IHD

Question 1

What 3 things on ECG would indicate thrombolysis is appropriate?

Answer 1

ST elevation (2 consecutive leads, 1mm or 2mm in anterior)
Posterior MI
new bundle branch block

Question 2

What are some contraindicators for thrombolysis?

Answer 2

stroke (any haemorrhagic, ischaemic in the last 3 months)
structural cerebral vascular lesion
malignant intracranial neoplasm
suspected aortic dissection
active internal bleeding
recent trauma, surgery or acute cerebrovascular event

Question 3

What are 4 types of thrombolysis drug?

Answer 3

alteplase, reteplase, streptokinase, tenecteplase

Question 4

What are some SE of thrombolysis?

Answer 4

bleeding (stroke), migration of blood clots, kidney damage if patient has kidney disease, hypotension, arrhythmias, streptokinase has antibodies which stop it working again

Question 5

Which treatment for MI is preferred?

Answer 5

PCI

Question 6

What are some RF for IHD?

Answer 6

age, sex, lack of exercise, high blood glucose, high cholesterol, stress, high BP, S. Asian, alcohol, autoimmune diseases, smoking, family history

Question 7

What are some differentials of acute coronary syndrome?

Answer 7

stable angina, PE, GORD, costrochondritis, anxiety, pericarditis, cardiac tamponade, shingles, pneumothorax, esophageal spasm, pancreatitis

Question 8

What are the blood tests to detect cardiac damage?

Answer 8

Troponin (T or I) -more specific

Creatine kinase or CK-MB

Question 9

Which leads on ECG are which areas?

Answer 9

Anterior/Septal - V1-V4
Lateral - I, aVL, V5-V6
Inferior - II, III, aVF

Question 10

How quickly does PCI need to be done?

Answer 10

90 mins of arrival at hospital - over 12 hours is unhelpful

Question 11

How quickly do you need to do thrombolysis?

Answer 11

Within 30 mins ideally - definetly 4 hours