ACS 5 - Early Mx

Question 1

first thing?
oxygen if?
baseline bloods incl ? and ?
what can you give chewed?
analgesic? 
what to give unless hypotensive?
MoANA

Answer 1

a-e
<94%
trop, clotting
aspirin 300mg
morphine
nitrates
Morphine, oxygen, aspirin, nitrates

Question 2

when to imm ref to cardio? for what?
when to use the GRACE score? this is when you add further meds..2?
all pt then referred - mx depends on acs type and grace score
grace score depends on many factors - gives a ?? at various ??

Answer 2

st elevation - pci
if nstemi
clopidogrel, fondaparinox
mort risk
time intervals

Question 3

STEMI
??? is gold standard - door to balloon in under ? minutes is worth pt transfer
two drugs given post procedure?
when is thrombolysis considered?

Answer 3

pci
90
clopidogrel
abciximab
when pci CId (eg many comorbidities)

Question 4

NSTEMI/UA
high risk -
grace score? or raised ?, persistent ?, ST ? or ?
get semi-elective ? as inpatient

low risk -
grace? or if it is unresolved ??
discharge with long term ?
potential for o/p ? test/? and elective pci

Answer 4

> 3% in 6m, trop, pain, depression, DM
pci

<3
unstable angina
meds
stress
angio

Question 5

how long must stay in bed? with continuous ?
2-3d of which bloods?
discuss needs with cardiology if ?
medication for thromboprophylx?
what given for LIFE? 2 (what is target HR?)
what given for a YEAR?

Answer 5

48h
ecg
trop, u+e
PCI recently/to be done
fondaparinox
aspirin, 75mg, bisoprolol 60bpm
clopidogrel

Question 6

what started after 2d?
address ? risk factors?
start oral nitrates if ?
discharge when ?

Answer 6

ACEi and statin
modifiable
angina
5-7d