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Vital Signs -- norms and ranges for basic pathology (e.g., hypertension, orthostatic hypotension, Spo2) ------------------------------------------------------------------------------------------------------- Spirometry interpretation (including GOLD classification if provided) ---------------------...

Vital Signs -- norms and ranges for basic pathology (e.g., hypertension, orthostatic hypotension, Spo2) ------------------------------------------------------------------------------------------------------- Spirometry interpretation (including GOLD classification if provided) --------------------------------------------------------------------- A yellow and black box with black text Description automatically generated Signs, symptoms, and basic pathology of CAD and Heart Failure ------------------------------------------------------------- +-------------+-------------+-------------+-------------+-------------+ | | **Coronary | **Angina | **Acute | **Heart | | | Artery | Pectoris** | MI** | Failure** | | | Disease** | | | | +=============+=============+=============+=============+=============+ | **Info** | - Inadequ | - Discomf | - 2 types | - Type 1 | | | ate | ort | based | HF with | | | blood | experie | on | ↓ | | | supply | nced | degree | ejectio | | | to the | when | of | n | | | heart | heart | thickne | fractio | | | due to | muscle | ss | n | | | a | is | of | (systol | | | blockag | deprive | ventric | ic | | | e | d | ular | failure | | | in the | of | wall | ) | | | blood | adequat | involve | L | | | vessels | e | d | ventric | | | which | O2 -- | transmu | le | | | supply | chest, | ral | can't | | | it | jaw, | (full | contrac | | | | shoulde | thickne | t | | | - Narrowi | r, | ss), | normall | | | ng | back, | subende | y. | | | | arms | ndocardial | | | | - Also | (replic | (part | - Type 2 | | | known | ate MI) | of | HF with | | | as | | myocard | preserv | | | ischemi | - Typical | ial | ed | | | c | ly | wall) | ejectio | | | heart | aggrava | | n | | | disease | ted | - Also | fractio | | | | by | classif | n | | | | exertio | ied | (diasto | | | | n | by | lic | | | | or | anatomi | failure | | | | stress | cal | ) | | | | | locatio | L | | | | - Stable | n | ventric | | | | Relived | | le | | | | by | | can't | | | | rest, | | relax | | | | NO | | normall | | | | | | y | | | | - Unstabl | | (becaus | | | | e | | e | | | | not | | the | | | | relieve | | muscle | | | | d | | has | | | | by rest | | become | | | | | | stiff). | | | | - Silent | | | | | | ischemi | | - R heart | | | | a | | failure | | | | no | | Occurs | | | | sx/px | | from L | | | | | | HF | | | | | | (pressu | | | | | | re | | | | | | and | | | | | | volume | | | | | | overloa | | | | | | d). | | | | | | When L | | | | | | ventric | | | | | | le | | | | | | fails, | | | | | | ↑ fluid | | | | | | pressur | | | | | | e | | | | | | is | | | | | | transfe | | | | | | rred | | | | | | back | | | | | | | | | | | | - Congest | | | | | | ive | | | | | | heart | | | | | | failure | | | | | | (systol | | | | | | ic) | | | | | | | | | | | | - Pulmona | | | | | | ry | | | | | | oedema | | | | | | respira | | | | | | tory | | | | | | distres | | | | | | s | +-------------+-------------+-------------+-------------+-------------+ | **Causes/** | - Clot/em | - Precurs | - Decreas | - | | | bolism | or | ed | | | **Risk | | for MI | or | | | Factors** | - Atheros | etc | complet | | | | clerosis | | e | | | | (plaque | | cessati | | | | build-u | | on | | | | p) | | of | | | | -- most | | blood | | | | common | | flow to | | | | | | a | | | | - Smoking | | portion | | | | , | | of the | | | | poor | | myocard | | | | diet, | | ium | | | | sedenta | | | | | | ry, | | | | | | family | | | | | | hx, | | | | | | comorbi | | | | | | dities, | | | | | | T2DM, | | | | | | HTN, | | | | | | male, ↑ | | | | | | age | | | | +-------------+-------------+-------------+-------------+-------------+ | **Symptoms* | | | - Chest | - Breathl | | * | | | pain -- | essness/SOB | | | | | retrost | (worse | | | | | ernal, | on | | | | | pressur | exertio | | | | | e | n | | | | | or | | | | | | heavine | - Fatigue | | | | | ss | , | | | | | -- not | letharg | | | | | affecte | y, | | | | | d | reduce | | | | | by | exercis | | | | | positio | e | | | | | nal | toleran | | | | | change | ce | | | | | or | | | | | | movemen | - Cough | | | | | t | and | | | | | | wheeze | | | | | - Referre | | | | | | d | - Orthopn | | | | | pain | oea | | | | | down | SOB | | | | | arm, | worse | | | | | mandibu | when | | | | | lar | lying | | | | | pain or | flat | | | | | reflux | | | | | | | - Paraoxy | | | | | - Dyspnoe | smal | | | | | a | nocturn | | | | | or | al | | | | | fatigue | dyspnoe | | | | | -- | a | | | | | sweatin | SOB | | | | | g, | that | | | | | nausea, | wakes | | | | | abdomin | them up | | | | | al | at | | | | | pain | night. | | | | | and | Relieve | | | | | syncope | d | | | | | | with | | | | | | upright | | | | | | sitting | | | | | | | | | | | | - Fluid | | | | | | retenti | | | | | | on | | | | | | pulmona | | | | | | ry | | | | | | and | | | | | | periphe | | | | | | ral | | | | | | oedema | | | | | | | | | | | | - Enlarge | | | | | | d | | | | | | liver | +-------------+-------------+-------------+-------------+-------------+ | **Dx** | - Cardiac | | - Criteri | - | | | stress | | a | | | | testing | | ↑ | | | | (more | | troponi | | | | communi | | n, | | | | ty | | ischemi | | | | outpati | | c | | | | ent) | | symptom | | | | | | s, | | | | - Coronar | | ECG | | | | y | | changes | | | | angiogr | | , | | | | aphy | | abnorma | | | | (GOLD | | lities | | | | STANDAR | | | | | | D) | | | | +-------------+-------------+-------------+-------------+-------------+ Aetiology of COPD and Restrictive lung disease ---------------------------------------------- +-------------+-------------+-------------+-------------+-------------+ | | **COPD** | **Asthma** | **Emphysema | **Chronic | | | | | ** | Bronchitis* | | | | | | * | +=============+=============+=============+=============+=============+ | **Aetiology | - Caused | - Exposur | - The | - Expecto | | ** | by | e | lung | ration | | | signifi | to some | tissue | on most | | | cant | viral | involve | days | | | exposur | infecti | d | for at | | | e | ons | in | least 3 | | | to | in | exchang | months | | | noxious | infancy | e | in the | | | particl | | of | year | | | es | - Nonster | gases | for at | | | or | oidal | is | least 2 | | | gases | anti-in | impaire | consecu | | | | flam | d | tive | | | - Smoking | drugs | or | years | | | , | | destroy | | | | polluta | - Irritan | ed | - At | | | nts, | t | | baselin | | | socioec | e.g. | - The | e | | | onomic | smoke, | alveoli | (withou | | | status, | polluti | don't | t | | | asthma, | on, | exchang | infecti | | | infecti | chemica | e | on), | | | ions | ls | gases | sputum | | | | | during | is | | | - Genetic | - Viral | ventila | general | | | s, | upper | tion | ly | | | airway | respira | -- | opalesc | | | hyperre | tory | little | ent | | | sponsivenes | infecti | to no | in | | | s, | on | movemen | colour | | | poor | | t | | | | lung | - Allerge | of gas | | | | growth | ns | out of | | | | in | e.g. | the | | | | childho | dust, | alveoli | | | | od | fur, | | | | | | mould | | | | | | | | | | | | - Heredit | | | | | | ary | | | | | | | | | | | | - An | | | | | | inherit | | | | | | ed | | | | | | tendanc | | | | | | e | | | | | | to | | | | | | develop | | | | | | allergi | | | | | | es | | | +-------------+-------------+-------------+-------------+-------------+ | **Pathophys | - Common, | - Heterog | - | - Mucous | | iology** | prevent | eneous | | gland | | | able | disease | | hypertr | | | and | | | ophy | | | treatab | - Chronic | | | | | le | airway | | - Cilial | | | disease | inflamm | | dysfunc | | | | ation | | tion | | | - Due to | | | | | | airway | - Smoking | | - Chronic | | | and/or | = ↑ | | inflamm | | | alveola | risk of | | ation | | | r | exacerb | | and | | | abnorma | ations, | | narrowi | | | lities | ↓ | | ng | | | | effecti | | of | | | - Persist | veness | | small | | | ent | of | | airways | | | respira | inhaled | | | | | tory | cortico | | | | | symptom | steroids | | | | | s | | | | | | and | - Sedenta | | | | | airflow | ry | | | | | limitat | lifesty | | | | | ion | le | | | | | | -- but | | | | | | some | | | | | | can be | | | | | | exacerb | | | | | | ated | | | | | | by | | | | | | exercis | | | | | | e | | | | | | EIA | | | | | | | | | | | | - Obesity | | | | | | = ↑ | | | | | | treatme | | | | | | nt | | | | | | complic | | | | | | ations | | | +-------------+-------------+-------------+-------------+-------------+ | **Clinical | - Barrel | - \>1 | - Long | - | | features** | chest | symptom | term, | | | | | (wheeze | progres | | | | - Accesso | , | sive | | | | ry | SOB, | obstruc | | | | muscle | cough, | tive | | | | use | chest | lung | | | | | tightne | disease | | | | - ↓ | ss) | -- | | | | breath | | causes | | | | sounds | - Symptom | SOB due | | | | on | s | to | | | | auscult | worse | over-in | | | | ation | at | flation | | | | | night | of | | | | - O2 | or in | alveoli | | | | desatur | early | and | | | | ation | morning | destruc | | | | | | tion | | | | - Hyperin | - Symptom | of | | | | flation | s | alveola | | | | on | vary | r | | | | chest | over | walls | | | | radiogr | time | | | | | aph | and in | - Noxious | | | | | intensi | thing | | | | - ↓ | - Symptom | atory | | | | Functio | s | immune | | | | nal | are | cells | | | | exercis | trigger | respond | | | | e | ed | -- | | | | capacit | by | destruc | | | | y | viral | tion | | | | -- 6MWT | infecti | of | | | | | ons | lungs | | | | - Gold | (colds) | epithel | | | | 1-4 | , | ial | | | | | exercis | barrier | | | | - MRC | e, | | | | | scale | allerge | - Abnorma | | | | | n | l | | | | - CAT ax | exposur | permane | | | | | e, | nt | | | | - Therefo | changes | enlarge | | | | re, | in | ment | | | | ABCD Ax | weather | of air | | | | Tool | , | spaces | | | | | laughte | | | | | | r, | - Destruc | | | | | irritan | tion | | | | | ts | of | | | | | e.g. | alveola | | | | | car | r | | | | | exhaust | walls | | | | | , | and | | | | | fumes, | without | | | | | smoke, | obvious | | | | | strong | fibrosi | | | | | smells | s | | +-------------+-------------+-------------+-------------+-------------+ | **Managemen |  | ler | | | | | | (preven | | | | | | ter) | | | | | | medicat | | | | | | ions | | | | | | ↓ | | | | | | airway | | | | | | inflamm | | | | | | ation, | | | | | | control | | | | | | symptom | | | | | | s, | | | | | | ↓ | | | | | | future | | | | | | risk of | | | | | | exacerb | | | | | | ations | | | | | | and | | | | | | reducti | | | | | | on | | | | | | in lung | | | | | | functio | | | | | | n | | | | | | | | | | | | - Reliver | | | | | | (rescue | | | | | | ) | | | | | | medicat | | | | | | ion | | | | | | Ventoli | | | | | | n, | | | | | | salbuta | | | | | | mol | | | | | | (bronch | | | | | | odilators | | | | | | or | | | | | | steroid | | | | | | s) | | | | | | | | | | | | - Add on | | | | | | therapi | | | | | | es | | | | | | for | | | | | | severe | | | | | | asthma | | | | | | -- | | | | | | other | | | | | | meds, | | | | | | non-dru | | | | | | g | | | | | | therapi | | | | | | es | | | | | | (breath | | | | | | ing | | | | | | exercis | | | | | | es) | | | +-------------+-------------+-------------+-------------+-------------+