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