ACS

Question 1

Angina

Answer 1

• transient occlusion

- no necrosis —> no troponin

Question 2

STEMI

Answer 2

• complete occlusion
• necrosis —> troponin
• transmural

Question 3

NSTEMI

Answer 3

• transient occlusion
• necrosis —> troponin
• sub endocardial

Question 4

Silent infarct

Answer 4

Infarct with no chest pain

Question 5

SI epi

Answer 5

• elderly

- diabetes

Question 6

ECG STEMI

Answer 6

• ST elevation

- new LBBB

Question 7

ECG NSTEMI

Answer 7

• ST depression
• T wave inversion
• Pathological Q waves

Question 8

Troponin ++ in

Answer 8

N/STEMI

Question 9

CXR ACS

Answer 9

• cardiomegaly
• p oedema
• ride mediastinum

Question 10

Acute STEMI 1st line intervention within 2 hours

Answer 10

PCI

Question 11

Acute STEMI 2nd line intervention if 1st line isn’t done

Answer 11

Thrombolysis

Question 12

Acute NSTEMI medication (BATMAN)

Answer 12

• beta-blockers
• aspirin
• ticagrelor
• morphine
• anticoagulant
• nitrates

Question 13

FXa inhibitor anticoagulant used in acute NSTEMI

Answer 13

Fondaparinux

Question 14

GRACE score

Answer 14

6m risk of death or repeat MI after ACS

Question 15

When is early PCI considered with relation to GRACE score & what % is that

Answer 15

Medium: 5-10%

Question 16

2ry prevention in ACS (6As)

Answer 16

• aspirin
• another anti platelet
• atrovastatin
• ACEi
• atenolol
• aldosterone

Question 17

Complications of ACS (DREAD)

Answer 17

• death
• rupture
• edema
• arrhythmia & aneurysm
• Dressler’s syndrome

Question 18

Dressler’s syndrome

Answer 18

Pericarditis 2-3w post MI

Question 19

Dressler’s features

Answer 19

• pleural chest pain
• fever
• pericardial rub
• effusion
• tamponade

Question 20

Dressler’s management

Answer 20

• NSAIDs

- steroids

Question 21

If mechanical thrombolysis is not used what chemical thrombolytic is used in acute STEMI

Answer 21

Tissue plasminogen activator