Clinical management scenarios for acute coronary syndrome, arrhythmia, and heart failure tested on USMLE Step 2 CK.
40 cards · basic cards · AI-written, checked twice. Edit anything.
- In suspected ACS, what immediate antiplatelet should be given at presentation and how?
- Non-enteric-coated aspirin 162-325 mg, chewed
- STEMI is diagnosed by new ST-segment elevation of at least ____ in two contiguous leads on ECG.
- 1 mm
- What is the guideline goal door-to-balloon time for primary PCI in STEMI?
- 90 minutes
- What is the guideline goal door-to-needle time for fibrinolytic therapy in STEMI?
- 30 minutes
- If a STEMI patient cannot reach a PCI-capable center within about 120 minutes, what is the preferred reperfusion strategy?
- Fibrinolytic therapy
- Name one absolute contraindication to fibrinolytic therapy in STEMI.
- Prior intracranial hemorrhage (or active internal bleeding)
- ____ is the most specific and sensitive cardiac biomarker for diagnosing myocardial infarction.
- Troponin
- Which medication class, started early post-MI, reduces mortality by lowering myocardial oxygen demand?
- Beta blockers
- In a post-MI patient with reduced ejection fraction, which drug class reduces mortality by limiting ventricular remodeling?
- ACE inhibitors
- What is the recommended statin intensity after an ACS event, regardless of baseline LDL?
- High-intensity statin (e.g., atorvastatin 80 mg)
- Why should nitrates be avoided in a patient with right ventricular infarction?
- RV infarction is preload-dependent; nitrates cause venodilation and can precipitate severe hypotension
- An inferior wall MI produces ST elevation in leads ____.
- II, III, and aVF
- ST elevation in leads V1 through V4 indicates infarction of which coronary territory?
- Anterior wall (LAD territory)
- Tall R waves with ST depression in V1-V3 suggest infarction of which wall?
- Posterior wall
- A new holosystolic murmur several days after an inferior MI suggests rupture of which structure?
- Papillary muscle, causing acute mitral regurgitation