Khalid Review Flashcards

1
Q

What are the intial steps in management of a patient with ACS?

A

oxygen via nasal cannula
pain relief with opiate or nitro
aspirin
ECG

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2
Q

If ECG shows NSTEMI, what should their treatment plan be?

A
aspirin 
P2Y12 inhibitor 
anticoagulation therapy 
beta blockers 
ACEI 
NO thrombolytics
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3
Q

What should be avoided in NSTEMI patients

A

Fibrinolytic/thrombolytic therapy

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4
Q

What are the two most common antiplatelet agents used for ACS?

A

clopidogrel

ticagrelor

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5
Q

What are the two most common anticoagulant therapies?

A

IV Heparin

fondaxaparin

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6
Q

What are the indications for PCI/coronary angiography?

A

recurrent angina at rest or with low level activity

elevated troponin or ST segment depression

recurrent ischemia with HF

High risk stress test result

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7
Q

if you can do immediate PCI, what is the time frame for doing so?

A

90 minutes or less

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8
Q

If you have to transfer a patient to another hospital for PCI, what is the time frame for doing so?

A

120 minutes.

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9
Q

If you cannot transfer the patient to another hospital for PCI, what do you administer?

A

thrombolytic therapy

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10
Q

When is thrombolytic therapy indicated?

A

acute STEMI

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11
Q

What are the contraindications for thrombolytic therapy?

A

previous hemorrhagic stroke

other stroke within a year

known intracranial neoplasm

recent head trauma

active internal bleeding

suspected aortic dissection

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12
Q

What are some post MI complications?

A

post infarction ischemia

arrhythmia

RV infarct

mechanical complications

myocardial dysfunction

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13
Q

What arrhythmia is most common in inferior post-MI?

A

sinus bradycardia

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14
Q

In a patient post - MI with a fib, what do you use to treat them?

A

metoprolol
CCB if can’t use BB
if still unstable, electrical cardioversion

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15
Q

How do you treat an AV block?

A

pacemaker

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16
Q

What is most common in the first few hours of an MI?

A

ventricular arrhythmia

17
Q

How to treat a patient with hemodynamically unstable v tach?

A

defibrillation

18
Q

How to treat a patient with stable V tach?

A

amiodarone

19
Q

What complication can be see 3-7 days after an acute MI?

A

papillary muscle rupture

20
Q

What PE finding will you see in a patient with a post MI papillary muscle rupture?

A

new systolic murmur - mitral regurgitation or VSD murmur.

mitral - heard apically
VSD - heard parasternally

21
Q

What post MI complication presents with hypotension, pulmonary edema and no response to fluid resuscitation ?

A

myocardial dysfunction

22
Q

What is cardiogenic shock?

A

systolic BP < 90 and signs of diminished perfusion (cold extremities, decreased UOP, confusion)

23
Q

How do you treat a patient with cardiogenic shock?

A

IV diuretics in less sick pts

dopamine, dobutamine, NE

24
Q

What is the triad for septic shock?

A

sepsis
hypotension fluid unresponsive
serum lactate levels >2 mmol and a need for vasopressors