MI

Question 1

chronic stable angina causes pain on?

Answer 1

exertion

Question 2

ACS causes pain on?

Answer 2

rest

Question 3

what causes MI?

Answer 3

occlusion of coronary artery due to rupture of athersclerotic plaque

Question 4

factors affecting atherosclerotic plaque rupture

Answer 4

fibrous cap thickness
lipid content 
intraluminal pressure change 
mechanical injury 
shape 
bending/twisting

Question 5

how do platelets aggregate to form a clot on a ruptured plaque

Answer 5

extend pseudopodia to collect platelets and ADP and TXA2 secretion

Question 6

true/false - aspirin stops production of ADP

Answer 6

false - stops production of TXA2

Question 7

clopidogrel/prasugrel/ticagrelor prevent ___ binding to platelet surface?

Answer 7

ADP

Question 8

what ST changes may be seen in STEMI?

Answer 8

> 1mm in 2 adjacent limb leads

>2mm in 2 contiguous precordial

Question 9

what is LBBB

Answer 9

left bundle branch block

wide QRS>120mm with IV conduction delay

Question 10

can T wave inversion still be STEMI sign?

Answer 10

yes! it is just slightly older. you need to check previous ECG

Question 11

anteroseptal MI leads

Answer 11

V1-4

Question 12

anterolateral MI leads

Answer 12

V1-6, I, aVL

Question 13

inferior MI leads

Answer 13

II, III, aVF

Question 14

what cardiac enzyme may be used if no ECG changes seen?

Answer 14

troponin

Question 15

first line treatment for MI

Answer 15

MONA+C

Question 16

indication for reperfusion within 2 hours?

Answer 16

STEMI

Question 17

if a patient cannot receive PCI in 90 mins of ECG diagnosis of STEMI what should be done

Answer 17

thrombolysis

Question 18

when can GTN be given to MI patient

Answer 18

when SBP >90 mmHg

Question 19

arrhythmic complications MI

Answer 19

VF

Question 20

Structural complications MI

Answer 20

VSD
Cardiac rupture 
mitral valve regurg 
left ventricular aneurism 
mural thrombus 
inflammation 
acute pericarditis 
dresslers syndrome

Question 21

Functional complications MI

Answer 21

Acute ventricular failure
chronic cardiac failure
cardiogenic shock

Question 22

what are the ECG changes associated with NSTEMI

Answer 22

normal or st depression

Question 23

is the main clot in NSTEMI the issue?

Answer 23

no, it is the micro infarcts that are

Question 24

cardiac specific troponins?

Answer 24

T and I

Question 25

managing NSTEMI

Answer 25

MONA+C LMWH or fondaparinux, aspirin and clopidogrel/ticagrelor beta blocker and group IIb/IIIa inhibitors

Question 26

how long is it recommended a PCI patient should be on antiplatelets for?

Answer 26

6m

Question 27

when else may troponins be raised?

Answer 27

``` CCF Hypertensive crisis PE Renal failure sepsis stroke/TIA pericarditis/myocarditis post arrhythmia ```

Question 28

what is cardiac arrest

Answer 28

effective cessation of the heart

Question 29

causes of airway issues

Answer 29

tongue blocking blocked lumen swelling muscle spasm

Question 30

treating airway obstruction

Answer 30

head tilt chin lift adjunct ETT O2

Question 31

causes of breathing issues

Answer 31

muscle weakness nerve damage haemothorax pneumothorax

Question 32

treating breathing issues

Answer 32

airway secured oxygen ventilate bag mask

Question 33

primary causes cardiac issues

Answer 33

ACS drugs arrhythmia

Question 34

secondary causes cardiac issues

Answer 34

hypovolaemia asphyxia hypothermia septic shock

Question 35

treating cardiac issues

Answer 35

IV/IO access fluids/vasopressors/inotropes/aspirin/ morphine

Question 36

what level would you treat blood glucose

Answer 36

<3 mmol/l

Question 37

4 Hs

Answer 37

Hypoxia Hypothermia Hypoolaemia hypo/hyperkalaemia

Question 38

4Ts

Answer 38

thrombosis tension PTX cardiac Tamponade toxins