CHAPTER 4 THE CARDIOVASCULAR HISTORY

CHEST PAIN

PAGE QUESTION
45 Describe the pathophysiological basis of angina or myocardial infarction pain.
Why are those with diabetes more likely to be diagnosed with silent infarct?
47 Is ischaemic pain usually affected by respiration?
If the chest pain is affected by respiration, which diagnoses are more likely?
Name >4 differences between angina & myocardial infarction pain.
48 Describe the typical location, radiation, aggravating and relieving factors of typical
angina.
How does atypical angina differ?
Patient present for > ____ minutes is more likely to be ACS than angina.
What about pain lasting for several days continuously?
Name >4 associated symptoms of ACS.
Define pleuritic pain.
2 main causes?
Pleurisy can be primary or secondary to what causes?
Often relieved by?
Name >3 characteristics of chest wall pain
Name >3 specific characteristics of aortic dissection pain
How can you clinically differentiate b/w proximal & descending aortic
dissection?
3 risk factors for aortic dissection
>2 features of chest pain from massive PE
Characteristics of pain in spontaneous pneumothorax

DYSPNOEA

PAGE QUESTION








ANKLE SWELLING

PAGE QUESTION
49







PALPITATIONS

PAGE QUESTION








SYNCOPE, PRESYNCOPE AND DIZZINESS

PAGE QUESTION








CHAPTER 31 THE NEUROLOGICAL HISTORY

PRESENTING SYMPTOMS

PAGE QUESTION
393 Most important aspect of neurological symptoms to determine underlying aetiology?
Acute onset of symptoms suggests an underlying _______ problem.
Give >3 examples of vascular causes.
What symptoms are very suggestive of a major or complex partial seizure?
Stroke/CVA causes symptoms appearing over how long typically?
Definition of a TIA
Symptoms characteristic of a hemiplegic migraine?
Why may it be difficult to differentiate with a TIA?
How do you differentiate between a myopathy and a vascular event?
Subacute onsets suggests what type of underlying pathology?
394 More chronic symptoms from weeks to months to years suggests what type of
underlying aetiology?
2 main aims of the history and examination
4 levels of the nervous system
What do you ask about after presenting problems in the history?

HEADACHES AND FACIAL PAIN

PAGE QUESTION
394 Main difference between common & classical migraine?
395 Describe the typical pain seen in cluster headache
3 associated symptoms?
Typical pattern of presentation?
Typical headache of a raised ICP?
When is it worse?
Name some associated symptoms
Typical headache seen in meningitis?
Name >3 associated symptoms
Typical headache seen in temporal arteritis?
Typical site
Associated symptoms
Typical headache seen in acute sinusitis?
Associated symptoms?
Typical headache seen in subarachnoid haemorrhage?
Associated symptoms?
Typical headache seen in idiopathic intracranial hypertension?
It is more commonly seen in who?
The most frequent type of headache
Typical sites?
Typical sensation / description of pain
Associated symptoms
How can one differentiate between migraine & tension headache?
Name each letter of the mnemonic
Name >3 causes for pain of the face.

FAINTS AND FITS

PAGE QUESTION
395 Name >5 differentials for syncope (transient LOC)
Name >4 associated features seen in generalized tonic-clonic seizures
2 possible causes of seizures affecting only one part of a body?
Difference b/w complex and simple seizures
Typical presentation of absence seizures
Most commonly seen in?
Definition of drop attacks? Is there typically aura associated?
396 Associated symptoms of hypoglycaemia before LOC?
BOX
31.4
For a patient with syncope, how do you ask for suspected:
Postural hypotension
Vertigo
LV outflow obstruction
Micturition syncope
What are 3 important types of drugs which can cause dizziness or syncope?
1 commonality & 1 difference b/w cardiac syncope & seizure?

DIZZINESS

PAGE QUESTION
396 Definition of true vertigo
3 associated symptoms
2 key factors to help with your differentials of vertigo?
Name >4 differentials
What causes BPV and vestibular neuronitis?
Name some ototoxic drugs. What does the vertigo it cause also associated with?
TABL
31.1
For the following diagnoses, describe whether the vertigo is persistent/intermittent,
and if there is associated hearing loss:
Vestibular neuronitis
Benign positioning vertigo
Labryrinthitis
Menieres disease

VISUAL DISTURBANCES AND DEAFNESS

PAGE QUESTION
396 Define diplopia and amblyopia

DISTURBED SENSATION OR WEAKNESS IN THE LIMBS

PAGE QUESTION
397 Pins and needles in the hands & feet 2 main differentials?
Carpal tunnel syndrome is due to?
Main symptoms experienced
Typically worse when? Relieved by?
Definition of a UMN lesion
Effect on tone, reflexes and muscle bulk?
Greatest effect on which group of muscles? AKA?
Definition of a LMN lesion
Effect on tone, reflexes & muscle bulk?
Pattern/distribution of weakness in muscle disease
Effect on tone, reflexes & muscle bulk?
Pattern/distribution of weakness in NMJ disease (eg. myasthenia gravis)?
Effect on tone & reflexes?

TREMOR AND INVOLUNTARY MOVEMENTS

PAGE QUESTION
397 Definition of a tremor?
Difference b/w resting and intention tremors
Intention tremors are due to?
Parkinsons tremors are typically what type?
3 causes of exaggerated physiological tremor
Typical tremor seen in benign essential (familial) tremor
Most easily seen when?
TABL
31.3
(398)
Definition of:
Chorea
Dyskinesia
Hemiballismus
Myoclonic jerk

PAST HEALTH, MEDICATION, SOCIAL AND FAMILY HISTORY


PAGE QUESTION
397 Name >5 relevant conditions to ask for in a patient with neurological symptoms
LIST
31.1
(393)
Name >5 risk factors for cerebrovascular disease
398 Name >5 groups of medications you should ask about in the medication history
If a neurological disease affects ones ability to work and look after themselves, what
are some relevant topics in the social history?
TABL
31.4
(399)
Name at least 4 inheritied neurological conditions to ask for bonus points if you can
also name the mode of inheritance.