

CXR

Question 24

What social history will most COPD patients also have?

Answer 24

Smoking

Question 25

What is the difference between an inhaler and a nebulizer for asthma?

Answer 25

Hand device vs a machine

Question 26

What is asthma?

Answer 26

Reactive Airway Disease (RAD) - constricting of the airway due to inflammation and muscular constriction of the bronchioles, known as a "bronchospasm".

Question 27

What physical exam finding closely associates with asthma?

Answer 27

Wheezes (Inspiratory or Expiratory)

Question 28

What is PNA?

Answer 28

Pneumonia

Question 29

What might a person with PNA complain of?

Answer 29

SOB or Productive cough (phlegm)

Question 30

How is PNA diagnosed?

Answer 30

CXR

Question 31

Name all 7 areas of the abdomen

Answer 31

Epigastrium, suprapubic, periumbilical, RUQ, LUQ, RLQ, LLQ

Question 32

What is the layman's name for GERD

Answer 32

Acid Reflux

Question 33

What might someone with GERD complain of?

Answer 33

Epigastric pain: Burning, Improved with antacids

Question 34

For older pts with GERD symptoms, what life-threatening disease may also need to be ruled out?

Answer 34

Cardiac risk factors (MI, CAD)

Question 35

What does bile do? Where is it stored?

Answer 35

Breaks down fat, stored in the gallbladder

Question 36

What is the difference between Cholelithiasis and Cholecystitis?

Answer 36

a gallstone vs inflammation of the gallbladder

Question 37

How are gallstones diagnosed?

Answer 37

abdominal US, RUQ

Question 38

Name associated symptoms of appendicitis (APPY)

Answer 38

Decreased appetite (anorexia), Fever, N/V

Question 39

How is appendicitis diagnosed?

Answer 39

CT A/P with PO contrast

Question 40

What would someone with pancreatitis c/o?

Answer 40

LUQ, Epigastric pain

Question 41

How is a pancreatitis diagnosed?

Answer 41

Elevated Lipase ab test (or sometimes elevated Amylase)

Question 42

Name four possible CC's for a GI bleed

Answer 42

Hematemesis, Coffee ground emesis, Hematochezia, Melena

Question 43

What are we worried about for someone with a GI bleed?

Answer 43

Can lead to anemia

Question 44

What is the pre-existing condition you must have before you can get diverticulitis?

Answer 44

Diverticulosis

Question 45

What will be the CC for someone diverticulitis?

Answer 45

LLQ pain

Question 46

What studies would diagnose diverticulitis?

Answer 46

CT A/P with PO Contrast

Question 47

What might a person with a SBO complain of?

Answer 47

Abdominal Pain, Vomiting

Question 48

How is SBO diagnosed?

Answer 48

CT A/P with PO contrast Acute Abdominal Series (AAS)

Question 49

What is a UTI

Answer 49

Urinary Tract Infection

Question 50

What is pyelo?

Answer 50

Infection of the kidneys (Pyelonephritis)

Question 51

What will be the CC of someone with a UTI?

Answer 51

Dysuria

Question 52

Where would a person feel pain if they had pyelo?

Answer 52

Flank Pain

Question 53

How is a UTI diagnosed?

Answer 53

Urine Drip, urinalysis

Question 54

What is CAD

Answer 54

Coronary Artery Disease (CAD)

Question 56

What might a person with kidney stones complain of?

Answer 56

Flank Pain: sudden onset, radiating to groin

Question 57

How are kidney stones diagnosed?

Answer 57

CT Abd/Pelvis RBC in UA may be a clue

Question 58

What is an ectopic pregnancy?

Answer 58

Tubal Pregnancy- fertilized egg develops outside the uterus, usually in the fallopian tubes.

Question 59

How is an ectopic pregnancy diagnosed?

Answer 59

US Pelvis -> determine location of fetus

Question 60

What is ovarian torsion?

Answer 60

Twisting of an ovarian artery reducing blood flow to an ovary, possibly resulting in infarct of the ovary

Question 61

Name the 2 types of CVA's

Answer 61

``` Ischemic Cerebral Vascular Accident Hemorrhagic CVA (brain bleed) ```

Question 62

What Sx might a person with an ischemic CVA c/o?

Answer 62

Unilateral focal neurological deficits: One sided weakness/numbness or changes in speech/vision VND (numb, weak, speech, vision)

Question 63

How is an ischemic CVA diagnosed?

Answer 63

Clinically, Potentially normal CT Head

Question 64

What is a common cause for seizures in children?

Answer 64

Febrile

Question 65

What is the name of the state after a seizure?

Answer 65

Post-Ictal

Question 66

What are 3 symptoms of meningitis?

Answer 66

Fever, Neck pain, neck stiffness, AMS

Question 67

What study would diagnose meningitis?

Answer 67

lumbar puncture

Question 68

What are 4 important things to document for syncopal episodes?

Answer 68

What happened prior, during, and after the syncopal episode, as well as how the patient currently feels

Question 69

Name 4 causes of altered mental status

Answer 69

Hypoglycemia, infection, intoxication, and neurological

Question 70

How is AMS different from a focal neuro deficit?

Answer 70

AMS is generalized and is typically caused by things that affect the whole brain. Focal neuro deficits are localized weakness/numbness in one specific area corresponding with damage at one specific site in the brain.

Question 71

What is a DVT

Answer 71

Deep Vein Thrombosis

Question 72

What are the risk factors for a DVT

Answer 72

PMHx of DVT or PE, Recent Surgery, Cancer, immobility, Pregnancy, BCP, smoking, LE trauma, LE casts

Question 73

What are common signs of a DVT?

Answer 73

Extremity Pain and swelling, Calf Tenderness, Cords, Homan's Sign

Question 74

What is an AAA

Answer 74

Abdominal Aortic Aneurysm

Question 75

What is an aortic dissection?

Answer 75

Separation of the muscular wall from the membrane of the artery, putting the patient at risk of aortic rupture and death

Question 76

What are 3 symptoms of cellulitis?

Answer 76

Erythema, Edema, Increased Warmth and Induration

Question 77

How is an abscess different from cellulitis?

Answer 77

Abscess have pus pockets

Question 78

What procedure will be performed for every abcess

Answer 78

Incision and drainage

Question 79

What is the main concern with an allergic reaction?

Answer 79

Anaphylaxis

Question 80

What are the only three symptoms of a true allergic reaction?

Answer 80

Swelling due to SOB, rash, itching.

Question 81

How can Diabetic Ketoacidosis (DKA) be diagnosed?

Answer 81

Arterial Blood Gas (ABG or VBG) showing low pH(acidosis) or positive serum ketones

Question 82

What is a physicians main responsibility for psychiatric patients?

Answer 82

medical clearance; determining the patient is not medically ill

Question 83

Name 3 important things to document for any trauma patient.

Answer 83

LOC, HA, Neck Pain, Back Pain

Question 84

What is a TIA?

Answer 84

Transient Ischemic Attack

Question 85

How does a TIA differ from a CVA

Answer 85

TIA regains neurological function

Question 86

What might be the CC of a person with gallstones?

Answer 86

RUQ Pain, Sharp, Worsened with Eating, Deep Breath, and Palpation

Question 87

What Sx might a person with a brain bleed complain of

Answer 87

Headache, Sudden Onset (Thunderclap, Worst of Life)

Question 88

What study would diagnose a brain bleed?

Answer 88

CT head or LP

Question 89

How is a GI bleed diagnosed in the ED?

Answer 89

Heme Positive Stool (Guaiac Positive), Gastroccult