BCPS 2025 review || 100% Verified Solutions.
what is the pathophysiology of acute coronary syndrome (ACS)? correct answers atherosclerotic
plaque rupture
what is the difference between unstable angina and ACS? correct answers troponins are WNL in
unstable angina
On an EKG, what is the criteria for STEMI? correct answers > 1 mm above baseline in 2
consecutive leads
what are the two treatment options for STEMI? correct answers fibrinolytics or PCI
STEMI: fibrinolytic door to needs time? correct answers 30 mins
STEMI: PCI should be performed within ______ of 1st medical contact correct answers 90 mins
A STEMI patient gets stented. What are the DAPT options and duration of therapy? correct
answers ASA + brilinta/clopidogrel/prasugrel x 12 months
What does a NSTEMI look like on an EKG? correct answers ST depression or inversion
An NSTEMI patient gets stented. What are the DAPT options and duration of therapy? correct
answers ASA + brilinta/clopidogrel/prasugrel x 12 months
An NSTEMI patient undergoing ischemia-guided therapy. What are the DAPT options and
duration of therapy? correct answers ASA + brilinta/clopidogrel x 12 months
If a STEMI/NSTEMI patient has a high bleeding risk, how is DAPT therapy adjusted? correct
answers reduce duration of therapy to 6 months
,when do you give O2 supplementation during initial management of ACS? correct answers if sat
< 90% or signs of hypoxia
What is the dosing of nitroglycerin according to the ACS algorithm? correct answers 0.4 mg SL
every 5 mins x 3 doses
IV 5-10 mcg/min, max 200 mcg/min
BB should be initiated in ACS patients within ________ unless in which patient populations?
correct answers 24 hours, ADHF or asthma
ACS patients should be on BB therapy indefinitely in which patient populations? correct answers
HF, CKD, HTN, T2DM
*insert p2y12 table here* correct answers
How do you dose cangrelor in PCI? correct answers 30 mg/kg bolus + infusion x 2 hours or
length of PCI
4 mcg/kg/min x 6 hours, f/b 0.75 mcg/kg/min
what did the SUPERIOR PHOENIX trial test? correct answers cangrelor vs plavix in PCI pts
what was the composite outcome of the SUPERIOR PHOENIX trial? correct answers cangrelor
superior for stent thrombosis and MI
what were the weaknesses of the SUPERIOR PHOENIX trial? correct answers 25% of plavix
group not adequately loaded, 55% of population had unstable angina
what did the BRIDGE trial prove? correct answers cangrelor 0.75 mcg/kg/min to get 60%
platelet inhibition in 80% of the population
,what do GP 11b/IIIa inhibitors do to platelets? correct answers inhibit aggregation
How do you dose eptifibatide? correct answers 180 mcg/kg x 2 doses, f/b 2 mcg/kg/min x 18-
24hr
when do you reduce the eptifibatide infusion rate by half? correct answers CrCl < 50. avoid in
HD (not studied)
which anticoagulants can you use in PCI? correct answers UFH, bivalrudin
which anticoagulants can you use in ischemia-guided therapy? correct answers UFH, lovenox,
fondaparinaux
how do you dose UFH in ACS? correct answers 60 unit/kg bolus f/b 12 unit/kg/hr x 48 hrs or
until PCI
how do you dose enoxaparin in ACS? correct answers 1 mg/kg BID x 48 hours
how do you dose fondaparinaux in ACS? correct answers 2.5 mg SC daily
how do you dose bivalrudin in STEMI? correct answers 0.1 mg/kg bolus f/b 0.25 mg/kg/hr
how do you dose bivalrudin in NSTEMI? correct answers 0.75 mg/kg bolus f/b 1.75 mg/kg/hr
how do you dose alteplase for STEMI? correct answers 15 mg IVP f/b 0.75 mg/kg (max 50) over
30 mins
0.5 mg/kg (max 35 mg)
, how do you dose TNK for STEMI? correct answers 0.5 mg/kg (max 50 mg)
List the absolute C/I of alteplase. correct answers - PMHx ICH
- brain tumor
- AVM
- active internal bleeding
- aortic dissection
- closed head injury w/i 3 mo
- head/spine surgery w/i 2 mo
- severe uncontrolled HTN
List the relative C/I of alteplase. correct answers - BP > 180/110
- PMHx AIS > 3 mo before
- recent major surgery (< 3 wk)
- CPR > 10 mins
- recent internal bleeding (2-4 wks)
- active PUD
- pregnancy
- dementia
- OAC therapy
In ACS patients, when should HI statins be initiated? correct answers ASAP
what is the LDL goal for ACS 2ndary prevention? correct answers LDL < 55 mg/dL + achieve >
50% reduction from baseline
