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Exam (elaborations)

CMN 574 Unit 1 Exam Questions and Answers 100% Solved

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  • CMN 574

CMN 574 Unit 1 Exam Questions and Answers 100% Solved Common causes of chest pain in the primary care office - Musculoskeletal/ chest wall pain Gastrointestinal disorders Anxiety/psychiatric disorders Respiratory disorders Stable angina Non-ischemic cardiac disorders Inflammatory disorders...

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  • October 31, 2024
  • 37
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CMN 574
  • CMN 574
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CMN 574 Unit 1 Exam Questions and

Answers 100% Solved


Common causes of chest pain in the primary care office -

✔✔Musculoskeletal/ chest wall pain

Gastrointestinal disorders

Anxiety/psychiatric disorders

Respiratory disorders

Stable angina

Non-ischemic cardiac disorders

Inflammatory disorders/infections

Causes of chest pain seen in Urgent care or ER - ✔✔Unstable angina/

Acute coronary syndrome

Pulmonary embolism

Pneumothorax

Esophageal rupture

Aortic dissection

How to manage chest pain - ✔✔Careful History & Physical Exam

,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
Risk assessment: what factors does this patient have that make a serious

cardiac cause more likely?

Focused testing

Referral to specialist or hospital

Non-cardiac causes of chest pain: Musculoskeletal disorders - ✔✔Most

common non-cardiac cause of chest pain: almost 40% of patients with CP

have a MS disorder/ chest wall pain

Chest wall pain most commonly caused by muscle strain or

costochondritis, less common causes are broken rib, herpes zoster,

fibromyalgia, fibrocystic breast, sickle cell crisis, chest wall contusions, or

protracted vomiting

More common in young, active patients involved in sports or work that

involves lifting.

MS chest pain - ✔✔Risk factors: trauma, overuse injury, hx of Chicken pox

Character and location of pain: ranges from sharp to dull, usually more

localized and can point to area with a finger. Zoster pain described as

burning and localized along a dermatone.

Aggravating factors: MS chest wall pain made worse with arm movement or

deep inspiration

Duration: gradual onset, longer duration

,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
Exam: chest wall pain often reproducible by palpation of the affected

muscles, ligaments or costochondral junction

Examine for rash associated with zoster, pain may occur before rash

develops

Tests: usually none indicated, Xrays if hx of trauma

Treatment: rest, anti-inflammatories, ice/heat

Non-cardiac chest pain: Gastrointestinal disorders - ✔✔GI disorders

account for 20-30% of patients with chest pain.

Causes include GERD, esophagitis, esophageal spasm, peptic ulcer

disease, hiatal hernia, and gallbladder disease

Factors increasing the likelihood are hx of ulcers, smokers, use of ETOH,

and use of NSAIDS or ASA.

Always ask about OTC pain medication use!

Gastrointestinal disorders - chest pain - ✔✔Character & Location: GERD

be described as substernal and burning pain, Eosphageal spasm may

present as substernal squeezing or pressure. PUD and pancreatitis may

present as epigastric pain radiating to the back.

Timing & duration: usually recurrent, may last minutes to hours.

Aggravating factors: worsened by meals, supine position

Relieved by: antacids, PPI, H2 blockers.

, ©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
Associated symptoms: nocturnal cough, flatus, belching, dysphagia

Exam findings: pain on palpation of epigastruim

Labs: test for H. pylori, EGD

Treatment: depends on cause: PPIs, antibiotics for H. pylori

Diet, elevate head of bed

Non-cardiac chest pain: Psychogenic causes - ✔✔Psychogenic causes

account for 10-20% of chest pain

Causes include stress-related disorders, panic attacks, and somatization

Stress also aggravates other conditions that cause CP such as GERD,

asthma, and angina

Psychogenic chest pain - ✔✔Character & location: varies. Panic disorder:

precordial CP, Depression: constant or intermittent heaviness unrelated to

meals or activity

Timing: sudden or gradual

Aggravating factors: stress, hx of panic disorder or depression

Associated symptoms: anxiety, dyspnea/ hyperventilation,

tingling/numbness or limbs, dizziness

Screening: 2 questions highly sensitive for panic disorder

1. "In the past 6 mo, did you ever have a spell or an attack when all of a

sudden you felt anxious, frightened, or very uneasy?"

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