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CARDIOLOGY > [NSTEMI] > Flashcards

[NSTEMI] Flashcards

1
Q
A

ST depression
flat/inverted T waves
or normal

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2
Q
A

O2 (sats below 90%)

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3
Q
A

morphine 5-10 mg IV
+
metoclopramide 10mg IV

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4
Q
A

GTN spray/sublingual (as required)

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5
Q
A

Aspirin 300mg PO initially then 75mg/day indefinitely
+
(if indicated)
clopidogrel 300mg PO initially then 75mg/day for 12 months

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6
Q
A 
raised troponin
ST depression on ECG
ACS when already on aspirin
ACS after recent MI
Transfered to for angioplasty
Aspirin intolerant
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7
Q
A

Hypertensive

signs of heart failure (tachycardia, LV function less than 40%)

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8
Q
A 
Asthma
COPD
LVF
bradycardia
coronary spasm
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9
Q
A

metoprolol 50mg/12hrs

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10
Q
A

Diltiazem 60-12mg/8hrs PO

Verapamil 80-120mg/8hrs PO

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11
Q
A

Fondapurinux 2.5mg OD SC daily until discharge

or LMWH/UFH

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12
Q
A

Factor Xa inhibitor

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13
Q
A

GTN 50mL in 0.9% saline at 2-10mL/h

intravenous NOT sublingual**titrated

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14
Q
A

it is titrated against pain

BP must remain >100mmHg systolic

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15
Q
A 
No recurrence of chest pain
No signs of heart failure
Normal ECG present
Normal baseline troponin 6-9-12 hours post pain
No inducible ischaemia
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16
Q
A

discharge

arrange further testing (angiography)

17
Q
A 
Rise in troponin
dynamic ST changes or Dynamic T wave changes
2ry criteria (inc. intermediate-high GRACE score)
18
Q
A 
DM
CKD
LVEF less than 40%
early angina post MI
recent PCI
prior CABG
intermediate-high GRACE score
19
Q
A

glycoprotein IIb/IIa inhibitor (e.g. Tirofiban)

angiography within either 120mins/24hrs/72 hrs (inpatient)

20
Q
A

doesn’t fill criteria for 120mins/24 hours

21
Q
A

GRACE score >140

22
Q
A

ongoing angina despite Tx
evolving ST changes
cardiogenic shock signs
life-threatening arrythmias

23
Q
A

ACE-i
statin
dual antiplatelet therapy
b-blocker (if LV depressed function)

24
Q
A

until discharge

25
Q
A

when stabilised on oral drugs - wean off

26
Q
A

troponin

serial ECG

27
Q
A

smoking
hypertension
hyperlipidaemia
diabetes

but all of them

28
Q
A

Global Registry of Acute Coronary Events

29
Q
A

guides future treatment in patients with current ACS: by predicting risk of future death or MI

30
Q
A

% chance of dying at 6months, 1yr and 3 yrs after admission

31
Q
A 
age
HR
BP
renal function
heart function
biomarkers

(90% accuracy!)

32
Q
A 
U+E
troponin
glucose
random cholesterol
FBC
CXR
33
Q
A

asystole inducing

CARDIOLOGY (11 decks)

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