insert ADHF chart here correct answers
what is the pathophysiology of acute coronary syndrome (ACS)? correct answers atherosclerotic
plaque rupture
what is the difference between unstable angina and ACS? correct answers troponins are WNL in
unstable angina
On an EKG, what is the criteria for STEMI? correct answers > 1 mm above baseline in 2
consecutive leads
what are the two treatment options for STEMI? correct answers fibrinolytics or PCI
STEMI: fibrinolytic door to needs time? correct answers 30 mins
STEMI: PCI should be performed within ______ of 1st medical contact correct answers 90 mins
A STEMI patient gets stented. What are the DAPT options and duration of therapy? correct
answers ASA + brilinta/clopidogrel/prasugrel x 12 months
What does a NSTEMI look like on an EKG? correct answers ST depression or inversion
An NSTEMI patient gets stented. What are the DAPT options and duration of therapy? correct
answers ASA + brilinta/clopidogrel/prasugrel x 12 months
An NSTEMI patient undergoing ischemia-guided therapy. What are the DAPT options and
duration of therapy? correct answers ASA + brilinta/clopidogrel x 12 months
If a STEMI/NSTEMI patient has a high bleeding risk, how is DAPT therapy adjusted? correct
answers reduce duration of therapy to 6 months
,when do you give O2 supplementation during initial management of ACS? correct answers if sat
< 90% or signs of hypoxia
What is the dosing of nitroglycerin according to the ACS algorithm? correct answers 0.4 mg SL
every 5 mins x 3 doses
IV 5-10 mcg/min, max 200 mcg/min
BB should be initiated in ACS patients within ________ unless in which patient populations?
correct answers 24 hours, ADHF or asthma
ACS patients should be on BB therapy indefinitely in which patient populations? correct answers
HF, CKD, HTN, T2DM
*insert p2y12 table here* correct answers
How do you dose cangrelor in PCI? correct answers 30 mg/kg bolus + infusion x 2 hours or
length of PCI
4 mcg/kg/min x 6 hours, f/b 0.75 mcg/kg/min
what did the SUPERIOR PHOENIX trial test? correct answers cangrelor vs plavix in PCI pts
what was the composite outcome of the SUPERIOR PHOENIX trial? correct answers cangrelor
superior for stent thrombosis and MI
what were the weaknesses of the SUPERIOR PHOENIX trial? correct answers 25% of plavix
group not adequately loaded, 55% of population had unstable angina
what did the BRIDGE trial prove? correct answers cangrelor 0.75 mcg/kg/min to get 60%
platelet inhibition in 80% of the population
,what do GP 11b/IIIa inhibitors do to platelets? correct answers inhibit aggregation
How do you dose eptifibatide? correct answers 180 mcg/kg x 2 doses, f/b 2 mcg/kg/min x 18-
24hr
when do you reduce the eptifibatide infusion rate by half? correct answers CrCl < 50. avoid in
HD (not studied)
which anticoagulants can you use in PCI? correct answers UFH, bivalrudin
which anticoagulants can you use in ischemia-guided therapy? correct answers UFH, lovenox,
fondaparinaux
how do you dose UFH in ACS? correct answers 60 unit/kg bolus f/b 12 unit/kg/hr x 48 hrs or
until PCI
how do you dose enoxaparin in ACS? correct answers 1 mg/kg BID x 48 hours
how do you dose fondaparinaux in ACS? correct answers 2.5 mg SC daily
how do you dose bivalrudin in STEMI? correct answers 0.1 mg/kg bolus f/b 0.25 mg/kg/hr
how do you dose bivalrudin in NSTEMI? correct answers 0.75 mg/kg bolus f/b 1.75 mg/kg/hr
how do you dose alteplase for STEMI? correct answers 15 mg IVP f/b 0.75 mg/kg (max 50) over
30 mins
0.5 mg/kg (max 35 mg)
, how do you dose TNK for STEMI? correct answers 0.5 mg/kg (max 50 mg)
List the absolute C/I of alteplase. correct answers - PMHx ICH
- brain tumor
- AVM
- active internal bleeding
- aortic dissection
- closed head injury w/i 3 mo
- head/spine surgery w/i 2 mo
- severe uncontrolled HTN
List the relative C/I of alteplase. correct answers - BP > 180/110
- PMHx AIS > 3 mo before
- recent major surgery (< 3 wk)
- CPR > 10 mins
- recent internal bleeding (2-4 wks)
- active PUD
- pregnancy
- dementia
- OAC therapy
In ACS patients, when should HI statins be initiated? correct answers ASAP
what is the LDL goal for ACS 2ndary prevention? correct answers LDL < 55 mg/dL + achieve >
50% reduction from baseline
insert ADHF chart here correct answers
