SCA

Question 1

Ce determina ruptura/eroziunea capsonului fibros al placii arteriale coronare?

Answer 1

agregare+aderare plachetara
tromboza
vasoconstrictie
embolizare DISTALA

Question 2

Simptome atipice

Answer 2

dispnee, indigestie, durere pleuritica

Question 3

Diagnostic diferential

Answer 3

edem pulmonar acut
disectie de aorta
boala ulceroasa

Question 4

Examen clinic-elemente de prognostic negativ

Answer 4

zgomot de galop
raluri de staza
hipotensiune
sufluri cardiace

Question 5

SCORUL GRACE

Answer 5

1.frecventa cardiaca
2. tensiunea arteriala
3. varsta
4. creatinina serica
5. clasa Killip la prezentare

Question 6

Ce mediatori determina formarea trombusului si vasoconstrictia?

Answer 6

tromboxan A2
serotonina

Question 7

In ce conditii utilizarea inhibitorilor de GPiib/iiia este limitata?

Answer 7

1. incarcare trombotica masiva observata la coronarografie
2. complicatii PCI (embolizare DISTALA)

Question 8

IECA si inhibitori HMG-CoA-beneficii

Answer 8

-amelioreaza remodelarea vasculara si miocardica
-stabilizeaza placa de aterom
-reduc evenimentele CV succesive

Question 9

NSTEMI PCI risc foarte inalt

Answer 9

coro <2h
-angina persistenta/recurenta care nu cedeaza la tratament
-insuficienta cardiaca acuta
-instabilitate hemodinamica
-soc cardiogen
-aritmii ventriculare

Question 10

NSTEMI PCI risc inalt

Answer 10

coro <24h
-crestere progresiva troponina
-modificari ST T in dinamica
-GRACE >140

Question 11

NSTEMI PCI risc intermediar

Answer 11

coro <72 h
-DZ
-RFG <60
-FEVS <40
-insuficienta cardiaca congestiva
-antecedente PCI/CABG
-angina precoce post infarct
-GRACE 109-140

Question 12

STEMI-caracteristici puls

Answer 12

filiform
in:
1. hipotensiune
2. tahicardie
3. bradicardie

Question 13

In ce conditii nu este posibil dg de IMA pe ecg?

Answer 13

1. BRD
2. pacient cardiostimulat electric

Question 14

STEMI-ETT diagnostic diferential

Answer 14

1. disectie acuta aorta
2. embolie pulmonara
3. pericardita acuta