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Internal Medicine > #15: ACS > Flashcards

#15: ACS Flashcards

1
Q

Opening statement

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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2
Q

⭐ definition of AMI

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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3
Q

Categories of AMI

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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4
Q

Epidemiology

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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5
Q

Risk factors?

A

Sfts

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6
Q

Pathophysiology

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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7
Q

⭐ Pathologic types of MI

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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8
Q

Explain the radiation to left arm etc

A

Sfts

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9
Q

Anginal equivalents?

A

Sfts

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10
Q

⭐Clinical manifestations

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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11
Q

Differentials?

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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12
Q

What to ask in the prinary history

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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13
Q

What to ask in the secondary history?

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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14
Q

What to ask in the tertiary histor?

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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15
Q

What to look for in PE?

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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16
Q

What is S3

A

The third heart sound (S3), also known as the “ventricular gallop,” occurs just after S2 when the mitral valve opens, allowing passive filling of the left ventricle. The S3 sound is actually produced by the large amount of blood striking a very compliant left ventricle.

CLINICAL PEARL: A S3 heart sound is often a sign of systolic heart failure, however it may sometimes be a normal finding.

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17
Q

What is S4

A

The fourth heart sound (S4), also known as the “atrial gallop,” occurs just before S1 when the atria contract to force blood into the left ventricle. If the left ventricle is noncompliant, and atrial contraction forces blood through the atrioventricular valves, a S4 is produced by the blood striking the left ventricle.

CLINICAL PEARL: A S4 heart sound is often a sign of diastolic heart failure, and it is rarely a normal finding (unlike a S3).

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18
Q

⭐ How to diagnose MI

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

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19
Q

What to request?

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

20
Q

How to determine NSTEMI and STEMI on ECG

21
Q

Management of Unstable angina?

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

22
Q

Discuss the cardiac enzymes and markers

23
Q

⭐ Management of NSTEMI?

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

24
Q

Goals of Tx in NSTEMI

25
Q

Discuss anti ischemic therapy

26
Q

Discuss nitrates

27
Q

Discuss beta blockers

28
Q

Discuss CCBs

29
Q

Discuss morphine

30
Q

What is dual antithrombotic therapy

31
Q

Discuss aspirin

32
Q

Discuss clopidogrel

33
Q

Discuss enoxaparin

34
Q

Discuss statin therapy

35
Q

⭐ management of STEMI

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

36
Q

What are your goals in tx for STEMI

37
Q

Discuss reperfusion therapy

38
Q

Indications of PCI

39
Q

Absolute contraindications to fibrinolytic therapy

A

Absolute contraindications
• Any prior ICH
• Known structural cerebral vascular lesion (e.g., arteriovenous malformation)
• Known malignant intracranial neoplasm (primary or metastatic)
• Ischemic stroke within 3 mo
• EXCEPT acute ischemic stroke within 4.5 h
• Suspected aortic dissection
• Active bleeding or bleeding diathesis (excluding menses)
• Significant closed-head or facial trauma within 3 mo
• Intracranial or intraspinal surgery within 2 mo
• Severe uncontrolled hypertension (unresponsive to emergency therapy)
• For streptokinase, prior treatment within the previous 6 mo
(AHA, 2013)

40
Q

Relative contraindications to fibrinolytic therapy

A

Relative contraindications
• History of chronic, severe, poorly controlled hypertension
• Significant hypertension on presentation (SBP >180 mm Hg or DBP >110 mm Hg)
• History of prior ischemic stroke >3 mo
• Dementia
• Known intracranial pathology not covered in absolute contraindications
• Traumatic or prolonged (>10 min) CPR
• Major surgery (<3 wk)
• Recent (within 2 to 4 wk) internal bleeding
• Noncompressible vascular punctures
• Pregnancy
• Active peptic ulcer
(AHA, 2013)

41
Q

Indications for CABG

43
Q

Supportive care post-MI

44
Q

Discuss pharmaco therapy for STEMI

45
Q

Prognosis

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

45
Q

Preventive aspect of mgt

A

“Excuse me while I kiss the stars.”

-Kobe Bryant

46
Q

What is the universal classification of MI?

A

Be micro-ambitious

47
Q

What is anginal pain?

A

Be micro-ambitious

Internal Medicine (13 decks)

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