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PR3154 > IC6 - ACS > Flashcards

IC6 - ACS Flashcards

1
Q

How is suspected ACS treated?

A
  1. Load aspirin (100-300mg) and check for ST elevation
  2. Once confirmed, load ticargrelor 180mg or clopidogrel 600mg
  3. If primary angioplasty is conducted, provide IV bolus UFH, LMWH, GP11B/11a f/b infusion or cangrelor
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2
Q

What is the duration of treatment for ACS with PCI?

A

12 months unless bleeding risk

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3
Q

What is the drug of choice for patients with ACS?

A

Ticagrelor + Aspirin

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4
Q

What is the drug of choice for patients with ACS and PCI?

A

Prasugrel (not available in SG - Give Ticargrelor instead) + Aspirin

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5
Q

Pre-treatment with P2Y12 inhibitor is recommended in patients in whom _________ is known.

A

coronary anatomy

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6
Q

________ and ______ is indicated for patient who cannot take ticagrelor or prasugrel, stable CAD undergoing stent implantation and prior intracranial bleeding or indication for OAC.

A

Clopidogrel, aspirin

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7
Q

The drug of choice for patients with STEMI receiving thrombolysis is _____ and ____.

A

Clopidogrel, aspirin

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8
Q

Choice of therapy in patients with STEMI and NSTEMI is ______ followed by _______.

A

Ticagrelor, clopidogrel

Note that prasugrel is not is not recommended in NSTEMI ischemia-guided strategy. It is the second choice after Ticagrelor but it is not available in SG.

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9
Q

Patient with ACS and is undergoing surgery should stop ticagrelor ___ days, clopidogrel ______ days, and prasugrel ___ days prior to surgery.

A

3, 5, 7

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10
Q

____ may be considered in patients with high risk of bleeding.

A

PPIs

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11
Q

P2Y12i are used in SIHD/CCS patients for ___ months.

A

6

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12
Q

When should one consider stopping P2Y12i if there is high bleeding risk in patients?

A

3 months

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13
Q

What is the purpose of the NIHSS risk score?

A

It is to evaluate effect of acute cerebral infarct on various functions. It is tied to eligibility for rTPA.

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14
Q

What is the ABCD^2 score for?

A

Estimate risk of ischemic stroke in the first two days after TIA.

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15
Q

For patients eligible for r-tPA, _______ should be started after 24 hours or within 48 hours.

A

single antiplatelet therapy

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16
Q

For patients who are not eligible for r-tPA and have minor strokes or high risk TIA, start ______ for ____ days.

A

dual antiplatelet therapy, 21

17
Q

What are the tests that can be performed to evaluate stroke mechanism?

A

MRI brain, 24 hour Holter, TTE, US carotids, lipid panel, TFTs, HbA1c

18
Q

How is non embolic severe major ICAS treated?

A

Add clopidogrel to Aspirin for 90 days

19
Q

What is the NIHSS score for minor stroke?

A

0 to 3

20
Q

What is the ABCD2 score to be considered as high risk TIA?

A

≥4

21
Q

For stroke patients with cardioembolic events and have underlying AF, what should be done?

A

Stop antiplatelet and give OAC

22
Q

Why should DAPT be given to before PCI?

A

Prevent stent thrombosis

23
Q

What are the two follow-up actions that should be done for patients given DAPT?

A
  1. FBC - bleeding
  2. Side effect i.e Ticagrelor (dyspnea)
24
Q

What the the signs and symptoms of a stroke patient?

A

Face dropping
Arm weakness
Speech difficulty
Time to call 995

25
Q

What are the eligibility criteria for rTPA in stroke patients?

A
  1. New onset and no antithrombotic therapy
  2. Present within 3 hours of symptoms
  3. Disabling stroke
  4. BP<185/110 or Glucose > 2.8 mmo/L
  5. CT brain changes
26
Q

______ intensity statins can be added for confirmed stroke patients.

A

High (Atorvastatin 40-80, rosuvastatin 20-40)

27
Q

What are the three medications that can be used for BP control in stroke patients?

A

ACEi, CCB, Thiazides

28
Q

Patients with CYP2C19 alleles ___ or ___ can be given clopidogrel.

A

1/1 or 1/17

29
Q

_____ should be considered for patients with CYP2C19 alleles *2 and *3.

A

Ticagrelor

PR3154 (16 decks)

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