ACUTE CORONARY SYNDROMES (STEMI, NON-STEMI, ETC)

Question 1

COMPARING UA, NSTEMI, STEMI
SYMPTOMS

Answer 1

CHEST PAIN

Question 2

COMPARING UA, NSTEMI, STEMI
CARDIAC ENZYMES

Answer 2

POSITIVE IN STEMI AND NSTEMI

Question 3

COMPARING UA, NSTEMI, STEMI
ECG CHANGES

Answer 3

ST ELEVATION IN STEMI
NONE OR TRANSIENT IN UA AND NSTEMI

Question 4

COMPARING UA, NSTEMI, STEMI
BLOCKAGE

Answer 4

COMPLETE IN STEMI
PARTIAL IN UA AND NSTEMI

Question 5

HOW IS NSTEMI TYPICALLY TREATED

Answer 5

USUALLY MEDICATIONS ALONE
“MEDICAL MANAGEMENT”
OR USING PCI

Question 6

HOW IS STEMI TYPICALLY TREATED

Answer 6

PCI
IF PCI DELATED, FIBRINOLYTICS

Question 7

DRUG TREATMENT FOR ACS

Answer 7

MONA-GAP-BA
MORPINE
OXYGEN
NITRATES
ASA
*
GPIIb/IIIa ANTAGONISTS
ANTICOAGULANTS
P2Y12 INHIBITORS
*
BETA BLOCKERS
ACEi

Question 8

WHAT IS THE TREATMENT FOR NSTE-ACS

Answer 8

MONA-GAP-BA +/- PCI

Question 9

WHAT IS THE TREATMENT FOR STEMI

Answer 9

MONA-GAP-BA + PCI OR FIBRINOLYTICS

Question 10

WHAT ARE THE GPIIb/IIIa AGENTS

Answer 10

ABCIXIMAB
EPTIFIBATIDE
TIROFIBAN

Question 11

WHAT ARE THE ANTICOAG AGENTS

Answer 11

LMWH, UFH, BIVALIRUDIN

Question 12

WHAT ARE THE P2Y12 INHIBITORS

Answer 12

CLOPIDOGREL
PRASUGREL
TICAGRELOR

Question 13

HOW SOON SHOULD BB BE GIVEN DURING ACS

Answer 13

WITHIN 24 HOURS
↑ LONG TERM SURVIVAL

Question 14

HOW SOON SHOULD ACEi BE GIVEN DURING ACS

Answer 14

ORAL ONLY
WITHIN 24 HOURS IF LVEF < 40% AND THOSE WITH HTN, GM, STABLE CKD

Question 15

PRASUGREL BOXED WARNING

Answer 15

DO NOT INITIATE IF CABG LIKELY
STOP AT LEAST 7 DAYS PRIOR TO ELECTIVE SURGERY

Question 16

TICAGRELOR AND ASA CONSIDERATIONS

Answer 16

ASA DOSE SHOULD NOT EXCEED 100 MG AS MAINTENANCE DOSE

Question 17

TICAGRELOR BOXED WARNINGS

Answer 17

AVOID IF CABG LIKELY
STOP 5 DAYS BEFORE ANY SURGERY

Question 18

CANGRELOR FORMULATION

Answer 18

INJECTION

Question 19

REOPRO

Answer 19

ABCIXIMAB

Question 20

TERGRILLIN

Answer 20

EPTIFIBATIDE

Question 21

WHEN ARE FIBRINOLYTICS USED

Answer 21

ONLY FOR STEMI

Question 22

HOW SOON SHOULD PCI OCCUR

Answer 22

WITHIN 90 MINUTES (OPTIMAL DOOR-TO-BALOON TIME)
OR
WITHIN 120 MINUTES OF FIRST MEDICAL CONTACT

Question 23

HOW SOON SHOULD FIBRINOLYTIC BE STARTED

Answer 23

IF PCI NOT POSSIBLE IN THE RECOMMENDED TIME FRAME, FIRBINOLYTICS SHOULD BE INITIATED WITHIN 30 MINUTES OF HOSPITAL ARRIVAL

Question 24

WHEN IS FIBRINOLYTICS CONTRAINDICATED

Answer 24

ACTIVE INTERNAL BLEEDING
HISTORY OF RECENT STROLE
SEVERE UNCONTROLLED HTN (NOT RESPONDING TO EMERGENCY THERAPY)

Question 25

SECONDARY PREVENTION
HOW LONG IS ASA INDICATED AT WHAT DOSE

Answer 25

81 MG DAILY
INDEFINITELY

Question 26

SECONDARY PREVENTION
P2Y12 INHIBITOR AGENT AND DURATION

Answer 26

IF RECEIVED FIBRINOLYTICS, TICAGRELOR OR CLOPIDOGREL FOR ≥ 12 MONTHS
PCI-TREATED: ANY P2Y12 FOR ≥ 12 MONTHS

Question 27

SECONDARY PREVENTION
NITROGLYCERIN DURATION

Answer 27

INDEFINITELY (PRN FOR ANGINA)

Question 28

SECONDARY PREVENTION
BETA BLOCKERS DURATION

Answer 28

3 YEARS AT LEAST
IF HF OR NEEDED FOR HTN, INDEFINITELY

Question 29

SECONDARY PREVENTION
ALDOSTERONE ANTAGONIST DURATION

Answer 29

INDEFINITELY IF EF<40% AND EITHER SYMPTOMATIC HF OR DM RECEIVING RTARGET DOSES OF ACEi AND BB

Question 30

SECONDARY PREVENTION
ALDOSTERONE ANTAGONIST CONTRAINDICATION

Answer 30

SIGNIFICANT RENAL IMPAIRMENT
HYPERKALEMIA

Question 31

SECONDARY PREVENTION
STATIN DURATION AND INTENSITY

Answer 31

INDEFINITELY AT HIGH INTENSITY
IF OLDER THE 75, MODERATE OR HIGH

Question 32

WHICH NSAID IS KNOWN TO HAVE THE LOWEST CARDIAC RISK

Answer 32

NAPROXEN