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21 Cards in this Set
- Front
- Back
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Esophageal perforation (Boerhaave syndrome)
age & SS |
pt looks sick; abnormal vitals
Age: usu 40-60yrs SS: odynophagia, vomiting, dyspnea tachypnea, cyanosis fever, shock |
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Tests for esophageal perf
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CXR, CT chest
-GASTROGRAFIN, not barium -hemoccult |
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Tx for esophageal perf
(Boerhaave syndrome) |
ABCs, surgical consult, NG tube, NPO
IV fluids & Abx, parenteral nutrition -pain & antiemetics |
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SS of Pulmonary emboli
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chest pain (pleuritic & unilat); sudden, sharp
-may have sharp sudden back pain -SOB, dyspnea, shock, tachycardia -tachypnea, hemoptysis |
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Tests for PE
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EKG findings, pulse ox (low)
D-dimer, CT chest w/IV contrast |
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Treatment for PE
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ABCs
Lovenox coumadin surgery |
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Usual age range for spontaneous pneumothorax?
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20-40 yrs
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SS of spontaneous pneumo
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unilateral pleuritic chest pain
-dyspnea, tachycardia -dec or no breath sounds -hypoxia, hypotension, tracheal deviation (tension pneumo) -hypoxic respiratory arrest |
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Tests & tx for spontaneous pneumo
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CXR
CT w/IV contrast Tx: needle decompression chest tube thoracostomy |
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Pericarditis: MC age group?
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Men 20-50yrs
-but can be all ages -viral is #1 cause |
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SS of pericarditis
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left side pleuritic chest pain, worse lying down, better sitting forward
-sharp pain, no change w/exertion PE: friction rub |
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Dx and Tx for pericarditis
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Dx: EKG (ST elevation in all leads)
-CBC elevated WBC -CXR, cardiac enzymes -ECHO Tx: ibuprofen, NSAIDS |
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What is included in acute coronary syndromes?
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acute MI and unstable angina
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SS of acute coronary syndromes?
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chest pain (pressure, heaviness, tightness), nausea, diphoresis
dyspnea, palpitations Location: substernal & left sided, usu worse w/activity; better w/ rest |
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Tests and Tx for acute coronary syndromes
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tests: EKG, cardiac enzymes, CXR, labs
Tx: cath lab within 90 mints; fibinolytics within 30 mins of arrival if PCI can't be done within 90 mins |
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Aortic dissection
-Risk factors |
over 50yrs w/HTN
prior cardiac surgery |
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SS of aortic dissection
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severe sharp tearing chest pain
-radiates to the back -worst pain ever (exam may be normal) -pulse deficits, new murmurs, pulsing abdominal mass |
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Tests & tx for aortic dissection
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EKG (no changes or nonspecific)
CT w/ & w/o contrast chest & abdomen (GOLD STANDARD) Tx: BB to control BP, surgery |
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Abdominal Aortic Aneurysms
risk factors, age |
> 60 yrs, males
-smokers, family history, HTN |
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SS of AAA
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abdo, flank, back pain
-sharp tearing, severe, abrupt pain -cullen's (bruise around umbilicus) and grey turners sign (bruising of flanks) |
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Dx & Tx of AAA
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Xray abdo: calcified or bulging aortic contour
US, CT w/ IV contrast Tx: surgery -emergency: abd/back pain, pulsatile abd mass, hypotension |
