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Year 1 MBChB Cardiology > Acute Coronary Syndromes > Flashcards

Acute Coronary Syndromes Flashcards

1
Q

What are the 3 acute coronary syndromes?

A

Unstable angina
NSTEMI
STEMI

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2
Q

What causes an ACS?

A

Rupture of an atheroma that occludes a coronary artery

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3
Q

How does unstable angina differ from stable angina?

A

Pain at rest and GTN less effective

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4
Q

How does unstable angina differ from acute MI?

A

Shorter
Troponin normal
GTN relief
No sweating and nausea

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5
Q

What are typical ECG changes that occur in STEMI?

A

ST elevation
T wave inversion
Q wave formation

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6
Q

Why are Q waves “useful”?

A

Signal that there has been a previous MI

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7
Q

2 options for diagnosing STEMI on an ECG + additional feature?

A

> 1mm STE in 2 adjacent limb leads
2mm STE in 2 adjacent precordial leads
LBBB

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8
Q

Which two proteins are used for diagnosing MI?

A

Troponin

CK

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9
Q

When does CK production peak following an MI?

A

24 hours

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10
Q

CK is also present in skeletal muscle and brain. True or false?

A

True

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11
Q

What is the benefit of troponin T?

A

Highly specific for cardiac muscle damage

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12
Q

Outline immediate treatment of MI (STEMI and NSTEMI)?

A 
diaMorphine
Oxygen 
Nitrate (GTN) if BP > 90
Aspirin (300mg)
Clopidogrel (600mg)
PCI within 90 mins, or else thrombolysis
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13
Q

If a patient fails to improve following thrombolysis, what is done?

A

Emergency angioplasty

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14
Q

What is Dressler’s syndrome?

A

Post MI pericarditis

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15
Q

Could the ECG be normal in acute MI?

A

YES

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16
Q

In a patient with a bare metal stent, how long should clopidogrel therapy last?

A

3-6 months

17
Q

How long does it take for cardiac troponin levels to increase + how long do they remain elevated?

A

4-6 hours + 7 days

18
Q

Name some contraindications to thrombolysis?

A 
Trauma, haemorrhage
Recent surgery 
Recent stroke 
Severe hypertension
Active peptic ulcers
19
Q

2 invasive options for ACS + which one is safest?

A

PCI

CABG (safest)

20
Q

Name the 2 vessels that can be used as a graft in CABG?

A

Saphenous vein or internal mammary artery

21
Q

Post-MI treatment (block an ACS)?

A 
Beta blocker
ACEi
Aspirin
Clopidogrel
Statin
22
Q

Most occluded artery in MI?

A

LAD

23
Q

What is involved in PCI + 2 sites of access?

A

Angioplasty with stenting + femoral or brachial/radial

24
Q

Length of aspirin treatment after MI?

A

Life long

Year 1 MBChB Cardiology (15 decks)

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