Pathophysiology Review

  1. What is CAD?
    Coronary Artery Disease.
  2. 2What other past histories would suggest that a patient has CAD?
    MI, Angina, CABG, Stent, Angioplasty
  3. Does a PMHx of CVA mean the patient has CAD?
  4. Does a surgical history of angioplasty mean the patient has CAD?
  5. Explain the difference between CAD and an MI.
    • CAD is a broad term for heart disease. MI is
    • included in CAD. It’s an active heart attack.
  6. If someone has a PMHx of A-Fib or CHF, do they also have CAD?
  7. What are the “cardiac risk factors?”
    HTN, DM, HLD, CAD, Smoking, FHx CAD < 55 y/o
  8. How is CAD diagnosed?
    By a cardiologist during a cardiac catheterization. Not done in the ED.
  9. Name two ways that an MI can be diagnosed?
    STEMI- EKG, Non-STEMI- Troponin
  10. What are some associated symptoms of an MI other than CP?
    N/V, SOB, Diaphoresis
  11. What are some associated symptoms for CHF?
    SOB (Orthopnea, PND, DOE), pedal edema
  12. What 2 studies would diagnose CHF?
    CXR or elevated BNP
  13. What is A-Fib?
    Electrical abnormality of the heart causing the top of the heart to quiver
  14. What might someone feel with A-Fib?
    Palpitations, fast, pounding, irregular heartbeat
  15. How is A-Fib diagnosed?
  16. What could be the CC of someone with a PE?
    Pleuritic CP or SOB
  17. What are risk factors for a PE?
    Known DVT, PMHx of DVT or PE, FHx of DVT or PE, recent surgery, CA, Afib, immobility, pregnancy, BCP, smoking
  18. What study would diagnose a PE?
    CTA Chest/VQ Scan. D-Dimer can only rule it out
  19. What part of the heart does CAD affect; Arteries, Veins, or Nerves?
  20. Can a CT Chest without IV contrast diagnose a PE? Why or why not?
    No. Contrast in the vessels(IV) helps clearly see a blockage.
  21. What is a PTX?
    Pneumothorax, “collapsed lung”
  22. What is the most common cause of a PTX?
  23. How is a PTX diagnosed?
  24. What social history will most COPD patients also have?
  25. What is the difference between an inhaler and a nebulizer for asthma?
    • An inhaler is portable and gives a one time dose and provides a rapid release of medication
    • A nebulizer is a home machine that delivers continuous treatment over a period of time.
  26. What is asthma?
    Constricting of the airway due to inflammation and muscular contraction of the bronchioles. Also called Reactive Airway Disease
  27. What physical exam finding is closely associated with asthma?
  28. What is PNA?
    Pneumonia. Usually a bacterial infection (infiltrates) and inflammation inside the lung
  29. What might a person with PNA complain of?
    Productive cough and fever
  30. How is PNA diagnosed?
  31. Name all 7 areas of the abdomen.
    Epigastric, RUQ, LUQ, RLQ, LLQ, Suprapubic, Periumbilical (Right/ Left flank)
  32. What is the layman’s name for GERD?
    “Heartburn” or Acid Reflux
  33. What might someone with GERD complain of?
    Epigastric pain “burning”
  34. For older patients with GERD symptoms, what life-threatening disease may also need to be ruled out?
  35. What does bile do? Where is it stored?
    Bile emulsifies the fats in foods. It is stored in the gallbladder and made in the liver
  36. What is the difference between Cholelithiasis and Cholecystitis?
    • Cholelithiasis is gallstones.
    • Cholecystitis is acute gallbladder inflammation/infection.
  37. What might be the chief complaint of a person with gallstones?
    RUQ abdominal pain
  38. What physical exam finding is closely associated with Cholecystitis?
    Murphy’s Signs
  39. How are gallstones diagnosed?
    Abdominal Ultrasound of the RUQ
  40. Name associated symptoms of appendicitis.
    Fever, N/V, decreased appetite (anorexia) Note: RLQ pain- gradual, constant, worse w/ movements is the CC (not associated sx)
  41. How is appendicitis diagnosed?
    CT A/P with PO contrast
  42. What would someone with pancreatitis c/o?
    LUQ or epigastric abdominal pain, N/V, fever
  43. How is pancreatitis diagnosed?
    Elevated Lipase (or Amylase which is less specific)
