Acute Coronary Syndrome Quiz! Trivia

Though atherosclerosis is NOT classified as an ACS, it is part of the etiology of ACS.

An acute coronary syndrome with total occlusion is most consistent with ST segment elevation myocardial infarction. This is because ST segment elevation myocardial infarction (STEMI) occurs when there is a complete blockage of a coronary artery, leading to a lack of blood flow and oxygen to the heart muscle. Plaque rupture can cause a STEMI, as it leads to the formation of a blood clot that completely blocks the artery. Unstable angina and non-ST segment elevation myocardial infarction (NSTEMI) are also acute coronary syndromes, but they do not involve total occlusion of the coronary artery.

A Percutaneous Coronary Intervention (PCI) is a minimally invasive procedure used to treat blocked or narrowed coronary arteries. It involves inserting a catheter into the blood vessels to open up the blocked artery and restore blood flow to the heart. Compared to a fibrinolytic, which is a medication used to dissolve blood clots, PCI has a lower bleeding risk. This is because PCI is a targeted procedure that directly treats the blocked artery, while fibrinolytics are systemic medications that can affect the entire body, increasing the risk of bleeding complications. Therefore, the statement is true.

Clopidogrel has the lowest risk of bleeding compared to Prasugrel and Ticagrelor. This is because Clopidogrel is a less potent antiplatelet drug, which means it has a lower effect on platelet function and therefore a lower risk of bleeding. Prasugrel and Ticagrelor are more potent antiplatelet drugs and have a higher risk of bleeding as a side effect. Hence, Clopidogrel is considered to be a safer option in terms of bleeding risk.

This is false. The "A" in MONA-B stands for antiplatelet/anticoagulation. The "M" in MONA-B stands for morphine, which would fall under "acute pain management".

With this question, it is a matter of onset of action of the drug. Sublingual nitroglycerin has a rapid onset of action which is important in an acute exacerbation in which the patient would have to seek medical attention (i.e. go to the hospital). On the other hand, transdermal nitroglycerin has a much longer onset because of the dosage formulation. The drug must be released from the patch, penetrate the skin, then make its way into the blood stream. This will not provide the relief needed in an acute exacerbation.

Current use of anticoagulants is not an absolute contraindication to fibrinolytic therapy. While anticoagulants increase the risk of bleeding, they can be managed and reversed if necessary. On the other hand, previous intracranial hemorrhage, suspected aortic dissection, and known structural vascular lesion are absolute contraindications to fibrinolytic therapy as they significantly increase the risk of bleeding and other complications.

Since there is no infarction in UA, this would not be an appropriate treatment goal.

CYP 2C19 is responsible for the interaction between PPIs (e.g. omeprazole) and clopidogrel. This enzyme is involved in the metabolism of both drugs, and when PPIs are co-administered with clopidogrel, they can inhibit CYP 2C19 activity, leading to decreased conversion of clopidogrel to its active form. This can result in reduced antiplatelet effects of clopidogrel and potentially increase the risk of cardiovascular events. Therefore, it is important to consider this interaction when prescribing these medications together.

This option is false because normally, vasculature is taken from another part of the body in order to bypass the atherosclerotic lesion.

Typical clinical presentations of ACS include angina, diaphoresis, shortness of breath, and nausea and vomiting. Angina refers to chest pain or discomfort, often described as pressure or squeezing, that occurs when there is reduced blood flow to the heart. Diaphoresis refers to excessive sweating, which can be a symptom of ACS due to increased sympathetic nervous system activity. Shortness of breath can occur due to reduced oxygen supply to the heart muscle. Nausea and vomiting can be caused by the body's response to the stress and pain associated with ACS.

Following a STEMI, a high intensity statin (e.g. atorvastatin 80mg) is recommended in ALL patients with no contraindications to a statin.

Prasugrel is the correct answer because it is specifically indicated for use in patients undergoing percutaneous coronary intervention (PCI), also known as angioplasty. PCI is a procedure used to open blocked arteries in the heart, and prasugrel is a potent antiplatelet medication that helps prevent blood clots during and after the procedure. Clopidogrel and Ticagrelor are also antiplatelet drugs, but they have broader indications and can be used in various cardiovascular conditions, not exclusively for PCI.