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1internyearprep > ACS!! > Flashcards

ACS!! Flashcards

1
Q

TIMI Score - A

A

age greater than 65
aspirin use in last week
2 or more episodes of angina in past 24 hours

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2
Q

TIMI Score - B

A

cardiac biomarkers

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3
Q

TIMI Score - C

A

CAD risk factors (htn, hld, dm, smoker, family hx)

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4
Q

TIMI Score - D

A

documented CAD with greater than 50% stenosis

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5
Q

TIMI Score - E

A

EKG Changes

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6
Q

What risk are we looking at w/ TIMI Score?

A

Risk of death/mi/urgent revasculariation in 14 d in pts with UA/NStEMI

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7
Q

Risk and TIMI

A

low - 02, inter 3-4, high 5-7

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8
Q

Family History of MI age

A

first degree relative
les than 55 for males
less than 65 for females

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9
Q

PCI - time frame

A

90 min from first medical contact

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10
Q

Thrombolytic therapy - time frame

A

30 minutes door to needle

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11
Q

STEMI Protocol - first 5 minutes

A

O2, 12 lead

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12
Q

STEMI Protocol - first 15 min

A

ASA 324 chewed
heparin 50u/kg IV
Plavix 600mg po

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13
Q

Prasugrel contraindictions

A

stroke or TIA as it increases risk for cerebral hemorrhage

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14
Q

ACS Medial treatment per Dr. Smyth

A 
Aspirin 81.  
P2y12 antagonist - for at least year
Beta blockers - at least year
ACEI
Aldosterone blockers
statin
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15
Q

ACEI if…

A

CHF, ef

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16
Q

Aldosterone blockade if…

A

ACEI + EF

17
Q

Discharge and MI Risk Reduction - A

A

aspirin and anti-anginals

18
Q

Discharge and MI Risk Reduction - B

A

beta blockers and BP

19
Q

Discharge and MI Risk Reduction - C

A

cholesterol and cigarettes

20
Q

Discharge and MI Risk Reduction - D

A

diet and diabetes

21
Q

Discharge and MI Risk Reduction - E

A

exercise and education about smoking cessation

22
Q

Typical Angina

A

1) substernal chest discomfort w/ characteristic quality and duration that is
2) provoked by exertion or emotional stress
3) relieved by rest or NG

23
Q

Atypical angina

A

2 characteristics

24
Q

Noncardiac chest pain

A

1 or 0 characteristics

25
Q

Very Low risk and diagnosing IHD

A

risk reduction

no additional testing due to high false positives

26
Q

Low risk and diagnosing IHD

A 
exercise test (High NPV)
Coronary CTA/calcium score
27
Q

Intermediate risk and diagnosing IHD

A

exercise test plus or minus imaging (echo/nuc/mri)
pharmagological + imaging
coronary CTA

28
Q

High risk and diagnosing IHD

A

cardiac cath w/ coronary angiogram

no imaging due to high false neg

29
Q

Features that make MI less likely

A

pleuritic chest pain
sharp or stabbing pain
positional chest pain
reproducible chest pain

30
Q

Early repolarization often has

A

J-point elevation

rapidly, up-sloping or normal ST segment

31
Q

Conditions that cause ST elevation

A 
MI. 
Vasospasm, Pericardiatis, LV aneurysm after Mi
Early repolarization
LVH
LBBB
Hypothermia (prom J waves)
Hyperkalemia (advanced)

1internyearprep (9 decks)

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