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M3 > Cardio - ACS ppt > Flashcards

Cardio - ACS ppt Flashcards

1
Q

clinical syndrome usually characterized by episodes or paroxysms of pain or pressure in the anterior chest

A

Angina pectoris

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2
Q

factors pptating angina (5)

A 
Physical exertion
Exposure to cold
Eating a heavy meal
Stress or any emotion-provoking situation
Sexual activity
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3
Q

Canadian cardiovascular society classification of angina:

angina evoked after walking <2 blocks

A

III

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4
Q

Canadian cardiovascular society classification of angina:

angina evoked with prolonged exertion

A

I

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5
Q

Canadian cardiovascular society classification of angina:

angina evoked with minimal activity

A

IV

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6
Q

Canadian cardiovascular society classification of angina:

angina evoked with rest

A

IV

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7
Q

Canadian cardiovascular society classification of angina:

angina evoked with walking >2blocks

A

II

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8
Q

An unprovoked prolonged episode of chest pain raising suspicion of AMI without definite ECG or laboratory evidence

A

unstable angina

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9
Q

chest pain suggestive of AMI with nonspecific ECG changes, (ST depression/T inversion/normal) with laboratory tests showing release of tropnonins

A

NSTEMI

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10
Q

sustained chest pain, acute ST elevation or new LBBB with release of troponins

A

STEMI

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11
Q 
Arrange the following in the correct order
A. Migration of monocyties
B.Growth factors
C. epithelial injury
D. foam cells
E. Atheromatous plaque forms
A

CADBE

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12
Q

Why is it possible for high grade stenoses to progress to complete occlusion but still do not precipitate acute STEMI?

A

due to collateral circulation

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13
Q

During development of plaques, abrupt transition can occur resulting in (3)

A

Platelet activation
Thrombin generation
Thrombus formation

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14
Q

What is the ultimate result of blood flow occlusion leading to imbalance between supply and demand?

a. Myocardial ischemia
b. Myocardial infarction
c. Myocardial necrosis
d. Myocardial apoptosis

A

C

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15
Q

This type of stenosis is likely to rupture causing thrombosis and STEMI

A

Less severe stenosis with lipid laden plaques and fragile caps

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16
Q

Caused by plaque formation, precipitated by stress or exertion, lasts <20min, relieved by NTG or resting

a. Stable angina
b. Unstable angina
c. NSTEMI
d. STEMI

A

A

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17
Q

platelet aggregation, chest paint at rest or minimal exertion, lasts >20min, often accompanied by other signs and symptoms, poor NTG relief. This is true for the following EXCEPT:

a. Stable Angina
b. Unstable Angina
c. NSTEMI
d. STEMI

A

A

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18
Q

what are the non-modifiable risk factors for ACS?

A

Increasing age

Gender (male)

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19
Q

Give 4 modifiable risk factors for ACS

A 
Smoking
Obesity
Diet
Lack of exercise
High Serum Cholesterol
Hypertension
DM
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20
Q

Give 3 Respiratory ddx for chest pain

A

pulmonary embolism
pneumothorax
pneumonia

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21
Q

Give 3 GI ddx for chest pain

A

Esophageal spasm
GERD
Pancreatitis

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22
Q

Give 2 MSK ddx for chest pain

A

Costochondriasis

Trauma

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23
Q

Give 4 modifiable risk factors for ACS

A 
Smoking
Obesity
Diet
Lack of exercise
High Serum Cholesterol
Hypertension
DM
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24
Q

Bedside investigations for ACS include (3)

A

Observation
ECG
BM

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25
Q

Blood investigations for ACS include (7)

A 
FBC
UE
LFT
lipids
cardiac enzymes
amylase
CRP
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26
Q

