4.1C Cvs Acs Gab

Front 1

Contraindication for fibrinolytic in AMI:

Back 1

Absolute:
Prior ICH
Cerebral vascular lesion (e.g. AVM)
Intracranial neoplasm
Ischaemic stroke within 3/12
Active internal bleeding (exclude menses)
Suspected aortic dissection or pericarditis
Relative:
Uncontrol BP (>180/100)
Prior ischaemic stroke >3/12
Use of anticoagulant (INR >2-3)
Known bleeding diathesis
Recent trauma past 2 weeks
Prolong CPE >10mins
Major surgery < 3 weeks
Pregnancy
Patient treated previously with Streptokinase should not receive Streptokinase second time
Active PUD
(Tin p377)

Front 2

Which is not true of the ISIS 2 study?
a) It was a large study of about 20000 patient with AMI
b) it shows that aspirin alone was better than placebo
c) it shows SK alone was better than placebo
d) it shows that aspirin alone & SK alone had a similar decrease in mortality
e) SK & aspirin together did not lower mortality significantly more than when each agent was given alone

Back 2

e) The early survival advantages produced by fibrinolytic therapy and one month of aspirin started in acute myocardial infarction seem to be maintained for at least 10 years

Front 3

Which is not a contraindication fot thrombolysis in STEMI?
a) BP180/100
b) ICH within 6 months
c) Preicarditis
d) CPR
e) Pregnancy

Back 3

d) only prolong CPR >10mins is contraindicated

Front 4

Which is not true for coronary arteries?
a) RCA supply SA node in 60% of case
b) RCA supply AV node in 80% of case
c) LCA supply SA node in 40% of case
d) LCA supply AV node in 20% of case
e) LCA supply SA node in 20 % of case

Back 4

e) LCA supply SA node in 40 % of case

Front 5

TIMI score

Back 5

Age >65
Previous coronary stenosis >50%
3 or more risk factors for coronary disease
ST segment deviation
Aspirin use in the preceding 7 days
Two or more anginal events in last 24 hours
Elevated cardiac biomarkers
(risk of death or MI at 14 days %: TIMI 0-2 = 3%, 3 = 4 %, 4 = 6%, 5 = 11%, 6 or 7 = 19%)