Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Step 2 CK > Cardiology - ACS > Flashcards

Cardiology - ACS Flashcards

(57 cards)

Start Studying
1
Q

Estimates the risk of mortality, new or recurrent myocardial infarction, or the need for urgent re-vascularization in a patient with NSTEMI and/or unstable angina

A

TIMI score for NSTE-ACS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

TIMI Score Characteristics

A
  • age 65+
  • 3+ CAD risk factors (family history of CAD, DM, smoking, HTN, HLD)
  • 2+ episodes of severe angina in the last 24 hours
  • ASA use in the past 7 days
  • ST deviation
  • elevated cardiac biomarkers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute myocardial ischemia that is not severe enough to cause detectable myocardial injury

A

Unstable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ischemia pain at rest or at lower threshold of exertion or new onset of chest pain

A

Unstable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chest pain due to fixed atherosclerotic lesions that narrow the major coronary arteries

A

Stable angina pectoris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Major risk factors for stable angina pectoris

A
  • Diabetes (worst risk factor)
  • HLD (elevated LDL, low HDL)
  • HTN (most common risk factor)
  • cigarette smoking
  • age (men > 45 and women > 55)
  • family history of CAD or MI in a first degree relative before age 45 in men or age 55 in women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Minor risk factors for stable angina pectoris

A
  • obesity
  • sedentary lifestyle
  • stress
  • excess alcohol use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute myocardial ischemia that is severe enough to cause myocardial injury without ST-segment elevations on EKG

A

NSTEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acute myocardial ischemia that is severe enough to cause ST segment elevations in two or more continuous leads on EKG

A

STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

STEMI is usually caused by

A

In situ thrombosis at the site of a ruptured atherosclerotic plaque in a coronary artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Use of this drug can precipitate STEMI by promoting both vasospasm and thrombosis.

A

Cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When a coronary artery occlusion is incomplete or if the thrombus undergoes spontaneous lysis

A

Unstable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When there is a complete coronary artery occlusion for more than 30 mins

A

Infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When there is a flow-limiting coronary artery stenosis (>70%) caused by atherosclerotic plaque that causes ischemia during exercise without acute thrombosis

A

Stable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

An S4 gallop on cardiac auscultation means

A

Myocardial noncompliance because of ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

An S3 gallop on cardiac auscultation means

A

Severe systolic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A new apical systolic murmur of mitral valve regurgitation is caused by

A

ischemic papillary muscle dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Heavy, squeezing or crushing chest pain localized to the retrosternal area or epigastrium, sometimes with radiation to the arm, lower jaw, or neck. This pain is often accompanied by sweating, nausea, vomiting and/or the sense of impending doom.

A

angina pectoris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Chest pain that is severe, persistent and worsening

A

crescendo angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Autonomic symptoms associated with ACS

A
  • diaphoresis
  • syncope
  • palpitations
  • nausea
  • vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Acute MI may be painless or associated with only vague discomfort with sudden onset of dyspnea, pulmonary edema or ventricular arrhythmias in a patient who is

A

older than 70 with diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The earliest change in EKG with acute MI

A

tall, positive, hyper-acute T waves in the ischemic vascular territory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The second changes seen on EKG in acute MI

Study These Flashcards
A

elevation of ST segments (myocardial injury pattern)

