ACS/AMI I Flashcards Preview

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Flashcards in ACS/AMI I Deck (27):
1

why do trops rise in NSTEMI?

distal embolization

2

exact definition of typical angina

1. SSCP/discomfort
2. worse w/ exertion or stress
3. relieved by NTG or rest

3

exact definition of atypical angina

chest pain with 2/3 characteristics of typical angina
(SSCP/discomfort, worse w/ exertion or stress, relieved by NTG or rest)

4

name 4 anginal equivalents

dyspnea
Nausea
fatigue
faintness

5

Classification system for MI

1- plaque rupture
2- supply/demand (spasm, HTN, arrhythmia, embolus)
3- SCA (no objective evidence)
4a- s/p PCI
4b- IST
5- s/p CABG

6

are elderly (>75) more likely to have STEMI or NSTEMI?

NSTEMI

7

who has higher risk of In-Hospital mortality (elderly or young)

elderly

8

When choosing meds for elderly s/p ACS, what to watch out for?

calculate creatinine clearance
bleeding

9

what are the two inflection point (in years) for closing of a SVG vs artery?

5 and 10 years

10

which pt pop is at high risk for coronary artery dissection?

pregnant

11

what are the two local vasoconstrictors released from activated platelets?

serotonin
thromboxane A2

12

who gets oxygen is NSTEMI/UA?

when O2 sat<90%

13

what med to discontinue in NSTEMI/UA?

NSAIDs

14

TIMI risk score components

1. >65yo
2. >3 CAD risk factors
3. prior obs CAD 50%
4. ASA in last 7d
5. >2 anginal events in 1d
6. ST deviation
7. high trop/CK

15

TIMI score of what is low risk?

<3

16

GRACE score components

age
resting HR
SBP
Cr
CHF (Killip)
cardiac arrest at admission
ST deviation
trop/CK

17

what does GRACE score predict?

probability of in-hospital and 6 month mortality and MI

18

in TIMI score, what are the markers of highest risk (regardless of other factors)? which is worse?

ST deviation
biomarkers- WORSE

19

3 factos contributing to myocardial oxygen demand

HR
Contractility
Wall tension (SBP, Vol)

20

Definition fo non-cardiac chest pain

Meets 1 or none of the angina criteria (SSCP/discomfort, worse w/ exertion or stress, relieved by NTG or rest)

21

definition of New onset angina

< 2 mo's, atleast CCS Class III (marked limitation with nl activity like 1-2 blocks or Flight of stairs).

22

3 A's of platelet activity

Adhesion, Activation, Aggregation

23

in a patient with suspected unstable angina, what serial test is important to do in ER?

EKG

24

how long after a pt has taken sildenafil or tadalafil do you wait until giving nitrates?

>24h

25

when is it recommended to give clopidogrel in UA/NSTEMI?

when pt is intolerant of ASA

26

for pt's with mild-mod CRI or DM and NSTEMI/UA, os conservative or early invasive strategy preferred?

invasive

27

which trial showed "an early invasive strategy (36h) in NSTEMI, and may be beneficial in high risk patients?"

TIMACS