Acute Coronary Syndromes And Cardiac Conditions Dr. Ross Exam 4

Question 1

Acute coronary syndrome is which of the following:
A. Unstable angina
B. Acute myocardial infarction
C. STEMI
D. NSTEMI
E. All of the above

Answer 1

E. All of the above

Question 2

Is stable angina part of acute coronary syndrome? Y/N

Answer 2

No, not acute

Question 3

What is good for predicting population risks for coronary artery disease?
A. Chest pain
B. Upper abd pain
C. Past history
D. EKG in isolation

Answer 3

C. Past history

Question 4

Label the following as acute or non-acute:

1. Unstable angina
2. Stable angina
3. Aortic dissection
4. Pericarditis

Answer 4

1. Acute
2. Non-acute
3. Acute
4. Non-acute

Question 5

What non-cardio things can cause chest pain?

Answer 5

Pulmonary embolism
Pneumonia
Spontaneous pneumothorax (tall white dudes)
GERD
Peptic ulcer
Pancreatitis
Costrochondritis/broken rib
Anxiety

Question 6

Clinical description of stable vs unstable angina:

Answer 6

Stable angina is when you get chest pain symptoms during moderate physical activity or when you are pushing yourself physically. These symptoms go away with rest/nitro.

Unstable angina is chest pain while doing very little or resting and it intensifies.

Question 7

Name this cause of acute chest pain:

Usually >30mins duration
Assoc. symptoms include dyspnea, weakness, diaphoresis

Answer 7

Myocardial infarction (MI) heart attack

Question 8

Name the cause of this acute chest pain:

Chest pain that occurs during moderate physical exercise

Answer 8

Stable angina

Question 9

Name the cause of this acute chest pain:

Chest pain occurs at rest or with minimal exertion

Answer 9

Unstable angina

Question 10

Name this cause of acute chest pain:

Sudden, severe pain, may radiate to back
Commonly associated with HTN or connective tissue disease

Answer 10

Aortic dissection

Question 11

Name the cause of this acute chest pain:

Pleuritic pain, worse in supine position
Fever, pericardial friction rub

Answer 11

Pericarditis

Question 12

Name the cause of this acute chest pain:

Sudden onset of pain, dyspnea, tachypnea, tachycardia

Answer 12

Pulmonary embolism PE

Question 13

Name the cause of this acute chest pain:

May be assoc. with localized pleuritic pain
Cough, fever, crackles

Answer 13

Pneumonia

Question 14

Name the cause of this acute chest pain:

Unilateral pleuritic pain assoc. with dyspnea and sudden onset

Answer 14

Spontaneous pneumothorax

Question 15

Name the cause of this acute chest pain:

Burning retrosternal and epicanthic discomfort
Aggravated by large meals and post-radial recumbency

Answer 15

GERD/esophageal reflux

Question 16

Name the cause of this acute chest pain:

Atypical symptoms for any organ system
Symptoms may persist despite negative evaluations of multiple organ systems

Answer 16

Psychological (like anxiety: saw this a lot in the ED)

Question 17

A heart score of 0-3:

Answer 17

2.5% chance of major acute coronary event (MACE) in next 6 weeks, discharge home

Question 18

A heart score of 4-6:

Answer 18

20.3% chance of MACE over next 6 weeks, admit for clinical obs

Question 19

Heart score of 7-10:

Answer 19

72.7% chance of MACE over next 6 weeks, early invasive strategies (cath lab for stents; surgery for bypass)