E. Med

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leaman7155
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8768
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E. Med
Updated:
2010-03-02 00:08:02
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  1. What are the classic sx of chest pain?
    • Crushing substernal pain or abdominal pain
    • N/V/diaphoresis/SOB
    • Sx last longer than 15-20 minutes
  2. What are important PMH to know with a pt presenting with CP?
    • HTN, DM, Cholesterol, Tobacco, Obesity, Drugs use/abuse
    • Family history
  3. What are clinical findings on PE for CP?
    • Dyspnea
    • Diaphoresis
    • JVD
    • Pulmonary Edema
    • New murmor
  4. What are the three kinds of angina discussed?
    • Rest angina - Pain >20 mins
    • New Onset - severe pain within 2 months of presentation. Marked decrease in PE
    • Increasing - Previously dx angina which is worsening
  5. What is the DDx for CP?
    • Cardiac
    • vascular
    • pulmonary
    • MS
    • GI
    • Derm
    • Connective Tissue
    • Psych
  6. What are the DEADLY SIX?
    • Aortic Dissection
    • PE
    • AMI/ACS
    • Arrythmia
    • Pericarditis
    • Tamponade
  7. What are the serum markers in CP?
    • Myoglobin - from muscle
    • CK-MB - from death of muscle
    • Troponin - from myocardial injury
  8. What are the most common presenting sx for AMI?
    • 26% - initial Cxr
    • 54% - SOB
    • 14% Abdominal Pain
  9. How do we treat an AMI?
    • 100% ASA
    • 100% low flow O2
    • B-Blocker
    • Nitro
    • Antiplatlet therapy
    • Heparin, LMW Heparin, Clopidogrel
    • Invaisive
  10. Complications of AMI
    • Dysrhythmia
    • Diastolic dysfunction - pulmonary congestion --> shock
    • Systolic dysfunction - diminished cardiac output -->shock
    • Mechanial Complications (wall rupture, pericarditis, thrombus)
  11. How do we treat Pulmonary Edema?
    • UNLOADME
    • U-upright
    • N-nitro
    • L-Lasix
    • O-O2
    • A-Apsirin/ACE
    • D-Dopamine/Dobutamine
    • M-Morphine
    • E-Endotracheal Intubation
  12. How do we classify aortic dissections?
    • Standford A/Debakey I-II - surgical
    • Standford B/Debakey III - Medical
  13. What will find on exam with a pneumothorax?
    • Decreased breath sounds
    • JVD
    • Tachypnea
    • Decreased BP
    • Trach Deviation
  14. What will we find on an EKG with a PE?
    • S1, Q3, T3
    • most common ST, R-Axis deviation
    • RBBB
  15. What hallmarks can we see on CXR with PE?
    • Westermark - cutoff Pulmonary Artery
    • Hamptons Hump - Pleural based wedge
  16. What is the gold standard for Dx of PE?
    Arteriogram
  17. What is a classic presentation of Pericarditis?
    • sharp, pleuritic pain
    • most severe in supine position
    • better when patient sits or leans forward
  18. What will pericarditis look like on EKG?
    • Diffuse ST elevations
    • PR depression

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