IAM

Question 1

¿Qué significa NSTE-ACS?

Answer 1

Síndrome coronario agudo sin elevación del segmento ST.

Question 2

¿Qué dos entidades clínicas incluye el NSTE-ACS?

Answer 2

Infarto de miocardio sin elevación del ST (NSTEMI) y angina inestable (UA).

Question 3

¿Cuál es la causa fisiopatológica principal del NSTE-ACS?

Answer 3

Desequilibrio entre suministro y demanda de oxígeno del miocardio con formación de trombo o espasmo coronario.

Question 4

¿Cuál es el biomarcador más específico y sensible para necrosis miocárdica?

Answer 4

Troponina cardiaca (cTn) I o T.

Question 5

¿Cómo se clasifica el riesgo en NSTE-ACS?

Answer 5

Mediante escalas como TIMI, GRACE y HEART.

Question 6

¿Cuál es la primera línea de tratamiento antiisquémico?

Answer 6

Reposo, nitratos y β-bloqueadores.

Question 7

¿Cuándo están contraindicados los nitratos?

Answer 7

Hipotensión, uso reciente de inhibidores PDE-5 o estenosis aórtica grave.

Question 8

¿Qué inhibidores de P2Y12 están disponibles para NSTE-ACS?

Answer 8

Clopidogrel, prasugrel, ticagrelor y cangrelor.

Question 9

¿Qué anticoagulantes parenterales se usan en NSTE-ACS?

Answer 9

Heparina no fraccionada, enoxaparina, bivalirudina y fondaparinux.

Question 10

¿Qué estrategia terapéutica se recomienda en pacientes con alto riesgo?

Answer 10

Estrategia invasiva temprana con arteriografía en las primeras 48 horas.

Question 11

¿Qué medicamentos deben indicarse al alta hospitalaria?

Answer 11

β-bloqueadores, estatinas, IECA o ARA-II, antiagregantes (aspirina + inhibidor P2Y12).

Question 12

¿Cuál es la duración recomendada de la doble antiagregación en NSTE-ACS?

Answer 12

Al menos 12 meses, ajustada según el riesgo hemorrágico e isquémico.

Question 13

¿Qué prueba de imagen puede ser útil para el diagnóstico rápido?

Answer 13

Angiografía coronaria por tomografía computarizada (CCTA).

Question 14

¿Qué características tiene típicamente la molestia torácica en NSTE-ACS?

Answer 14

Ocurre en reposo, dura >10 minutos y puede seguir un patrón in crescendo.

Question 15

¿Qué alteraciones electrocardiográficas sugieren NSTE-ACS?

Answer 15

Descenso del ST persistente y/o inversión de la onda T.

Question 16

What is the primary cause of coronary syndromes?

Answer 16

Atherosclerosis leading to plaque rupture and thrombosis.

Question 17

True or False: All patients with acute coronary syndromes present with chest pain.

Answer 17

False.

Question 18

Fill in the blank: The three main types of acute coronary syndromes are ______, ______, and ______.

Answer 18

unstable angina, NSTEMI, STEMI.

Question 19

What does NSTEMI stand for?

Answer 19

Non-ST elevation myocardial infarction.

Question 20

Which biomarker is most commonly used to diagnose myocardial infarction?

Answer 20

Troponin.

Question 21

Multiple choice: Which of the following is NOT a risk factor for coronary artery disease? A) Smoking B) Hypertension C) Regular exercise D) Diabetes

Answer 21

C) Regular exercise.

Question 22

What is the standard initial management for a patient presenting with suspected acute coronary syndrome?

Answer 22

Administer aspirin and nitroglycerin.

Question 23

True or False: A patient with unstable angina will have elevated troponin levels.

Answer 23

False.

Question 24

What is the significance of ST-segment elevation on an ECG?

Answer 24

It indicates a STEMI.

Question 25

Fill in the blank: The treatment goal in acute coronary syndromes is to restore ______ to the myocardium.

Answer 25

blood flow.

Question 26

What is the role of beta-blockers in the management of acute coronary syndromes?

Answer 26

To reduce myocardial oxygen demand and control heart rate.

Question 27

Multiple choice: Which medication is a thrombolytic agent? A) Aspirin B) Clopidogrel C) Alteplase D) Atorvastatin

Answer 27

C) Alteplase.

Question 28

What is the difference between STEMI and NSTEMI?

Answer 28

STEMI involves ST-segment elevation on ECG, while NSTEMI does not.

Question 29

True or False: Coronary angiography is only indicated after medical management in all cases of acute coronary syndrome.

Answer 29

False.

Question 30

Fill in the blank: Risk stratification in acute coronary syndromes is important for determining the need for ______ intervention.

Answer 30

invasive.

Question 31

What lifestyle modification is most effective in reducing coronary artery disease risk?

Answer 31

Smoking cessation.

Question 32

Multiple choice: Which of the following is a common symptom of acute coronary syndrome? A) Nausea B) Headache C) Dizziness D) All of the above

Answer 32

D) All of the above.

Question 33

What does the term 'acute coronary syndrome' encompass?

Answer 33

Unstable angina, NSTEMI, and STEMI.

Question 34

True or False: Patients with diabetes have a higher risk of coronary artery disease.

Answer 34

True.

Question 35

Fill in the blank: The presence of ______ can indicate a worse prognosis in acute coronary syndromes.

Answer 35

heart failure.

Question 36

What is the purpose of cardiac rehabilitation after an acute coronary syndrome event?

Answer 36

To improve physical fitness and reduce the risk of future cardiac events.

Question 37

Multiple choice: Which of the following is a common complication of myocardial infarction? A) Heart failure B) Stroke C) Arrhythmias D) All of the above

Answer 37

D) All of the above.

Question 38

What is the acute treatment for STEMI?

Answer 38

Percutaneous coronary intervention (PCI) or thrombolysis.

Question 39

True or False: Chronic stress has no impact on coronary artery disease risk.

Answer 39

False.

Question 40

Fill in the blank: The use of ______ improves outcomes in patients with STEMI undergoing PCI.

Answer 40

dual antiplatelet therapy.