Acute Coronary Syndrome

Question 1

What is the persistence of cTnI?

Answer 1

3-10 days

Question 2

What is the persistence of myoglobin?

Answer 2

24 hours

Question 3

What is the persistence of cTnT?

Answer 3

7-10 days

Question 4

What does ACS stand for?

Answer 4

acute coronary syndrome

Question 5

What is the time to peak elevation of cTnT?

Answer 5

12-48 hours

Question 5

What is the onset of detection of LD-I?

Answer 5

10-12 hours

Question 6

Unstable angina?

Answer 6

discomfort which is new in onset or is increased in duration, frequency or intensity with less exertion or at rest compared to previous episodes of discomfort

Question 7

How is STEMI treated?

Answer 7

1. open the artery- give fibrinolytic if cath lab is >90 min away 2. reduce myocardial O2 demand w/ beta-blockers and nitrates (if stable)

Question 8

What is STEMI?

Answer 8

Complete coronary vessel occlusion: ST elevation myocardial infarction (STEMI)

Question 9

_____ is very sensitive and specific for myocardium.

Answer 9

Cardiac troponin

Question 10

What is acute coronary syndrome (ACS)?

Answer 10

any array of clinical symptoms resulting from underlying acute myocardial ischemia

Question 11

What is the persistence of LD-I?

Answer 11

7-10 days

Question 11

How are NSTEMI or unstable angina treated?

Answer 11

halt the coagulation cascade (enoxaparin, heparins OR bival/thrombolytics) AND the platelet cascade (aspirin + P2Y12 inhibitor OR -ogrels OR GPIIb/IIIa inhibitor)

Question 13

What is the onset of detection of cTnT?

Answer 13

4-6 hours

Question 13

Partial coronary vessel occlusion, escalating symptoms without myocardial necrosis?

Answer 13

unstable angina

Question 14

Stable angina?

Answer 14

present when there is increased demand for myocardial oxygen in a reproducible fashion

Question 15

present when there is increased demand for myocardial oxygen in a reproducible fashion

Answer 15

stable angina

Question 16

What is the onset of detection of myoglobin?

Answer 16

1-2 hours

Question 18

What is the time to peak elevation of cTnI?

Answer 18

12 hours

Question 19

What is the onset of detection of cTnI?

Answer 19

4-6 hours

Question 20

What is the onset of detection of CK-MB isoforms?

Answer 20

4-6 hours

Question 21

Dysfunctional endothelium + coagulation + platelet aggregation =

Answer 21

Coronary thrombosis

Question 23

What is the persistence of CK-MB isoforms?

Answer 23

2-4 days

Question 24

What is the time to peak elevation of LD-I?

Answer 24

48-72 hours

Question 25

Causes of ACS?

Answer 25

Atherosclerotic plaque rupture with thrombus Coronary embolism Congenital anomalies Coronary trauma or aneurysm Severe coronary artery spasm (e.g. cocaine) Increased blood viscosity Spontaneous coronary dissection Markedly increased myocardial O2 demand

Question 26

discomfort which is new in onset or is increased in duration, frequency or intensity with less exertion or at rest compared to previous episodes of discomfort

Answer 26

unstable angina

Question 27

What is the time to peak elevation of CK-MB isoforms?

Answer 27

18 hours

Question 28

What is NSTEMI?

Answer 28

Partial coronary vessel occlusion with myocardial necrosis: non ST elevation MI (NSTEMI)

Question 29

any array of clinical symptoms resulting from underlying acute myocardial ischemia

Answer 29

acute coronary syndrome (ACS)

Question 30

What is the time to peak elevation of myoglobin?

Answer 30

8-10 hours