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Year 2 CR > MI > Flashcards

MI Flashcards

1
Q

What is ACS

A

acute coronary syndrome

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2
Q

what is chem marker of cv necrosis

A

troponin

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3
Q

pain ACS

A

central crushing chest pain
nausea
impending sense of doom
pain radiating to arm/jaw

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4
Q

first line of investigation ACS

A

ECG

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5
Q

why could troponin be elevated but not MI (4)

A

kidney, sepsis, PE, aortic dissection

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6
Q

how many ecgs should you do?

A

a series (plenty as dynamic situation)

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7
Q

ST elevation not MI

A

pericarditis, digoxin toxicity

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8
Q

when think of MI

A

RISK FACTORS
DM
smoking
overweight
HTN etc

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9
Q

stable angina definition

A

angina on exertion relieved by rest or GTN

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10
Q

unstable angina

A

obviously worsening angina

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11
Q

bloods ACS

A

troponin
FBC
renal

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12
Q

gold standard test find ischaemia

A

coronary angiogram

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13
Q

what is reperfusion

A

percutaneous coronary intervention = balloon stent

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14
Q

what tablets initially after MI

A

anti-platelets - aspirin for all
clopi or ticagrelor
swap in prasugrel after surgery

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15
Q

how many ppl unresponsive for clopi

A

30%

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16
Q

higher ischamic risk, which second anti-platelet

A

ticagrelor

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17
Q

give oxygen in ACS

A

only if hypoxic

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18
Q

which antiplatelets are more potent but higher bleeding risk

A

ticagrelor or prasugrel

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19
Q

higher bleeding risk in pts

A

ticagrelor or prasugrel so prescribe clopi

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20
Q

when prasugrel

A

ONLY AFTER ANGIOGRAM/surgery

21
Q

LV function impaired, what drugs

A

statin
b blocker
acei

22
Q

what use if v acute tachycardic

A

short acting b blocker eg metaprolol

23
Q

STEMI timeline

A

should have balloon with 120 mins

24
Q

NSTEMI timeline

A

angiography but ballooon quickly if unwell/unstable
within 72h if stable

25
Q

what history v important

A

family history

26
Q

fondaparinux mechanim of action

A

inhibits factor Xa

27
Q

compare antiplatelet meds

A

clopidogrel is weaker but safer for bleeders
ticagrelor is stronger but less safe for bleeders
prasugrel is better than ticagrelor but needs to be stopped 7d before surgery so only to be used post surgery

28
Q

what is Wellen syndrome? what would you see in ECG?

A

significant proximal LAD disease. MI in 1-2weeks. Big inverted T waves in anterior leads

29
Q

what do you do if Wellens syndrome + inability to control chest pain medicallly + dynamic ST depressions. WHy?

A

call cardiology! for immediate catheterisation

only 80% of completely occluded CA MIs have elevated ST. This patient is in the 20%

30
Q

what is PCI

A

balloon angioplasty

31
Q

what scoring system is used in MI

A

GRACE

32
Q

what are the 3 ACS type 1 sub-types

A

STEMI
NSTEMI
UA

33
Q

what is Fondaparinux?

A

another anticoagulant

34
Q

mechanism of action ticagrelor

A

reversibly prevents adp binding to platelets

35
Q

mech of action clopidogrel

A

binds specifically and irreversibly to the platelet P2RY12 purinergic receptor, inhibiting ADP-mediated platelet activation and aggregation

36
Q

mech of action prasugrel

A

Prasugrel is a thienopyridine, an irreversible antagonist of the ADP P2Y12 receptor. [2] Thienopyridine antiplatelet agents interfere with platelet activation and aggregation induced by ADP. [1] The antiplatelet effect of prasugrel lasts for the lifespan of platelets

37
Q

what complication 7 days after PCI

A

cardiac tamponade

38
Q

which clotting factors affected by Warfarin

A

1972 plus protein C

39
Q

main cause of mitral stenosis

A

rheumatic fever

40
Q

key diagnostic feature of Left HF

A

Paroxysmal nocturnal dyspnoea

41
Q

origin of Tetralogy of Fallot

A

neural crest doesn’t migrate properly

42
Q

arterial ulcer looks like…

A

pale ulcer which has a ‘punched out’ appearance

43
Q

which cardiac anomaly Patau

A

VSD

44
Q

in HF, which drugs provide prognostic advantage

A

ACE i

45
Q

chest pain relieved by leaning forwards

A

pericarditis

46
Q

left renal artery originates at which level`

A

T1 - slightly inferior to right renal artery

47
Q

propanolol is lipid soluble so it can…

A

cross the BBB

48
Q

Parathyroid glands are supplied oxygenated blood by the..

A

by the superior and inferior thyroid arteries.

49
Q
A

Year 2 CR (33 decks)

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