CAD/MI

Question 1

Omega 3 1g/d

Answer 1

Benefits in reducing CV events in EF

Question 2

STE definition

Answer 2

> /=2 contiguous leads with >/=1 mm except v2-v3: >/=2mm in men, >/=1.5 in women
New LBBB

Question 3

PCI time

Answer 3

90 min

Question 4

Fibrinolytic therapy time

Answer 4

30 min

Question 5

Indication for primary PCI

Answer 5

STE and symptoms

Question 6

Indication of fibrinolytic

Answer 6

STE/LBBB with symptoms

Question 7

iCH in fibrinolysis

Answer 7

2% in >75 yo

Question 8

Contraindications to fibrinolysis

Answer 8

Hx ICH
Intracranial neoplasm, aneurysm, AVM
Within last 3mon, no hemorrhagic stroke, or closed head trauma
Active bleeding or known bleeding diathesis
Suspected aortic dissection

Question 9

gP 2b/3a

Answer 9

No role in lysis

Peri PCI decrease death, MI

Question 10

uFH

Answer 10

No mortality benefit

Increase patency with lyrics

Question 11

Beta blockers in MI immediately

Answer 11

Decrease arrhythmic death or reMI, increase cardio genie shock,
NO overall mortality change when given early, esp if HF

Question 12

Inotropes in HF

Answer 12

Use inotropes if HF despite diuresis, and decrease after load, use dopamine, dobutamine or milrinone

Question 13

RV infarct

Answer 13

1mm STE in V4R, RA/PCWP>/=0.8
Optimize preload RA goal 10-14
Increase contractility dobutamine

Question 14

Post MI mechanical complications

Answer 14

Free wall rupture
vSD: aMI, IMI
Papillary muscle rupture: IMI

Question 15

Predictor of mi mortality

Answer 15

Age, time to rx, anterior MI or LBBB, heart failure

Question 16

Beta blockers after MI long term therapy

Answer 16

23% reduction in mortality

Question 17

ACEI in MI

Answer 17

Life long if HF, decreased EF, HTN, DM

4-6 weeks in all STEMI

Question 18

Aldosterone antagonist

Answer 18

15% reduction in mortality if EF

Question 19

iCD indications post MI

Answer 19

Sustained VT/VF >2d post MI not due to reversible ischemia

Indicated in primary prevention of SCD if post MI with EF

Question 20

Posterior infarct

Answer 20

V1-V2 with ST depressions. to request posterior (V7-V9) leads to check for posterior MI. Posterior infarct can be associated with inferior infarcts (90%) and lateral infarcts (10%) as the posterior descending artery may be supplied by RCA or left circumflex coronary artery.

Question 21

Tall R waves in V1 (R/S >1)

Answer 21

RBBB, RVH, left ventricular ectopy, acute right ventricular dilation (acute right heart strain), type A Wolff-Parkinson-White syndrome, posterior myocardial infarction, hypertrophic cardiomyopathy, progressive muscular dystrophy, dextrocardia, misplaced precordial leads, and normal variant (