ACS

Question 1

Non-modifiable risk factor for ACS

Answer 1

Age, male, FH

Question 2

Non-modifiable risk factor for ACS

Answer 2

Age, male, FH

Question 3

Modifiable risk factors for ACS

Answer 3

HTN, DM, high cholesterol, obesity, smoking

Question 4

Types of angina

Answer 4

Stable, unstable
Decubitis (lying down)
Prinzmetal’s variant (coronary spasm)
Syndrome X - no evidence of atherosclerosis

Question 5

Low likelihood of CAD Ix

Answer 5

CT calcium scoring

Question 6

High likelihood of CAD Ix

Answer 6

Coronary angiography

Question 7

30-60% likelihood of CAD Ix

Answer 7

Functional imaging:
Stress echo
Myocardial perfusion scan + SPECT, MRI for wall motion abnormalities

Question 8

Prevention cardiovascular event

Answer 8

Aspirin, statins

Antihypertensive - ACE I

Question 9

Anti-anginal medication

Answer 9

GTN +
1. Beta blocker
2. Ca blocker (rate control - verapamil)
If not controlled then: 1 or 2 + dihydropyridine

Question 10

Anti-anginal medication if still not controlled

Answer 10

Ivabradine
Nicorandil
Ranolazine

Question 11

STEMI acute management

Answer 11

MONARCH

Question 12

Gold standard reperfusion for STEMI

Answer 12

Primary PCI

Question 13

Perform PCI within how many hours

Answer 13

12

Question 14

Thrombolysis CI after how many hours

Answer 14

24h

Question 15

Modifiable risk factors for ACS

Answer 15

HTN, DM, high cholesterol, obesity, smoking

Question 16

Types of angina

Answer 16

Stable, unstable
Decubitis (lying down)
Prinzmetal’s variant (coronary spasm)
Syndrome X - no evidence of atherosclerosis

Question 17

Low likelihood of CAD Ix

Answer 17

CT calcium scoring

Question 18

High likelihood of CAD Ix

Answer 18

Coronary angiography

Question 19

30-60% likelihood of CAD Ix

Answer 19

Functional imaging:
Stress echo
Myocardial perfusion scan + SPECT, MRI for wall motion abnormalities

Question 20

Prevention cardiovascular event

Answer 20

Aspirin, statins

Antihypertensive - ACE I

Question 21

Anti-anginal medication

Answer 21

GTN +
1. Beta blocker
2. Ca blocker (rate control - verapamil)
If not controlled then: 1 or 2 + dihydropyridine

Question 22

Anti-anginal medication if still not controlled

Answer 22

Ivabradine
Nicorandil
Ranolazine

Question 23

STEMI acute management

Answer 23

MONARCH

Question 24

Gold standard reperfusion for STEMI

Answer 24

Primary PCI

Question 25

Perform PCI within how many hours

Answer 25

Less 12h

Question 26

Thrombolysis CI after how many hours

Answer 26

24h

Question 27

Thrombolysis agents

Answer 27

Streptokinase, altekinase, tenecteplase

Question 28

Continuing therapy post-MI

Answer 28

ACE I, B blocker, cardiac rehab, statin

Question 29

How long before can drive and work post MI

Answer 29

1 and 2 months respectively

Question 30

NSTEMI acute management

Answer 30

MONARCH + GRACE/TIMI

Question 31

High risk following TIMI/GRACE

Answer 31

GPIIb/IIIa antagonist (tirofiban) Angiography + PCI Clopidogel 75mg one year

Question 32

Low risk following TIMI/GRACE

Answer 32

Continuing therapy post MI

Question 33

Post MI complications

Answer 33

``` DARTH VADER Death Arrythmia Ruptured myocardium Thrombus Heart failure Ventricular aneurysm Another MI Dresslers (2-10 weeks post) Emboli Regurgitant murmur (MR) ```