  44. Name four possible CC’s for a GI bleed pt.
    Hematemesis, coffee ground emesis, hematochezia, melena
  45. How is a GI bleed diagnosed in the ED?
    Guaiac positive or heme + stool, gastroccult
  46. What are we worried about for someone with a GI bleed?
    Too much blood loss, Anemia
  47. What is the pre-existing condition you must have before you can get diverticulitis?
  48. What will be the CC for someone with diverticulitis?
    LLQ abdominal pain
  49. What studies would diagnose diverticulitis?
    CT A/P with PO contrast
  50. What might a person with a SBO complain of?
    Abd pain/bloating, vomiting, abdominal distention, no BM’s, constipation
  51. How is an SBO diagnosed?
    CT A/P w/ PO contrast or AAS (acute abd series) X-ray
  52. What is a UTI?
    Urinary tract infection
  53. What is pyelo?
    Pyelonephritis, Kidney infection (different and worse than a UTI), usually spread from an UTI
  54. What will be the CC of someone with a UTI?
    • Painful urination (dysuria), frequency, burning,
    • hesitancy, malodorous urine
  55. Where would a patient feel pain if they had pyelo?
    Flank pain, fever and dysuria
  56. How is a UTI diagnosed?
    Urine dip or urinalysis (UA) showing white blood cells, bacteria and nitrites
  57. What might a person with kidney stones c/o?
    Flank pain, sudden onset, radiating to groin
  58. How are kidney stones diagnosed?
    CT A/P or RBC in UA
  59. What is an ectopic pregnancy?
    Tubal pregnancy, when a fertilized egg develops outside the uterus (usually in the fallopian tube). High risk for rupture and death.
  60. How is an ectopic pregnancy diagnosed?
    US of the pelvis
  61. What is ovarian torsion?
    Twisting of the ovarian artery, which reduces the blood flow to the ovary. Could result in infarct of the ovary.
  62. How is ovarian torsion diagnosed?
    US Pelvis
  63. Name the 2 types of CVA’s (strokes).
    • Hemorrhagic CVA.
    • Ischemic CVA. (TIA is not a type of a stroke)
  64. What sx might a person with a brain bleed c/o?
    HA- sudden (“thunderclap”) onset, worst HA of their life, changes in speech, vision, motor (weakness), sensation (numbness), AMS
  65. What study would diagnose a brain bleed?
    CT Head or Lumbar Puncture
  66. What sx might a person with an ischemic CVA c/o?
    Focal Neurological Deficit: changes in speech, changes in vision, one-sided motor changes (weakness), one-sided sensation changes (numbness)
  67. How is an ischemic CVA diagnosed?
    Clinically, potentially normal CT head
  68. What is a TIA?
    Transient Ischemic Attack. Mini-stroke. Temporary loss of blood supply to the brain
  69. How does a TIA differ from a CVA?
    • TIA - mini stroke, symptoms usually resolve in less than an hour.
    • CVA - Stroke, symptoms last longer, and potentially may not go away
  70. What is a common cause for seizures in children?
  71. What is the name of the state after a seizure?
  72. What are 3 symptoms of meningitis?
    Fever, neck pain/stiffness, headache
  73. What study would diagnose meningitis?
    LP- Lumbar puncture
  74. What are 4 important things to document for syncopal episodes?
    How they felt before, during, after, and how they currently feel
  75. Name 4 causes of altered mental status.
    Hypoglycemia, infection, intoxication, neurological
  76. How is AMS different from a focal neuro deficit?
    AMS is generalized and typically caused by something that can affect the whole brain (drugs, low BS). FND are localized (weakness/numbness/speech/vision) to one specific area and corresponds with damage to specific spot in the brain
  77. What is a DVT?
    Deep venous thrombosis
  78. What are the risk factors for a DVT?
    Known DVT, PMHx of DVT or PE, FHx of DVT or PE, recent surgery, CA, Afib, immobility, pregnancy, BCP, smoking
  79. What are common signs of a DVT?
    Extremity pain, swelling (atraumatic)
  80. What is an AAA?
    Abdominal aortic aneurysm
  81. What is an aortic dissection?
    The separation of the muscular wall from the membrane of the artery, putting the pt at risk for aortic rupture and death
  82. What are 3 symptoms of cellulitis?
    Redness, swelling, and pain to an area of the skin
  83. How is an abscess different from cellulitis?
    Abscess is cellulitis with fluctuance (pus pocket)
  84. What procedure will be performed for every abscess?
    Incision and drainage
  85. What is the main concern with an allergic reaction?
    Anaphylaxis or respiratory failure
  86. What are the ONLY three symptoms of a true allergic reaction?
    Rash, itching, swelling, SOB due to airway swelling
  87. How can Diabetic Ketoacidosis (DKA) be diagnosed?
    Arterial Blood Gas showing low pH or Positive Serum Ketones
  88. What is the Emergency Physician’s main responsibility for psychiatric patients?
    Medical clearance
  89. Name three important things to document for any trauma patient.
    LOC, head injury, neck pain, back pain, numbness, weakness
Card Set
Pathophysiology Review
patho - course 2