24
Q

Changes seen in EKG over hours to days after acute MI

Study These Flashcards
A

T-wave inversions

25
EKG finding consistent with a prior infarction
Q waves
26
The final change in EKG patten representing myocardial necrosis and replacement by scar tissue
diminished R wave amplitude or Q waves
27
ST-segment depression is seen when
acute ischemia is limited to the subendocardium
28
Typical pattern of acute transmural ischemia
ST-segment elevation
29
STEMI is defined as
- ST-segment elevation more than 0.1 mV in two or more contiguous leads (same vascular territory) - new LBBB which obscures usual ST-segment analysis
30
The inferior surface of the heart is supplied by ____ and corresponds to leads _____.
- RCA - leads II, III, aVF
31
The anterior surface of the heart is supplied by ____ and corresponds to leads _____.
- LAD - leads V2 to V4
32
The lateral surface of the heart is supplied by ____ and corresponds to leads _____.
- LCX - leads I, aVL, V5, V6
33
CK levels rise within ___ hours and returns to normal by ____.
- rises within 4-8 hours - return to normal by 48-72 hours
34
Cardiac biomarkers most specific to the heart and the preferred markers of myocardial injury.
- cardiac specific troponin I - cardiac specific troponin T
35
Troponin I and Troponin I rise about ____ hours after infarct.
3-5 hours
36
What troponin exclude MI?
Two sets of normal troponin levels 6-8 hours apart exclude MI.
37
Diagnosis of MI
1. typical chest pain persisting for more than 30 mins 2. typical EKG findings 3. elevated cardiac biomarkers
38
How can you distinguish MI from aortic dissection?
Aortic dissection often presents with: - unequal pulses or blood pressures in the arms, - a new murmur of aortic insufficiency, or - widened mediastinum on CXR.
39
How can you distinguish MI from acute pericarditis?
Acute pericarditis often presents with: - chest pain and pericardial friction rub - EKG with diffuse ST-segment elevations, not limited to a vascular territory
40
MONABASH
- morphine - oxygen - nitroglycerin - anti-platelet (aspirin, ADP receptor inhibitor) - beta-blocker - ACEi - statins - heparin
41
Cardiac catheterization in which a guide wire is inserted into the occluded coronary artery and a small balloon threaded over the guide wire and inflated in an attempt to open the blockage and restore blood flow.
Percutaneous coronary intervention (PCI)
42
The preferred therapy for most patients because it is more effective than fibrinolysis in opening occluded arteries and is associated with better clinical outcomes.
PCI
43
First medical contact to PCI time is ideally
less than 90 minutes, but not more than 120 minutes
44
Indications for fibrinolytic therapy
- PCI cannot be performed - symptoms started less than 12 hours ago - symptoms started 12-24 hours ago but there are clinical signs of ongoing ischemia (PCI is preferable) - no contraindication to fibrinolysis
45
Contraindications for fibrinolytic therapy
- symptoms started more the 24 hours ago - active bleeding or known coagulopathy - prior intracranial bleed - recent surgery - recent stroke - internal bleeding - solid malignancies
46
Fibrolytic options
- tenecteplase - alteplase - reteplase - streptokinase
47
Contraindicated within 6 months of previous exposure to streptokinase
Streptokinase is nonfibrin-specific and highly antigenic. It is contraindicated within 6 months of previous exposure
48
Indications for PCI after thrombolysis
- PCI can be considered if fibrinolysis fails - PCI is still indicated after successful thrombolysis
49
Mortality in acute MI is usually a result of
- ventricular arrhythmias - myocardial pump failure leading to cariogenic shock
50
Early complications of MI in the first 0-24 hours
- ventricular arrhythmia (sudden cardiac death) - bradyarrhythmia (sinus bradycardia, AV block) - acute heart failure - cariogenic shock
51
Common arrhythmias in the first 24 hours after MI
- ventricular tachycardia - ventricule fibrillation
52
Arrhythmia common after inferior MI
Sinus bradycardia (the RCA supplies the sinus and atrial nodes)
53
Complications of MI in the first 1-3 days
early infarct associated pericarditis
54
Complications of MI in days 3-14
- papillary muscle rupture (acute mitral regurgitation) - ventricular septal rupture (left to right shunting of blood) - ventricular free wall rupture (cardiac tamponade) - left ventricular pseudoaneurysm (mural thrombus)
55
Late complications of acute MI 2 weeks to months later
- left ventricular aneurysm (mural thrombus) - Dressler syndrome (post-myocardial infarction syndrome)
56
A late complication of acute MI (2-10 weeks later) that develops as a result of circulating antibodies against cardiac muscle cells which causes inflammation (pericarditis)
Dressler syndrome (post-myocardial infarction syndrome)
57
The most important modifiable risk factor in post-MI care
smoking cessation

Step 2 CK (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions