CMN 574 Elaborate Exam Study
Questions with Detailed Answers |
Latest Edition
1. Musculoskeletal CP - ANSWER Usually more localized and pt can point to
it
Made worse with movement/deep inspiration
Often reproducible
*Examen for rash associated with zoster
X-rays if hx of trauma
Tx: Rest, anti-inflammatories, ice/heat
2. Aortic aneurysm/dissection - ANSWER abrupt onset severe, tearing,
ripping, knife-like CP radiating to back
s/s: anxiety, dyspnea, hypo/hyperTN, difference between R& L arm BP, absent
UE pulses
harsh holosystolic murmur
Tx: Emergent chest CT and echo--> Surgery!!
3. Pericarditis - ANSWER Pleuritic substernal CP radiates to shoulders, back,
epigastrium
,Worse when supine, +Fever, +dyspnea
Caused by virus/bacteria/autoimmune
Dx: CBC, Sed rate, cardiac enzymes, ECG, echo
Tx: Bedrest, ASA, NSAIDS, Colchicine, Steroids
4. Risk factors for CAD - ANSWER Male
Increased age
Fam Hx
Dyslipidemia
HTN
DM
Smoking
Sedentary
Obesity (esp abd)
Stress
Poor diet
ETOH (excessive)
5. Rouan Decision Rule - ANSWER Predicts when pts with CP (but normal
ECG) are at high risk for MI Mnemonic-An MI rouans your life
6. Respiratory CP - ANSWER Pleuritic, dull, sharp, or stabbing- worse with
deep breath or cough, fever, dyspnea
,Labs: CXR (PNA), D-dimer or helical CT and venous US (PE)
PNA tx: ABX
PE tx: anticoagulation
7. Wells Model - ANSWER For diagnosis of PE
Mnemonic, Well I guess I have a PE
8. Gastrointestinal CP - ANSWER (always ask about OTC pain meds)
Substernal, burning pain, nocturnal cough, flatus, belching, dysphagia
Esophageal spasm -> squeezing or pressure
Epigastric pain radiating to back -->Pelvic Ulcer disease, pancreatitits
Usually recurrent, worsened by meals/supine
Relieved by antacids, PPI, H2 blockers
Tx: PPIs, ABX for H. pylori, Diet, Elevate HOB
9. Psychogenic CP - ANSWER Precordial CP
constant or intermittent heaviness unrelated to meals or activity
Screening Questions
In past 6 mos, any spell/attack where suddenly felt anxious, frightened, uneasy?
In past 6 mos, suddenly heart race, felt faint, or couldn't breathe?
*Yes to either is positive screen. No makes panic disorder unlikely
, Mitral Valve Prolapse - ANSWER Usually asymptomatic but can have non-
specific CP, dyspnea, palpitations
Inc risk in healthy females, thin collagen disease (Marfan's, Ehlers-Danlos
Syndrome)
Pansystolic or late systole with single to multiple mid-systolic click
Skeletal changes such as pectus excavatum or scoliosis
Diagnosis confirmed by echo, ambulatory ECG (palpitations)
Tx: Low dose BB, mitral valve repair
ACRONYM:
PEEP-EM
PECTUS EXCAVATUM
ECHOCARDIOGRAM
ECG (Ambulatory/Palpitations)
Pansystolic
EHLER'S DANLOS SYNDROME
Marfan's
Stable Angina - ANSWER SYMPTOMS W/ ACTIVITY
Questions with Detailed Answers |
Latest Edition
1. Musculoskeletal CP - ANSWER Usually more localized and pt can point to
it
Made worse with movement/deep inspiration
Often reproducible
*Examen for rash associated with zoster
X-rays if hx of trauma
Tx: Rest, anti-inflammatories, ice/heat
2. Aortic aneurysm/dissection - ANSWER abrupt onset severe, tearing,
ripping, knife-like CP radiating to back
s/s: anxiety, dyspnea, hypo/hyperTN, difference between R& L arm BP, absent
UE pulses
harsh holosystolic murmur
Tx: Emergent chest CT and echo--> Surgery!!
3. Pericarditis - ANSWER Pleuritic substernal CP radiates to shoulders, back,
epigastrium
,Worse when supine, +Fever, +dyspnea
Caused by virus/bacteria/autoimmune
Dx: CBC, Sed rate, cardiac enzymes, ECG, echo
Tx: Bedrest, ASA, NSAIDS, Colchicine, Steroids
4. Risk factors for CAD - ANSWER Male
Increased age
Fam Hx
Dyslipidemia
HTN
DM
Smoking
Sedentary
Obesity (esp abd)
Stress
Poor diet
ETOH (excessive)
5. Rouan Decision Rule - ANSWER Predicts when pts with CP (but normal
ECG) are at high risk for MI Mnemonic-An MI rouans your life
6. Respiratory CP - ANSWER Pleuritic, dull, sharp, or stabbing- worse with
deep breath or cough, fever, dyspnea
,Labs: CXR (PNA), D-dimer or helical CT and venous US (PE)
PNA tx: ABX
PE tx: anticoagulation
7. Wells Model - ANSWER For diagnosis of PE
Mnemonic, Well I guess I have a PE
8. Gastrointestinal CP - ANSWER (always ask about OTC pain meds)
Substernal, burning pain, nocturnal cough, flatus, belching, dysphagia
Esophageal spasm -> squeezing or pressure
Epigastric pain radiating to back -->Pelvic Ulcer disease, pancreatitits
Usually recurrent, worsened by meals/supine
Relieved by antacids, PPI, H2 blockers
Tx: PPIs, ABX for H. pylori, Diet, Elevate HOB
9. Psychogenic CP - ANSWER Precordial CP
constant or intermittent heaviness unrelated to meals or activity
Screening Questions
In past 6 mos, any spell/attack where suddenly felt anxious, frightened, uneasy?
In past 6 mos, suddenly heart race, felt faint, or couldn't breathe?
*Yes to either is positive screen. No makes panic disorder unlikely
, Mitral Valve Prolapse - ANSWER Usually asymptomatic but can have non-
specific CP, dyspnea, palpitations
Inc risk in healthy females, thin collagen disease (Marfan's, Ehlers-Danlos
Syndrome)
Pansystolic or late systole with single to multiple mid-systolic click
Skeletal changes such as pectus excavatum or scoliosis
Diagnosis confirmed by echo, ambulatory ECG (palpitations)
Tx: Low dose BB, mitral valve repair
ACRONYM:
PEEP-EM
PECTUS EXCAVATUM
ECHOCARDIOGRAM
ECG (Ambulatory/Palpitations)
Pansystolic
EHLER'S DANLOS SYNDROME
Marfan's
Stable Angina - ANSWER SYMPTOMS W/ ACTIVITY
