ACS lecture practice Flashcards
(20 cards)
What is the mnemonic for the life threatening causes of ACS?
DEATH
Dissection of Aortic Aneurysm
Emboli - PE
ACS
Tension Pneumothorax
Hole in GI tract (Esophageal rupture + Perf PUD)
T/F: Unstable angina is an NSTE ACS, but does NOT have elevated troponins
True
A patient has a father who was diagnosed with unstable angina at the age of 60. Is this a risk factor for your patient?
No (male = <55)
Where do the coronary arteries go through?
a) Subendocardium
b) Endocardium
c) Myocardium
d) Epicardium
d) Epicardium
What is the most common symptom of ACS for both men and women?
Chest pain
T/F: Pain that gets worse with exertion and better with rest is characteristic of ACS
True
What are the clinical decision tools to estimate cardiac risk and mortality in ER or inpatients? Select two
a) Marburg Heart score
b) HEART score
c) Thrombolysis in MI risk score
b) HEART score
c) Thrombolysis in MI risk score
A patient has a HEART score of 3. What is their risk of a major adverse cardiac event within the next 6 weeks?
a) Low (1.7%)
b) Intermediate (17%)
c) High (50%)
a) Low (1.7%)
Which of the following is generally a consequence of coronary artery disease (CAD)?
a) Pericarditis
b) Myocarditis
c) Ischemia
d) Aortic dissection
c) Ischemia
List 3 things that are evidence of ischemia on an EKG
1) Hyperacute T waves (first few minutes)
2) ST segment & T wave changes
3) Q wave
A patient has elevated cardiac enzymes and ischemic symptoms. Is this enough to diagnose an MI?
Yes
Chronic and Acute renal disease may cause what according to the powerpoint?
a) Abnormal EKG
b) Elevated cardiac enzymes
c) Ischemic symptoms
d) Coronary thrombus on angiography
b) Elevated cardiac enzymes
A patient presented to the ER with a STEMI MI 100 minutes ago. What do you do?
a) PCI angioplasty only, then DAPT
b) Fibrinolytics, then PCI, then DAPT
c) PCI angioplasty and DES placement, then DAPT
d) Fibrinolytics, then PCI and DES, then DAPT
c) PCI angioplasty and DES placement, then DAPT
(don’t need fibrinolytics if within 120 minutes)
How long should DAPT typically be continued after MI?
1 year
Patients with ACS + AFIB have an increased risk of ____________
bleeding
Which of the following medications for DESs should not be used if h/o CVA or increased bleed risk?
a) Clopidogrel (Plavix) 75 mg qd
b) Ticagrelor (Ticlid) 90 mg bid
c) Prasugrel 10 mg qd
d) ASA 81 mg daily
c) Prasugrel 10 mg qd
A patient has a DAPT score of 2. Do you give prolonged DAPT?
Yes (≥2 = give DAPT)
Which of the following should all ACS patients receive? Select all that apply
a) High intensity statin therapy
b) Cardioprotective B-blockers
c) ACEi
d) SGLT-2 inhibitors
e) GLP-1 agonist
f) SL NTG PRN
a) High intensity statin therapy
b) Cardioprotective B-blockers
d) SGLT-2 inhibitors
f) SL NTG PRN
(most patients get ACEis, but not all)
Celecoxib and meloxicam are examples of what group of meds?
Cox 1 inhibitors
Cox-2i and Cox-1i (traditional NSAID) received boxed warnings on their labels regarding ____________ risks
cardiovascular