Imaging investigations for ACS include

A

CXR

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27
Q

Normal troponin

a. UA
b. NSTEMI
c. STEMI
d. B and C
e. A and B
f. AOTA

A

A

28
Q

Raised Troponin

a. UA
b. NSTEMI
c. STEMI
d. B and C
e. A and B
f. AOTA

A

D

29
Q

ECG normal

a. UA
b. NSTEMI
c. STEMI
d. B and C
e. A and B
f. AOTA

A

A

30
Q

ST depression

a. UA
b. NSTEMI
c. STEMI
d. B and C
e. A and B
f. AOTA

A

C

31
Q

ST elevation

a. UA
b. NSTEMI
c. STEMI
d. B and C
e. A and B
f. AOTA

A

C

32
Q

New LBBB

a. UA
b. NSTEMI
c. STEMI
d. B and C
e. A and B
f. AOTA

A

C

33
Q

T inversion

a. hours
b. days

A

A

34
Q

Q waves

a. hours
b. days

A

B

35
Q

ST elevation is __mm in limb leads and __mm in chest leads

A

1mm, 2mm

36
Q

II,III avF

A

Inferior

37
Q

I aVL, V5, V6

A

lateral

38
Q

V1-2

A

Septal

39
Q

V3-4

A

Anterior

40
Q

V5-6

A

Lateral

41
Q

Right coronary involvement

a. Lateral
b. Anterior
c. Posterior
d. Inferior

A

D

42
Q

Left Circumflex (or LAD) involvement

a. Lateral
b. Anterior
c. Posterior
d. Inferior

A

A

43
Q

Left circumflex or right coronary artery involvement

a. Lateral
b. Anterior
c. Posterior
d. Inferior

A

C

44
Q

LAD

a. Lateral
b. Anterior
c. Posterior
d. Inferior

A

B (or A)

45
Q

II, III avF

a. Right coronary
b. Left circumflex (LAD)
c. LAD
d. Left circumflex or right coronary

A

A

46
Q

V3-V4

a. Right coronary
b. Left circumflex (LAD)
c. LAD
d. Left circumflex or right coronary

A

C

47
Q

I, aVL V5-6

a. Right coronary
b. Left circumflex (LAD)
c. LAD
d. Left circumflex or right coronary

A

B

48
Q

V1-3 ST depression

a. Right coronary
b. Left circumflex (LAD)
c. LAD
d. Left circumflex or right coronary

A

D

49
Q

Common ACS management meds

A 
MONA
morphine
oxygen
Nitrates
Aspirin
50
Q

dose of morphine in ACS

A

5-10 mg slow IV injection

51
Q

ACS management: Nitrates GTN spray dose

A

400mcg = 1 spray

52
Q

ACS management: Nitrates dose tablet

A

1mg

53
Q

ACS management: Aspiring dose

A

300mg chewed

54
Q

The following can be given in ACS management EXCEPT

a. morphine
b. oxygen
c. nitrates
d. aspiring
e. metoclopramide
f. NOTA

A

F

55
Q

Unstable angina and NSTEMI meds (5)

A

LABN

LMWH
Aspirin
Beta Blocker
Nitrates

56
Q

Predicts 6/12 mortality in NSTEMI patients

a. GRACE scoring
b. TIMI

A

A

57
Q

Predicts Risk of cardiac events in next 30 days

a. GRACE scoring
b. TIMI

A

B

58
Q

Door to balloon time in PCI for STEMI

A

120 min

59
Q

PCI requires

a. aspirin 300 mg
b. clopidogrel 300 mg
c. both
d. neither

A

C

60
Q

Door to needle time for thrombolysis in STEMI

A

90 min

61
Q

Thrombolytic agents given in STEMI (3)

A

streptokinase
alteplase
tenecteplase

62
Q

aspirin 300mg/ clopidogrel 300mg

a. PCI
b. Thrombolysis
c. both
d. neither

A

C

63
Q

dose of aspirin for lifelong long-term management

A

75 mg OD

64
Q

Dose of clopidogrel for 1 year

A

75 mg

65
Q

How long should beta blockers be given

A

1 year to lifelong

66
Q

Complications <72 hr (early)

A 
Death cardiogenic shock
heart failure
ventricular arrhythmia
myocardial rupture
thromboembolism
67
Q

Late complications (>72 hrs)

A 
ventricular wall rupture
valvular regurgitation
ventricular aneurysms
cardiac tamponade
dresslers syndrome
thromboembolism

M3 (66 decks)

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