B4-074 Myocardial Infarction

Question 1

modifiable risk factors for CAD and MI

Answer 1

• hypertension
• dyslipidemia
• diabetes
• smoking
• tobacco
• obesity
• sedentary lifestyle

Question 2

nonmodifiable risk factor, but very important for CAD and MI

Answer 2

family hx

Question 3

cell death results in damaged or destroyed heart tissue

Answer 3

myocardial infarction

Question 4

• causes severe chest pain or discomfort
• medical emergency that requires prompt dx

Answer 4

acute coronary syndrome

Question 5

goals of treatment for acute coronary syndrome

Answer 5

• improving blood flow
• treating complications
• preventing

Question 6

“typical” chest pain

Answer 6

• substernal
• provoked by excertion/stress
• relieved by rest or nitroglycerin

Question 7

“atypical” chest pain

Answer 7

2 of the typical characteristics

Question 8

“noncardiac” chest pain

Answer 8

meets 1 or none of the typical characteristics

Question 9

common symptoms of acute coronary syndrome

Answer 9

• chest pain
• SOB
• abdominal pain
• back pain
• dizziness
• nausea
• sweating

Question 10

most important initial clinical test for diagnosis of MI

Answer 10

12 lead ECG

serial ECGs can be beneficial as well

Question 11

ST depression

Answer 11

NSTEMI

Question 12

T inversion

Answer 12

NSTEMI

Question 13

ST elevation

Answer 13

STEMI

Question 14

proteins found in skeletal and cardiac muscle fibers that regulate muscular contraction

Answer 14

troponin

Question 15

a troponin test measures

Answer 15

troponin I or T

Question 16

released when the heart muscle has been damaged

Answer 16

troponin

Question 17

preferred biomarker for myocardial injury

Answer 17

troponin

Question 18

caused by sudden complete blockage of coronary artery

Answer 18

STEMI

Question 19

caused by severly narrowed artery, which is not usually occluded

Answer 19

NSTEMI

Question 20

both STEMI and NSTEMI demonstrate elevated

Answer 20

biomarkers

Question 21

intial therapy for acute myocardial infarction is directed toward

Answer 21

restoration of perfusion

Question 22

medical management of reperfusion

Answer 22

• aspirin, heparin
• thrombolytics

Question 23

mechanical management of reperfusion

Answer 23

• percutaneous coronary intervention
• CABG

Question 24

early interventions and supportive measures

Answer 24

• morphine/pain control
• Oxygen >94%
• Nitrate
• Anti-platelet: Aspirin
• Beta blockers
• Ace inhibitor
• Statin
• Heparin

MONABASH

Question 25

used to lyse blood clots by activating plasminogen

Answer 25

fibrinolysis

Question 26

fibrinolysis is only used in

Answer 26

STEMI

Question 27

only used when primary PCI not available with 90 minutes

Answer 27

fibrinolysis

Question 28

if used, should be administered within 30 minutes of patient presentation

Answer 28

fibrinolysis

Question 29

PCI: catheter thread though femoral or radial artery to the

Answer 29

aortic root

Question 30

PCI: guide wire is inserted and advanced

Answer 30

past stenosis

Question 31

metal mesh

Answer 31

percutaneous coronary artery stent

Question 32

major surgical procedure requiring sternal incision and cardiopulmonary bypass

Answer 32

CABG

Question 33

reserved for patient with multiple arterial stenoses

Answer 33

CABG

Question 34

post MI complications: 1-3 days

Answer 34

* ventricular arrhythmias * bradyarrhythmias * cardiogenic shock * stroke

Question 35

post MI complications: 3 days - 2 weeks

Answer 35

* ischemic MR/papillary rupture * ventricular septal rupture * LV free wall rupture

Question 36

post MI complications: > 2 weeks

Answer 36

pericarditis