Stemi

Question 0

Thrombus aspiration

Answer 0

Better out comes
Class 2A
Taste trial

Question 1

PRAMI study

Answer 1

Multi vessel pci in STEMI non-culprit vessel has less event rates

Question 2

Do not use DES

Answer 2

If pt can not take DAPT therapy

Question 3

Loading doses

Answer 3

Plavix 600
Effient 60
Ticagrelor 180
At the time if the pci

Question 4

P2y12 agents

Answer 4

Class 1 indications for 1 year
Class 2 b longer than I year 
Effient and stroke class 3

Question 5

Anti coagulation

Class1

Answer 5

UFH 50-70u/kg with 2b3a
UFH 70-100u/kg without 2b3a
Angio max
Fondaparinaux as a sole agent class3

Question 6

Heparin and angio max

Answer 6

Horizons heparin plus 2b3a and angio max — angio max was better
Heat trial heparin and angio max head to head and heparin was better

Question 7

Thromolytics

Answer 7

Less than 12 hours class 1
After 12 non pci hospital available pt with hemodynamic compromise 2a
St depression even with STT elevation in AVR class 3

Question 8

Thrombolysis

Answer 8

Tnk single bolus preferred

Question 9

After Thrombolysis

Answer 9

Asa 81 mg preferred dose
Plavix 300 load and 75 for people less than 75
For people older than 75 do not bolus
Do not use effient or ticagrelor after Thrombolysis

Question 10

Anticoag post Thrombolysis

Answer 10

UFH 60u/kg max 4000 units
Followed by 12u/kg max 1000u/hr for 48 hours
Enoxeparin paring less than 75 years 30 mg bolus then 1 mg/ kg max 100 ever 12
Older than 75 no bolus then 0.75 mg/kg
Any age if cr cl less than 30 it is 1 mg/ kg every 24hours
Fondaparinaux for 8 days don’t use in RF

Question 11

After Thrombolysis

Answer 11

Transfer every one asap regardless their reperfusion status

3-24 for stable patients

Question 12

Pci s/ p Thrombolysis

Answer 12

Class 1 for shock and high risk
Class 2 for failed reperfusion and stable patients 3-24 hours
Class 2b stable 24 hours after Thrombolysis
Class 3 more than 24 hours and totally occluded artery

Question 13

Caress in MI trial

Answer 13

Immediate pci after Thrombolysis better out comes

Question 14

Raas inhibitors EF less than 40

Answer 14

Class 1 indication

Question 15

It ok check lipid levels

Answer 15

24 hours after MI

Question 16

Shock

Answer 16

Thrombolysis if you can’t intervene

Question 17

IABP in shock

Answer 17

Class 2 a

Impella 2a

Question 18

Icd before discharge after mi

Answer 18

For sudden death 48 hours after mi

Question 19

Icd

Answer 19

Reevaluate the EF after 40 days if mi

Question 20

If you have to use triple anti coag

Answer 20

Use only plavix and 81 Asa

If you have to stop you rather stop Asa than plavix

Question 21

In STEMI

Answer 21

Do not give BB
If the pt is tachycardic
Hypotensive BP <120
Or have signs of shock