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27 Cards in this Set
- Front
- Back
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what are the general principles of diagnosis? (ie what should you always ask a pt?) which one is the most important?
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-location, radiation, duration
-quality, intensity -what makes it better/worse - History of similar episodes (is it the same or different) *** Most important -associated symptoms |
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what are the things that you have to check for on a cardiac physical?
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visual signs
optic fundi neck vein distention and carotid upstroke murmurs, rubs, clicks abnormal precordial thrust or heave rales, wheezes abdominal masses or tenderness peripheral edema or pulse abnormality atrophic skin changes third or fourth heart sounds |
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what does AV-nicking in the eye show?
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hypertension
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If you find deposits on the retina, what is that indicative of?
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hypercholesterolemia (very sick)
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When the arterioles in the eye turn yellowish is indicative of?
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atherosclerosis
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what does atrophic skin changes mean? imply?
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means: appendage loss (hair follicles, sweat glands) --> skin becomes dry and hairless.
imply: poor vascular supply |
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what 4 things are measured in a blood gas analysis?
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oxygenation
amount of CO2 (ventilation) pH of blood HCO3 |
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what is the levine sign? what is it characteristic of?
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fist on the center of the chest (pounding), unprovoked.
characteristic of angina |
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what is the most common place for ischemic pain to radiate? close seconds?
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left arm; jaw or shoulder
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what pt group tends to produce with non-classic symptoms? what percentage?
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women; <50% of the time
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what does eating or exposure to cold have anything to do w/ angina?
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it takes energy to digest food. So when people eat a meal, the metabolism goes up as if you are doing exercise which requires increased blood to the gut. This can cause a strain in the myocardium.
Cold--> you get increased peripheral vascular resistance which makes the work harder on the heart and you have an increased volume to the heart. So it makes it hurt. |
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what is the most frequent time for people to have a heart attack?
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Monday morning before work (when they wake up or right before normal awakening)
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what are the four physical exam signs of atherosclerosis?
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arcus senilis
optic fundi atrophic skin changes bruits |
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what is arcus senilis? what does it correlate with?
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a white ring around the peripheral of the iris that is a deposition of calcium.
The presence of atherosclerosis |
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where are bruits most commonly heard?
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Femorals
Carotids Abdominal aorta--> at the bifurcation (L2) above umbilicus |
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T/F
Angina doesn't change in different postions. |
true
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how do you distinguish pericarditis from angina?
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pericarditis is relieved by sitting forward; angina is not relieved by any position. Cause for pericarditis is usually viral, not related to the heart
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on a physical exam, how do you distinguish pericarditis from angina?
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no signs of atherosclerosis and they have a pericardial rub
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where is the precordium?
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chest wall over the left side (parasternal)
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what is the only condition that gives you mid-systolic click on physical?
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MVP
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Sudden onset of unilateral chest pain, usually not substernal.
dx |
pulmonary embolism
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what 2 cardiac conditions hurt more with respiration?
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pericarditis and pulmonary embolism
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what are the only two symptoms that differentiate esophageal spasm from angina?
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frequent assoc w/ reflux
occasionally associated w/ dysphagia |
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What differentiates musculoskeletal pain from cardiac pain?
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cardiac pain happens at the event of the activity and then goes away
MSK pain comes later |
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sharp stabbing pain that lasts for days
dx |
pleurisy
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tearing, severe chest and back pain.
dx |
aortic dissection
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BP is different in the arms than in the legs.
dx |
aortic dissection
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