Acute coronary syndrome

Question 1

indications for CABG?

Answer 1

3 vessel dz, left main, 2 vessel plus DM

Question 2

how long DAPT after DES?

Answer 2

1 year

Question 3

3 drugs that decrease mortality in ischmeic CM?

Answer 3

ACE, BB, statin

Question 4

who should not get BB?

Answer 4

concern oin asthmatics

Question 5

irreversible P2y12 inhibitors?

Answer 5

clopidogrel and ticagrelor

Question 6

brillinta versus clopidogrel

Answer 6

mortality benefit with brillinta

Question 7

prasugral other name?

Answer 7

effient

Question 8

MOa of prasugral?

Answer 8

reversible inhibition of P2y12

Question 9

concern with prasugrel?

Answer 9

more bleeding, contraindication in CVA hx

Question 10

when to use thrombolysis in ACS?

Answer 10

within 12 hours of CP onset

Question 11

if patient with high TIMI risk score or going to cath lab give what? and what is mechanism?

Answer 11

eptifibatide(integrillin), 2bIIIa inhibitor

Question 12

LAD lesion EKG?

Answer 12

V1-V4

Question 13

inferior MI affected by what vessel? what EKG findings?

Answer 13

RCA, II, III, AVF

Question 14

posterolateral MI what vessel, EKG findings?

Answer 14

left circ, I, II, III AVL

Question 15

patient with history of Raynauds an migrianes with chest pain

Answer 15

prinzmetal angina

Question 16

tx prinzmetal?

Answer 16

CCB, smoking cessation

Question 17

2-3 months post MI, diffuse STE, pericardial rub?

Answer 17

Dresslers syndrome

Question 18

MOA dresslers?

Answer 18

immune mediated damage to pericardium

Question 19

papillary muscle rupture signs?

Answer 19

pulmonary edema with systolic murmur at apex causing acute MR

Question 20

timing of papillary muscle rupture post MI?

Answer 20

3-5d

Question 21

test of choice to determine reinfarction?

Answer 21

CK Mb because shorter time to noramalization

Question 22

ventircular aneurysm post MI signs?

Answer 22

persistent STE, deep Q waves

Question 23

timing on ventricular aneurysm?

Answer 23

5d-3 months

Question 24

LV free wall rupture timing?

Answer 24

3-14 d psot MI

Question 25

pericarditis timing post MI?

Answer 25

1-3d

Question 26

Brugada syndrome MOA?

Answer 26

LOF Na channels

Question 27

Brugada EKG findings?

Answer 27

STE in V1/V2

Question 28

workup for Brugada?

Answer 28

need to get EP study

Question 29

LBBB QRS?

Answer 29

120-180 ms

Question 30

signs of LBBB?

Answer 30

RR in v6, SS in V1. T wave opposite ORS in anteroseptal and lateral leads

Question 31

how does aspirin work in acute MI?

Answer 31

plaque stabilization along with antithrombotic and antiinflammatory properties

Question 32

msot sensitive leads for detecting periop ischemia?

Answer 32

V4,V5, II

Question 33

patient post MI with now ischemic leg?

Answer 33

consider ECHO for LV thrombus

Question 34

type 3 MI?

Answer 34

instant death

Question 35

type 4 MI

Answer 35

associated with percutaenous intervention

Question 36

type 5 MI?

Answer 36

associated with CABG