CLPA Definitions Part 2

Normal BP

Systolic: < 120

Diastolic: < 80

Elevated BP

Systolic: 120 - 129

Diastolic: < 80

Hypertension Stage 1

Systolic: 130 - 139

Diastolic: 80 - 89

Hypertension Stage 2

Systolic: ≥ 140

Diastolic: ≥ 90

Hypertensive Crisis

Systolic: > 180

Diastolic: > 120

Tachycardia

> 100 BPM

Bradycardia

< 60 BPM

Bulging eyes

exophthalmos

Nystagmus

involuntary, rapid eye movements

Bacterial (conjunctivitis)

Purulent discharge

Viral (conjunctivitis)

Watery discharge

Allergic (conjunctivitis)

 Itching, watery discharge

Clear discharge

Allergic rhinitis, viral URI

Purulent discharge

bacterial or viral URI, sinusitis

Hemorrhagic discharge

Epistaxis (nosebleed)

Allergic rhinitis

Pale/blue mucosa with watery discharge

Infectious URI

Erythematous mucosa with purulent discharge

Qualitative tests

Results are binary (positive/negative) or categorical

Example: COVID-19 PCR test (positive or negative)

Quantitative tests

Provide a numerical value with a reference range

Example: Potassium level = 7.2 mEq/L (abnormal high)

TP (True Positive)

positive test, disease present

FP (False Positive)

positive test, disease absent

TN (True Negative)

negative test, disease absent

FN (False Negative)

negative test, disease present

D-dimer

serum test, measures a product of fibrin degradation, can be used as a preliminary test in the diagnosis of DVT

Vascular ultrasonography

assessment of vascular anatomical structures and blood flow using reflected ultrasonic waves

most commonly used to assess venous flow using ‘Doppler’ signal processing

Vascular diagnostic tests

angiography/arteriography, vascular ultrasonography, D-dimer

Angiography (/Arteriography)

X-ray of peripheral arteries after direct injection of radioopaque dye

BNP (B-type natriuretic peptide)

important role in regulating the circulation (they act on blood vessels)

They also work on the kidneys (excretion of more salt and water)

Useful for monitoring recovery from acute CHF

Cardiac Troponin (I and T)

remain elevated much longer than CK-MB

More sensitive to mild muscle injury then CK-MB (fewer false negatives, but many false positives)

Cardiac enzymes (in serum)

Useful only to identify infarction

CK-MB, Cardiac Troponin I and T

Doppler Echocardiography

generates real-time video images of structure and motion of interior heart components and blood flow through chambers (using reflection of ultrasonic waves)

CAD (Coronary Artery Disease) tests

Coronary angiography, ECG or imaging study

Arrhythmias

rhythm disturbances

Myocardial Infarct (/Ischemia) Tests

Electrocardiography (ECG or EKG), coronary angiography, serum labs

Cardiovascular system

consists of heart and blood vessels

Oxygen-poor blood

carried by the pulmonary circuit to the lungs

Systemic circuit

sends oxygen-rich blood to all body cells

SA node

sinoatrial node

AV node

atrioventricular node

First heart sound (S1)

caused by AV valves closing at start of systole

the lub in ‘lub-dub’

Second heart sound (S2)

caused by aortic (mostly) and pulmonic valves closing at start of diastole

The ‘dub’

S3 (‘gallop’)

adventitious heart sound

occurs early in diastole

pathological causes: ventricular failure, ventricular volume overload

S4

occurs late in diastole

may be physiological in endurance athletes

pathological cause: decreased ventricular compliance

IJV (internal jugular vein) pressure

a good estimate of central venous pressure