AMI/AIS

Question 1

FAST in stroke

Answer 1

Face drooping
Arm weakness
Speech difficulty
Time to call 995

Question 2

ABCD2 risk scoring

Answer 2

Age >60
bp >140/90
clinical features
duration of tia
diabetes

Question 3

PCI treatment

Answer 3

ufh bolus (+- eptifibatide),
LD and MD for antiplatelets within 24-48 hours
DAPT (aspirin + clopi/tica)

Question 4

duration of dapt for pci

Answer 4

ACS: 12m/6m
CCS: 6m/3m

take off dapt and change to sapt if high bleeding risk after 3 m

Question 5

what to do at ane for ais pt

Answer 5

thrombolytic once confirmed and within 3-4.5h

Question 6

what to do at icu for ais

Answer 6

dapt within 24-48h, oac after 24h of rtpa if indicated

Question 7

what to do at gen ward for ais

Answer 7

vtep w lmwh within 48h but after 24 hrs if rtpa used, ipc for high bleeding risk within 72h

Question 8

what to do at home for ais

Answer 8

sapt lifelong, dapt duration for 21/90d

Question 9

aspirin dosing

Answer 9

load 300mg fb 100mg OM lifelong

Question 10

clopidogrel dosing

Answer 10

load 300/600mg fb 75mg OM

Question 11

dipyridamole dosing

Answer 11

25-150mg tds

Question 12

aspirin ae

Answer 12

bleed

Question 13

clopi ae

Answer 13

hypersensitivity, bleed

Question 14

dipyridamole ae

Answer 14

flushing, dizziness, ab distress

Question 15

ticagrelor dose

Answer 15

load 180mg fb 90mg BD up to 12m, then 60mg BD

Question 16

eptifibatide dose

Answer 16

double bolus of 180µg/kg at 10min interval, fb infusion of 2µg/kg/min for up to 18h

infused for 72h

Question 17

ticagrelor ae

Answer 17

bleeding, dyspnea, bradycardia

Question 18

eptifibatide avoid in

Answer 18

end stage renal disease, dose adj below crcl<50

Question 19

why is tica preferred over clopi

Answer 19

recovery from stopping ticagrelor twice as rapid
no cyp2c19 polymorphism issue (LoF)

Question 20

AIS: if eligible for rtpa

Answer 20

start sapt within 24-48h, lifelong treatment

Question 21

AIS: if ineligible for rtpa, minor stroke / high risk TIA

Answer 21

dapt 21d, then lifelong sapt

Question 22

AIS: if ineligible for rtpa, not minor stroke/high risk TIA

Answer 22

sapt minimum 12m

Question 23

goal of therapy of ais/mi

Answer 23

reperfusion

Question 24

anticoag use ais

Answer 24

for secondary prevention of cardioembolic stroke

Question 25

anticoag use in mi

Answer 25

prevent thrombus expansion

Question 26

antiplatelet agents use in ais

Answer 26

sapt/dapt

Question 27

antiplatelet agents in mi

Answer 27

dapt (12m for ACS, 6m for CCS)