ACS & Stable Angina

Question 1

CYP enzyme that metabolizes clopidogrel?

Answer 1

CYP2C19; *NO renal adjustment required

Question 2

at risk of atypical angina?

Answer 2

-females
-elderly
-diabetic patients

Question 3

Aspirin dosage?

Answer 3

Dosage for ACS:
-Load: 160mg PO x 1
-Maintenance: 81mg PO daily

Question 4

Contraindications to fibrinolytic therapy :

Answer 4

-current or prior intracranial hemorrhage (ICH)
-suspicion of aortic dissection, –intracranial neoplasm
-cerebrovascular lesions
-severe hypertension
-serious head trauma or stroke
within the last 3 months, active bleeding, and current anticoagulant use.

Question 5

warfarin-induced bleeding showing signs/symptoms is treated by _____.

Answer 5

Admit to hospital
Vitamin K 10 mg IV over 30mins
+Fresh Frozen Plasma (15-30 ml/kg)

-OR-
Prothrombin Complex Conc. (25-50 IU/kg)

Question 6

warfarin-induced bleeding that shows no signs/symptoms is treated by_____?

Answer 6

INR 4-10: Interrupt warfarin and closely monitor the patient
(*ONLY CONSIDER VIT-K 1-2.5MG PO IN PATIENTS AT HIGH RISK)
INR >10: Interrupt warfarin & give vit.K P.O. 2.5mg-5mg w/ close outpatient follow up

Question 7

T/F: Dual anti-platelet therapies are recommended in ischemic heart disease

Answer 7

FALSE;

Question 8

treatment duration for emergency hypertensive crisis?

Answer 8

gradual bp lowering over hours

Question 9

treatment duration for urgency hypertensive crisis?

Answer 9

gradual bp lowering over 1-2 days

Question 10

the preferred method of measuring blood pressure set in place by the guidelines?

Answer 10

automated office blood pressure