Session 11 Flashcards
Describe cardiac pain
Pleuritic pain?
Central,dull, crushing pain that radiates to arm,shoulder,neck
Thoracic wall or shoulder tip, well localised and sharp, worse with breathing/coughing
Clear sputum?
Yellow?
Large volumes of yellow?
Red?
No infection, COPD/bronchitis
Infection
Bronchiectasis
Red flag
What do wheeze and stridor indicate?
Distinguish and what they indicate?
Narrowing of airways causing turbulent air flow
Wheeze,high pitch on expiration, intrathoracic airways (from oedema/mucous/constriction)
Stridor, high pitch but loud, inspiration so extrathoracic airways (supraglottis,infraglottis,trachea)
When are pursed lips commonly seen?
Barrel chest?
COPD
Lung hyperinflation in COPD
What does hyper resonance indicate?
Dull?
Air trapping
Consolidation
Types of embolism?
Most common cause of PE?
Risk factors?
Thrombus,tumour,air,fat,amniotic
DVT in popliteal vein
Endothelium injury,stasis,hypercoagubility (pregnancy/surgery/immobilisation/antitheombin 3 deficiency)
How can PE cause death?
Acute right ventricular overload-PA artery pressure increase so RV dilation,exaggerated as vasoconstriction of PA from body mediators. So death from carcinogenic shock and arrest.
Resp failure-due to ventilation perfusion mismatch, right to left shunting through patent foramen ovale causing hypoxaemia.
Pulmonary infarction-small distal emboli create alveolar haemorrage.
Symptoms of PE?
Physical signs?
PE on CXR?
Dysponea,pleuritic chest pain, cough, haemoptysis, syncope
Tachypnoea >16/min
Tachycardia >100/min
Decreased breath sounds
Normal
Blood gas in PE?
Blood test for?
Beat diagnosis?
Hypoxia/hypocapnia so resp alkaliosis
D dimer
Ct
Treatment of PE?
Complication of heparin?
Oxygen,give heparin, then warfarin (low risk), haemodynamic/resp support, streptokinase, catheter directed thromboectomy (high risk).
Heparin induced thrombocytopenia, antibodies to heparin-platelet. Activating platelet clumping.
