ACS

Question 1

Right coronary artery supplies the

Answer 1

Right atrium and ventricle
Inferior left ventricle
Posterior septal area

Question 2

Left coronary artery divides into

Answer 2

Circumflex artery
left anterior descending artery

Question 3

Circumflex artery supplies

Answer 3

left atrium
posterior left ventricle

Question 4

Left anterior descending supplies the

Answer 4

anterior left ventricle
anterior septum

Question 5

ECG changes in a STEMI

Answer 5

ST segment elevation
New left bundle branch block

Question 6

ECG changes in an NSTEMI

Answer 6

ST segment depression
T wave inversion

Question 7

Pathological Q waves suggest

Answer 7

deep infarction involving the full thickness of the heart

Question 8

Q waves typically appear

Answer 8

6 or more hours after the onset of symptoms

Question 9

Left coronary artery infarction will show on ECG leads

Answer 9

I, aVL, V3-V6

Question 10

Left anterior descending infarction will show on ECG leads

Answer 10

V1-V4

Question 11

Circumflex artery infarction will show on ECG leads

Answer 11

I, aVL, V5-6

Question 12

Right coronary artery infarction will show on ECG leads

Answer 12

II, III and aVF

Question 13

PCI should be performed in STEMI patients

Answer 13

within 2 hours of presenting

Question 14

Alternative causes for a raised troponin other than an MI

Answer 14

CKD, sepsis, myocarditis, aortic dissection, PE

Question 15

If PCI cannot be performed within 2 hours thrombolytics such as … should be used

Answer 15

streptokinase, alteplase, tenecteplase

Question 16

mnemonic for the management of an NSTEMI

Answer 16

BATMAN

Question 17

management of an NSTEMI

Answer 17

Base the decision about angiography based of a GRACE score
Aspirin 300mg
Ticagrelor
Morphine
Antithrombin (fondaparinux)
Nitrate

Question 18

What does a GRACE score calculate

Answer 18

6 month probability of death after an NSTEMI

Question 19

A GRACE score above… suggests medium to high risk and means patients should be considered for early angiography

Answer 19

3%

Question 20

Complications of MI

Answer 20

Death
Rupture of the heart septum or papillary muscles
oedema
Arrhythmia
Aneurysm
Dressler’s syndrome

Question 21

Dressler’s syndrome usually occurs

Answer 21

2-3 weeks after an MI

Question 22

What is Dressler’s syndrome

Answer 22

localised immune response causing pericarditis

Question 23

Prolonged ST elevation after MI is indicative of

Answer 23

Left ventricular aneurysm