Study 2 Flashcards
(27 cards)
Chief Complaint: angina: exertional chest pain or chest pressure
Assoc. Sx: SOB
Diagnosed by: Cardiac catheterization (Cannot be diagnosed in ED)
Coronary artery disease (CAD)
Narrowing of the coronary arteries, causing reduce blood flow to the heart muscle
Risk factors: Hypertension (HTN), Hyperlipidia (HlD), diabetes mellitus (DM), Smoking, family history of CAD/MI<55 y/o.
Medications: nitroglycerin (NTG) to manage angina, Acetylsalicylic Acid (ASA) to decrease chances of blockage
Chief complaint: chest pain or pressure
Assoc. Sx: diaphoresis, nausea/vomiting, SOB
Diagnosed by: diagnosed by EKG/elevated troponin
myocardial infarction (MI)
Acute blockage, the coronary arteries, causing ischemia or infract to the heart muscle
Risk Factors: CAD, hypertension, hyperlipidemia, diabetes mellitus, smoker, FHx of CAD <55 y/o
Medications: Acetylsalicylic Acid (aspirin or ASA), nitroglycerin (NTG), thrombolytic (Heparin)
Chief Complaint: SOB (worse when lying flat (orthopnea), worse with exertion (dyspnea on exertion), and episodically worse at night) paroxysmal nocturnal dyspnea (PND)
Assoc. Sx: bilateral extremity swelling, fatigue, cough.
Physical exam: rales (crackles) in lungs, jugular vein distention (JVD), pedal edema
Diagnosed by: CXR, and elevated BNP (B– type Natriuretic peptide)
Congestive heart failure (CHF)
The heart becomes enlarged and inefficient and congested with excess fluid
Risk factors: history of CHF, hypertension, hyperlipidemia, diabetes mellitus, kidney disease, smoking
Medication’s: diuretics (Lasix/furosemide) -> urinate extra fluid
Chief complaint: palpitations
Assoc Sx: global weakness, fatigue, lightheadedness
Physical exam: irregularly irregular rhythm
Diagnosed by: electrocardiogram (ECG/EKG)
Arterial fibrillation (a fib)
Electrical abnormalities in the wiring of the hard cause top of the heart (atria) to quiver abnormally
Risk factors: paroxysmal afib, chronic afib, alcoholism
Medications: Coumadin/Warfarin (blood thinners) Anna Digoxin (slows down heart rate)
Chief complaint: chest pain (worse with deep breathing/pleuritic)
Assoc. Sx: SOB, patients are often hypoxic (low oxygen saturation), tachycardic (elevated heart rate).
Diagnosed by: screening tool: D dimer, diagnostic tool: CTA chest (CT chest w/ IV contrast)
Pulmonary embolism (PE)
blood cot becomes lodged in the pulmonary artery in blocks blood flow to the lungs
Risk factors: non-DVT, PMHx of DVT, or PE, FHx, recent surgery, cancer, afib, pregnancy, BCP (birth control, pills), smoking
Chief complaint: productive, cough
Assoc. Sx: SOB, fever, chest pain.
Physical exam: rhonchi
Diagnose by: chest x-ray (CXR)
Pneumonia (PNA)
Infiltrate (bacterial infection), and inflammation inside the lungs
Risk factor: elderly, bedridden, immuno-compromised, recent chest injury, call recent surgery
Medication’s: Rocephin and Zithromax (antibiotics)
Chief complaint: SOB
Assoc. Sx: wheezing, coughing, chest tightness.
Physical exam: decreased breathing sounds, wheezes
Diagnosed by: acute infections are very common cause for an exacerbation of this. For this reason, a CXR may be ordered to rule out a PNA. Otherwise, this is not diagnosed in the ED.
Chronic obstructive pulmonary disease (COPD)
Long-term damage, the lungs of alveoli (emphysema) along with information and mucus production (chronic bronchitis)
Risk factors: single greatest risk factor is smoking (80 to 90% of all cases)
Treatment: bronchodilators, supplemental oxygen, corticosteroids, Ventilatory support
Chief complaint: SOB (improved with breathing treatments, exacerbated by certain triggers.)
Assoc. Sx: wheezing.
Physical exam: wheezes (inspiratory or expiratory)
Asthma
Constricting of the airways due to inflammation and muscular contractions to the bronchioles, known as a “bronchospasm“
Risk factors: personal or family, history of asthma, smoking, occupational exposure, obesity, allergies
Treatment: bronchodilators, corticosteroids, inhaler, or nebulizers
CVA vs TIA
A true stroke causes permanent brain damage it is known as ache cerebrovascular accident (CVA). There are two types of CVA:
Ischemic
Hemorrhagic
A “mini – stroke” does not cause permanent brain damage and is referred to as a transient ischemic attack (TIA)
Chief complaint: unilateral, focal neurological deficits: one sided weakness/numbness or changes in speech/vision
Physical exam: unilateral neurological deficits
Diagnosed by: clinically, following a CT had in order to rule out hemorrhagic CVA
Ischemic cerebrovascular accident (CVA)
Blockage of the artery supply blood to the brain resulting in permanent brain damage
Risk factors: hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), Hx. TIA/CVA, smoking, FHx CVA, AFIB
Medication’s: tPA(thrombolytic) will be administered if the patient meet the criteria
Chief complaint: severe, sudden onset (“thunderclap”) headache
Assoc. Sx: nausea, altered mental status (AMS), focal neurological deficits
Physical exam: unilateral neurological deficits
Diagnosed by: CT is the preferred method of speedy diagnosis over imaging is not 100% reliable and detecting the brain bleed there for the patient clinical presentation will also play a role in diagnostic process and rare cases a lumbar puncture (LP) may be performed for further diagnostic purposes.
