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Cardiorespiratory flashcards

Terms in this set (18)

What is the most characteristic clinical finding of aortic incompetence?
A collapsing pulse
What is the most characteristic clinical finding of pericardial tamponade?
Pulse paradoxus
What is the most characteristic clinical finding of right ventricular hypertrophy?
Left parasternal heave (muscle contraction can be felt because of increased muscle bulk)
A 46 year old woman, recently discharged following hysterectomy, collapses with acute central chest pain and profound breathlessness, what is the likely diagnosis?
Pulmonary embolism (Acute MI is the main differential diagnosis)
A 56 year old overweight man is woken repeatedly at night with central burning chest pain, what is the likely diagnosis?
Nocturnal burning chest pain typical of gastro-oesophageal reflux disease
A 76 year old male retired banker, enjoys golf, but is having difficulty on the uphill holes because of central chest discomfort and breathlessness, what is the likely diagnosis?
Chronic stable angina (relationship to exertion is the most characteristic feature of this)
A 24 year old man with sudden onset of left sided chest pain and breathlessness. Breath sounds on the left are diminished and the percussion note is resonant, what is the initial investigation?
Chest x-ray (patient is likely to have spontaneous pneumothorax as resonance with silence is typical)
A 62 year old lady with chest tightness that comes on when doing housework such as hoovering. The resting ECG is normal, what is the initial investigation?
Myocardial perfusion imaging as history suggestive of angina.
A 58 year old man with acute onset of central chest pain, nausea and sweating being assessed in the Emergency Medicine Department triage, what is the initial investigation?
12 lead ECG (critical in determining the presence of acute MI and those who will benefit from urgent coronary intervention)
A 24 year old woman with exertional breathlessness, dizziness, chest discomfort and central cyanosis, what is the most likely diagnosis?
Pulmonary arterial hypertension (rare disease but this is how it presents)
What is a common complication of MI?
Heart failure
A 73 year old man having smoked 50 pack years with long-standing productive cough and wheeze presenting with slowly progressive breathlessness, what is the likely diagnosis?
COPD (chronic bronchitis and emphysema)
A 35 year old man needs treatment for his newly diagnosed hypertension. He is known to have severe asthma with several previous hospital admissions. Which drug is best avoided?
Beta blockers e.g. bisoprolol
Why are beta blockers avoided in asthma?
They cause broncospasm and peripheral vasoconstriction
A 67 year old woman complains that her new anti hypertensive medication is making her ankles swell. Which is the most likely culprit?
Dihydropyridine calcium channel blockers e.g. amlodipine
How do clacium channel blockers produce ankle swelling?
By reducing force of contraction and arteriolar vasodilation
A 78 year old man with recurrent gout needs treatment for his hypertension. Which drug is best avoided?
Thiazide diuretics e.g. bendroflumethiazide
Why should thiazide diuretics be avoided in gout?
They reduce the clearance of uric acid and raise the levels of uric acid in the blood so should be prescribed with caution in patients with gout or hyperuricaemia. Loop diuretics also produce this problem but less so.
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