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20 Cards in this Set
- Front
- Back
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1. Utility of knowing risk factors for ischaemic heart disease on USMLE (2 things)?
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1. Helping answer diagnostic questions in equivocal cases.
2. Modifying them can lower mortality |
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2. Criteria for significant family history of ischaemic heart disease?
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a. Family member must be young
b. Female relative <65, Male relative <55 |
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3. Presentation of Coronary Artery Disease?
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a. Presents w/chest pain that does not change with body position or respiration.
b. CAD is NOT associated w/chest wall tenderness |
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4. Single worst or most dangerous factor for Coronary Artery Disease?
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a. Diabetes
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5. Risk factors for Ischaemic heart disease (CAD)?
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1. DM
2. HTN 3. Tobacco 4. Hyperlipidemia 5. Peripheral artery disease 6. Obesity 7. Inactivity 8. Family hx |
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6. When any one of the following 3 features, the patient does NOT have CAD?
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1. Pleuritic chest Pain (changes w/respiration)
2. Positional chest pain 3. Tender (pain on palpation) |
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7. Pleuritic pain differential?
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1. Pulmonary embolism
2. Pneumonia 3. Pleuritis 4. Pericarditis 5. Pneumothorax |
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8. Positional chest pain differential?
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a. Pericarditis.
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9. Tender chest pain differential?
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a. Costochondritis.
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10. Most common cause of chest pain?
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a. Acid reflux.
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11. A pt comes to the ED w/chest pain. The pain also occurs in the epigastric area and is associated w/a sore throat, a bad metallic taste in the mouth, and a cough. What do you recommend?
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a. PPI
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12. An alcoholic pt comes to the ED w/CP. There is N/V and epigastric tenderness. What do you recommend?
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a. Check amylase and lipase levels.
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13. A pt comes to the ED w/CP. There is right upper quadrant tenderness and mild fever. What do you recommend?
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a. Order an abdominal sonogram for gallstones.
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14. Besides chest pain, other clues to ischaemic disease as the cause of chest pain are?
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a. Dull pain
b. Lasts 15-30 minutes c. Occurs on exertion d. Substernal location e. Radiates to the jaw or left arm. |
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15. Significance of S3 gallop?
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a. Dilated left ventricle
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16. Significance of S4 gallop (4)?
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a. Left ventricular hypertrophy
b. Jugular venous distention c. Holosystolic murmur of mitral regurg |
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17. Rales on physical exam?
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a. Suggestive of CHF
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18. Mitral regurg murmur?
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a. Holosystolic murmur.
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19. Note: An EKG is always the best initial diagnostic test for ischemic-type pain. If the case presented to you is very clearly a case of ischaemic pain and the examiners ask you to choose between and EKG and aspirin, nitrates, oxygen, and morphine, then choose treatment first.
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19. Note: An EKG is always the best initial diagnostic test for ischemic-type pain. If the case presented to you is very clearly a case of ischaemic pain and the examiners ask you to choose between and EKG and aspirin, nitrates, oxygen, and morphine, then choose treatment first.
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20. Note: When the question asks about the most ACCURATE test for ischaemic chest pain, the answer is CK-MB or troponin.
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20. Note: When the question asks about the most ACCURATE test for ischaemic chest pain, the answer is CK-MB or troponin.
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