Acute Coronary Syndrome

Question 1

Name 5 modifiable risk factors for acute coronary syndrome?

Answer 1

Smoking
Diabetes
High BP
Hypercholesterolaemia
Obesity

Question 2

Which two tests should be used for acs?

Answer 2

ECG
Troponin

Question 3

How should you initially manage ACS?

Answer 3

MONA

Morphine
Oxygen if <94%
Nitrates
Aspirin

Question 4

How should you manage STEMI?

Answer 4

Antiplatelet eg Clopidogrel, Prausgrel and Ticagrelor
PCI within 2 hours

Question 5

If using a PCI for Stemi and your patient has taken oral anticoagulants what medication should you prescribe?

Answer 5

Clopidogrel

Question 6

If using a PCI for stemi and your patient does not take oral anticoagulation what medication should you prescribe?

Answer 6

Prausegrel

Question 7

If your patient has a low risk of bleeding what medication should you give for NSTEMI/Unstable Angina when no immediate angiography?

Answer 7

Aspirin and Fondaparinux

Question 8

If your patient has a high risk of bleeding what medication should you give for NSTEMI/Unstable Angina and needs immediate angiography?

Answer 8

Unfractioned Heparin

Question 9

For an STEMI what is present on ecg at 3 days?

Answer 9

Q Waves

Question 10

How do NSTEMI’s present on ECG?

Answer 10

St Depression and T Wave Inversion

Question 11

What is Fondaparinux?

Answer 11

Blood thinner that selectively inhibits factor XA

Question 12

If thrombolysing a STEMI patient what should you use?

Answer 12

Telecteplase

Question 13

When should you never useTelecteplase with in STEMI thrombolysis?

Answer 13

Previous stroke or previous intracranial bleed

Question 14

Which leads would you expect to see changes for a STEMI in the Left Anterior Descending Artery

Answer 14

V1-4

Question 15

Which leads would you expect to see changes for a STEMI in the Right Coronary Artery?

Answer 15

IV, III, AVF

Question 16

Which leads would you expect to see changes for a STEMI in the Left Circumflex Artery?

Answer 16

I, V5-6

Question 17

Which leads would you expect to see changes for a STEMI in Right Coronary Artery?

Answer 17

Posterior Leads

Question 18

Which arrythmia complications can happen after ACS? (7)

Answer 18

Sinus Bradycardia
1st Degree AV Block
Morbitz Type 2 (Wenckleback Phenomena)
Sudden complete AV Block
Sinus Tachycardia
SVT
VT

Question 19

Sinus Bradycardia is a particular risk of ACS if there is a heart attack where?

Answer 19

Inferior MI

Question 20

1st Degree AV Block is a particular risk of ACS if there is a heart attack where?

Answer 20

Inferior MI

Question 21

Mobitz Type 2 gives a high risk of?

Answer 21

Sudden complete AV Block and needs paced

Question 22

How does Pericarditis present on ecg?

Answer 22

Saddle shaped and ST Elevation

Question 23

What happens to cardiac output and JVP in Right Ventricular Failure?

Answer 23

CO Decreases and JVP increases

Question 24

What happens to cardiac output in cardiac tamponade?

Answer 24

Decreased

Question 25

Name 3 features of cardiac tamponade?

Answer 25

Pulsus Paradoxus Kussmaul Sign Muffled Heart Sounds

Question 26

What kind of murmur is present in ventricular septal defect?

Answer 26

Pansystolic

Question 27

What happens to JVP in ventricular septal defect

Answer 27

Increased

Question 28

Name 4 Features of Dresslers related to ACS?

Answer 28

Recurrent Pericarditis Pleural Effusion Fever Anaemia

Question 29

Name 4 Features of Dresslers related to ACS?

Answer 29

Recurrent Pericarditis Pleural Effusion Fever Anaemia

Question 30

Which blood test is important to check in Dresslers?

Answer 30

ESR as it will be raised 1-3 weeks post MI

Question 31

How to treat Dresslers?

Answer 31

NSAIDS

Question 32

When should CABG be used? (2)

Answer 32

Unstable Angina Triple Vessel Disease

Question 33

What medications should be given for a year after an MI?

Answer 33

Aspirin and Ticagrelor or Clopidogrel