Myocardial infarction II

Question 1

what are the three main classes of medical therapy for MI?

Answer 1

antiplatelet
anticoagulant
anti-ischemic

Question 2

everyone with chest pain gets what four treatments?

Answer 2

oxygen
aspirin
sublingual NTG
anticoagulant

Question 3

what is the result of an NSTEMI?

Answer 3

ruptured / eroded plaque with acute thrombus formation and INCOMPLETE obstruction of blood flow

Question 4

thrombolytics are contraindicated in what type of clot?

Answer 4

platelet rich white clot

Question 5

what is the initial management for medically refractory ischemia / symptoms and hemodynamic / electrical instability?

Answer 5

ASA 
P2Y12 inhibitors 
anticoagulants 
beta blockers 
nitrates 
statins 
cardiac catheterization within 24-48 hours

Question 6

what is the most sensitive lead for a RV MI?

Answer 6

V4R

Question 7

what is the time frame for lytic therapy in STEMI?

Answer 7

30m

Question 8

what is the time frame for balloon therapy for PCI?

Answer 8

90 m

Question 9

what are the absolute contraindications for thrombolytic therapy?

Answer 9

prior intracranial hemorrhage 
known cerebral vascular lesion 
known malignant intracranial neoplasm 
ischemic stroke within 3 months 
suspected AAA 
active bleed 
closed head wound 
intracranial or intraspinal surgery within 2 months 
severe uncontrolled HTN

Question 10

where does damage occur first in NSTEMI?

Answer 10

site furthest from blood flow, in the subendocardium

Question 11

post MI care is dictated based on what factors?

Answer 11

EF
CV risk factors
education

Question 12

what are the post MI medical therapies?

Answer 12

aspirin for life 
P2Y12 inhibitor (clopidogrel, ticagrelor) for 1 year 
beta blocker 
ACE inhibitor 
aldosterone antagonist if EF less than 40% 
statins 
NTG 
1 week follow up