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CDM II Fall Block > CP > Flashcards

CP Flashcards

1
Q

What are the goals for CP in primary care?

A
  • Don’t kill patients
  • Exclude things that make people die
  • Find those at risk and intervene NOW
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2
Q

What is clutching of the chest called?

A

Levine sign

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3
Q

What are differenttial for CP?

A
  • CV
  • Trauma/MS
  • Pulmonary
  • Infectious
  • Other
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4
Q

What are the CV disorders?

A
  • ACS
  • AAA
  • AS
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5
Q

What are the Trauma/MS disorders?

A
  • Chest wall fx/contusion
  • PTX
  • Boehaaves syndrome
  • Costchondritis
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6
Q

CP differential for pulmonary

A

PE

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7
Q

CP differential for infection

A
  • Pleurisy
  • PNA
  • Myocarditis
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8
Q

What are other CP differential

A
  • GI (GERD, esophageal, PUD, GB, psych, toxicity)
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9
Q

what is the most common cause of CP in office?

A

Chest wall syndrome

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10
Q

Whats the most common cause of CP?

A
  • MSK
  • Nonspecific CP
  • GI
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11
Q

If its non of the dx listed on the chart, what can you call it?

A

Chest wall syndrome

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12
Q

if there is any concerns for ABC what should you do?

A

Emergent transfer to the ER

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13
Q

what should you obtain in CP visit?

A

ECG

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14
Q

Aggravating factors postprandial?

A

GI

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15
Q

Aggravating factors exertion?

A

Cardiac

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16
Q

Aggravating factors cold, emotional stress, sexual intercourse?

A

cardiac

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17
Q

Aggravating factors worse with swallowing?

A

esophageal origin

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18
Q

Aggravating factors body position, movement, deep breathing?

A

MSK

19
Q

Alleviating factors w/ antacids/food?

A

GI

20
Q

Sublingual nitro alleviating factors?

A

Esophageal or cardiac

21
Q

“GI cocktail” alleviating factors?

A

GI or cardiac

22
Q

cessation of pain with rest?
alleviating factors?

A

Cardiac

23
Q

Sitting up and leaning forward alleviating factors?

A

Pericarditis

24
Q

Bleching, bad taste in mouth, dysphagia HPI assocaited sx?

A

Esophageal dz

25
Q

Vomiting HPI assocaited sx?

A

MI or GI

26
Q

Diaphoresis HPI associated sx?

A

MI, possibly esophageal dz

27
Q

Syncope HPI associated sx?

A

dissection, PE, AS, ruptured AAA

28
Q

Near syncope HPI associated sx?

A

MI

29
Q

Fatigue HPI associated sx?

A

MI in elderly

30
Q

HPI region/location

A

larger areas of discomfort more likely ischemic etiolgoy

31
Q

T/F severity is useful in predictor for presence of CAD?

A

False, not useful predictor

32
Q

Whats the timing of HPI, Abrupt onset with greatest intensity in beginning

A

PTX, dissection, acute P

33
Q

Whats the timing of HPI, gradual increasing onset overtime

A

Ischemic

34
Q

Whats the timing of HPI, crescendo pattern

A

esophageal dz

35
Q

Whats the timing of HPI, lasts for seconds or constant over weeks

A

not related to ischemic

36
Q

Whats the timing of HPI, circadian rhythm?

A

correlating with increase sympathetic tone- more likely ischemia

37
Q

What are PE that point towards ACS?

A
  • S3 or S4
  • Systolic BP <80 mm/Hg
  • Crackles on auscultation
38
Q

T/F Absence of S3 or S4, Systolic BP <80 mm/Hg, Crackles on auscultation exclude ACS

A

False!! it does not exclude ACS

39
Q

if the ECG shows no signs and cp suspicious for CAD, what should you do?

A
  • get cardiac biomarkers to eval for non-ST elevation MI
  • consider c-xray if they have resp disease
40
Q

what is the standard of care in the ED?

A

Only an initial trop if >3 hours from onset
If under 3 hours need a second one an hour later

41
Q

outpt troponin for pt with sx suggestive of acute coronary syndrone is?

A

transfer for eval w/o troponin testing

42
Q

is it reasonable to use single troponin test to exclude acute MI?

A

Only with asymptomatic patients whose symptoms resolved at least 12 hours prior, so long as they have no high-risk features and a normal electrocardiogram.

43
Q

if a pt is better with nitro, can they go home?

A

NOOO

44
Q

can post-parandial pain be ischemic?

A

yes!

CDM II Fall Block (9 decks)

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