Clinical: Patient History

Question 1

What are the two common/concerning tyoes of cardiac related dyspenia?

Answer 1

1. Dyspenia Types

• Orthopenia
  
  • shortness of breath (dyspnea) that occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair.
• Paroxysmal nocturnal dyspnea
  
  • Attacks of severe shortness of breath and coughing that generally occur at night. It usually awakens the person from sleep, and may be quite frightening.

Question 2

A patient has chest pain and is not in severe repirtory distress or shock.

• The patient has sharp pleuritic pain, sudden onset dyspnea.
• The patient reports that sometimes they cough up blood and have short “black outs”.

What is your top Ddx?

Answer 2

• Pulmonary Embolism
  
  • Could also be penumothorax, penumonia, or pleutis.

Question 3

A patient has chest pain and is not in severe repirtory distress or shock.

• The patient has atypical angina pain, along with a high risk of coronary artery disase.

What is your top Ddx?

Answer 3

Myocardial Infarction or Ischemia

• Also think of pulmonary embolism, digestive pain, psychogenic pain.

Question 4

Define Anasarca

Answer 4

Edema EVERYWHERE in the body

Question 5

What is the difference between lipedema and lymphodema?

Answer 5

• Lipedema
  
  • Edema from fluid retained in the interstital space by lipids in the dermis
• Lymphodema
  
  • Edema from lymphatic drainage obstruction.

Question 6

Define Ascites

Answer 6

Colleciton of fluid in the peritoneal cavity

Question 8

What are the different types of edema?

Answer 8

• Anasarca
• Ascites
• Lipedema
• Lymphedema
• Myexedma
• Pretibial Myexedma

Llama

Question 9

A patient has chest pain and is not in severe repirtory distress or shock.

• The patient has atypical angina pain, along with a low risk of coronary artery disase.

What is your top Ddx?

Answer 9

• Pulmonary Embolism
• Mitral Valve Prolapse
• Digestive Pain
• MSK Pain
• Psychogenic Pain

Question 10

A patient has chest pain and is not in severe repirtory distress or shock.

• The patient has sharp pleuritic pain that radiates to the shoulders and the back.
• The patient reports that they learn forward to relieve the pain.

What is your top Ddx?

Answer 10

Pericarditis

Question 11

If a patient is having palpitations, what would make you immediately suspect that there is underlying arrhythmia?

Answer 11

1. If the palpitations occur with syncope or presyncope.
2. Known history of cardiac disease

Question 12

What are palpitations? What is it usually due to?

Answer 12

Awareness of heartbeat

• Cardiac causses
• Sinus Tachycardia
• Heightened awarness of NORMAL sinus rhythm.

Question 13

A patient has chest pain and is not in severe repirtory distress or shock.

• The patient has typical angina pain.
  
  • Diffuse retrosternal pressure that radiates to the one arm.
  • Dyspenia, and nausea

What is your top Ddx?

Answer 13

• Myocardial Infarction or Ischemia
  
  • Also think of pulmonary embolism, digestive pain, psychogenic pain.

Question 14

What are the 5 concerning/common cardiac symptoms?

Answer 14

1. Chest ppain
2. Palpitations
3. Dyspenia
4. Edema
5. Syncope

PC DEmS

Question 15

A patient has chest pain and is not in severe repirtory distress or shock.

• The patient reports that the pain feels like a ripping or tearing senstion.
  
  • The pain radiates to the back.
• The patient also has a history of hypertension.

Answer 15

Aortic Disection

Question 16

What are the 4 causes of chest pain?

Answer 16

1. Ischemic Cardiac
2. Non-ischemic Cardiac
3. NonCardiac
4. Psycho

Question 17

What is the difference between myxedema and pretibial myxedema?

Answer 17

• Myxedema
  
  • Edma from HYPOthyroidusm
• Pretibial myxedema
  
  • Swelling of the shins due subcuntaneas plaques form Graves Disease