Hemorrhagic cerebrovascular accident (CVA)
Traumatic or spontaneous rupture of blood vessels in the head lead to bleeding in the brain
Risk factors: hypertension (HTN), anticoagulant use, recent head trauma
Chief complaint: transient focal neurological deficits
Diagnosed by: clinically
Transient ischemic attack (TIA)
Vascular changes, temporary deprive a part of the brain of the oxygen. (sentence usually last less than one hour).
Risk factors: hypertension (HTN), hyperlipidemia (HLD), hx. TIA/CVA, smoking, FHx CVA, AFIB
Chief complaint: headache, neck pain, or stiffness, fever, AMS
Physical exam: meningismus, Nuchal Rigidity
Diagnosed by: lumbar puncture (LP)
Meningitis
Information in infection of the meninges; the sax running to brain and spinal cord
Risk factors: recent international travel, recent exposure to contact
Chief complaint: confusion, decreased unresponsiveness,
Diagnose by: case dependent
Altered mental status (AMS)
Globalize confusion caused by things that affect the entire brain, most common or hypoglycemia infection intoxication and neurological
Risk factors: known infection (commonly UTI and elderly patients), diabetic, elderly, dementia, ETOH use, drug use
Chief complaint: loss of consciousness (LOC), fainting, or passing out
Syncope (passing out.)
temporary loss of blood supply to the brain, resulting in loss of consciousness there a variety of causes; most common are vasovagal and low blood volume (dehydration/hypovolemia) occasionally syncope occurs due to cardiac/neurologic causes.
Chief complaint: abdominal pain, location, RLQ (worse with movement)
Assoc. Sx: nausea, vomiting, fever, decreased appetite
Physical exam: RLQ tenderness, McBurney’s point tenderness
Diagnosed by: CT abdomen/pelvis with PO contrast
Appendicitis
Infection of the appendix causes, inflammation and blockage, possibly leading to rupture
Chief complaint: abdominal pain, location RUQ, typically sharp (worse when eating fatty foods, deep breaths, and palpation.).
Physical exam: RUQ tenderness, Murphy’s sign
Diagnosed by: abdominal ultrasound. (RUQ)
Cholelithiasis
Minerals from the livers bile condense to form gall stones, which can irritate inflame or obstruck the gallbladder
Risk factors: females, age 40 or older. Being Native American or Hispanic or Mexican origin. Being overweight or obese. Being sedentary. Being pregnant, eating a high fat diet.
Chief complaint: painful urination (dysuria)
Assoc. Sx: urinary frequency, urgency, malodorous, urine, AMS (elderly).
Physical exam: suprapubic tenderness
Diagnosed by: urine dip or urinalysis (UA)
Urinary tract infection (UTI.)
Infection of the urinary tract (bladder or urethra)
Risk factors: female
Chief complaint: flank pain
Assoc. Sx: blood in urine (hematuria), nausea/vomiting, unable to void.
Physical exam: costovertebral angle (CVA) tenderness
Diagnosed by: CT of abdomen/pelvis; red blood cells in the UA may be a clue
Kidney stones
Kidney stone dislodged from the kidney and begins, traveling down the ureter, the stone scrapes and irritates ureter, causing severe flank pain and bloody urine
Chief complaint: lower abdominal pain or vaginal bleeding while pregnant
Diagnosed by: ultrasound pelvis (determine location of fetus intrauterine is a normal finding
Ectopic pregnancy
Fertilized egg develops outside the uterus, usually in the fallopian tubes high risk for rupture and death
Risk factors: pregnant, female (HCG positive), STD (pelvic inflammatory disease (PID))
Chief complaint: back pain (mostly lumbar)
Physical exam: paraspinal, tenderness, positive straight leg raise (+ SLR diagnosis sciatica; back pain that radiates down the legs)
Back pain
Deterioration or straight in the back creates pain that is worse with movement
Risk factor: chronic back pain, age, physically, demanding job
Chief complaint: midline abdominal pain
Physical exam: Midland pulsatile abdominal mass, abdominal bruit, unequal tempo, pulses, hypotension
Diagnosed by: CT abdomen/pelvis with IV contrast dye
Abdominal aortic aneurysm (AAA)
Widened and weakened arterial wall at risk of rupture
Risk factors: age, hypertension, smoking, CAD
Chief complaint: ripping, or tearing chest pain, radiates to the back
Physical exam: unequal, brachial, or radial pulses, hypotension
Diagnosed by: CT chest with IV contrast dye
Aortic dissection
Separation of the muscular wall from the membrane of the artery, putting the PT at risk of aortic rupture in death
Risk factors: age, HTN, connective, tissue disorder
Chief complaint: fever and AMS
Assoc. Sx: symptoms very dependent on the source of the infection.
Sepsis
And infection to get into the bloodstream in response to a systemic infection chemicals released from the immune system, cause inflammation throughout the entire body, potentially lead into shock and death
Risk factors: current infection: viral and bacterial or fungal. Compromised immune system. Open wounds. Chronically, ill, young, and old populations. Having an invasive device, such as an IVC or breathing tube.
