Clinical Medicine (CV Disease)40 cards

Tagged as: medical, medicine, nursing, history, fitness, sports

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Screening for CVD is done by doing what first?

Take a comprehensive hx and physical


What are the 4 hazards of Inappropriate Testing?

-Increased risk to the patient -Patient discomfort -Unnecessary cost -Risk of false positives leading to more unnecessary testing


What are the 9 most common symptoms of heart disease?

-Fatigue -Edema -Cough -Related to heart failure -Hemoptysis -Nocturia -Wake @night to urinate -Chest pain -Dyspnea -SOB -Orthopnea -PND-paroxysmal nocturnal -Syncope -Palpitations


Define Angina Pectoris.

-A discomfort in the chest and/or adjacent area associated with myocardial ischemia but without myocardial necrosis -Definition is based on history alone, even if diagnostic tests do not reveal evidence of CAD


What is the presentation of someone with Typical Angina Pectoris and what can be done to relieve the problem?

-Substernal or retrosternal -Burning, heavy or squeezing sensation -Precipitated by exertion or emotion -Promptly relieved by rest or nitroglycerin


What is the presentation of someone with Atypical Angina Pectoris?

-Located in right/left chest, abdomen, back, or arm in the absence of substernal chest pain -Sharp or fleeting -Very prolonged -Unrelated to exercise -Not relieved by rest or nitroglycerin -Relieved by antacids -Characterized by palpitations


Aortic dissection is described as what?

-Pain in anterior chest, may radiate to back -Described as excruciating, tearing, knifelike -Sudden onset, unrelenting


Name the accompanying symptoms of a Pulmonary Embolism.

Dyspnea, tachycardia, hypotension, hypoxia, hemoptysis, signs of right-sided heart failure


Where would one see pleurisy/pleuritis?

Viral infections, pneumonia, and pleural effusion


Name the causes of Acute Dyspnea (good luck).

-Heart disease- Acute Coronary Syndrome (ACS),new onset Afib -Flare of Asthma/COPD -Pneumonia -Spontaneous pneumothorax -PE (can be little or large problem) -Pulmonary Edema (cardiogenic, or Non-cardiogenic) -Pleural effusion


Name the causes of Chronic Dyspnea

-COPD/Asthma -Left ventricular failure, cardiomyopathy -Diffuse interstitial fibrosis -Deconditioning -Valvular Heart Disease- left sided ? Neurological disorders ? Generalized Anxiety ? Metabolic- Anemia, Hypothyroidism (or Hyper)


What are the 3 types of neurally mediated reflex syncope?

-Vasovagal, Carotid sinus syncope, postmicturition


A cardiogenic syncope most commonly results from what?

bradyarrhythmias, very rapid supraventricular rhythms, VT or VF


Define Palpitations.

an unpleasant awareness of the forceful or rapid beating of the heart


Unilateral, localized edema causes are what?

cellulitis, DVT, lymphatic blockage-pelvic/retroperitoneal tumors


Bilateral, localized edema causes are what?

Characteristic of CHF or venous insufficiency


Name the causes for generalized edema

-Cardiac – CHF -DOE, orthopnea, PND, rales on exam -Hepatic – Cirrhosis, Liver failure -Abdominal distension from ascites often precedes generalized edema -Often there is a history of alcohol abuse -Renal – Nephrotic syndrome -Decreased appetite


Why is a ECG performed?

Symptoms or clinical suspicion warrants one performed to diagnose arrhythmia, conduction disturbance or other abnormality


What does a parasternal lift indicate?

RVH, pulmonary hypertenstion, or LA enlargement


Explain the difference between Rales that are cardiac vs pulmonary

-Cardiac – tend to occur late in inspiration, fine, more prominent at base, usually bilateral -Pulmonary – occur in early or mid inspiration, coarse, often heard in all lung field (pul. fibrosis), or localized (pneumonia)


Ascites is seen with what conditions?

Present with more right sided HF, tricuspid valve disease, or chronic constrictive pericarditis