MI & ACS EXAM REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES|AGRADE

MI & ACS EXAM REAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES|AGRADE What conditions are included in Acute Coronary Syndrome (ACS)? - Answer- Unstable angina, NSTEMI, STEMI What causes Acute Coronary Syndrome (ACS)? - Answer- Plaque rupture → thrombosis → reduced coronary blood flow What is a myocardial infarction (MI)? - Answer- Irreversible myocardial cell death due to prolonged ischaemia What is the difference between STEMI and NSTEMI? - Answer- STEMI = complete occlusion; NSTEMI = partial occlusion When does irreversible myocardial damage begin? - Answer- ~6 hours after occlusion What are typical symptoms of a myocardial infarction (MI)? - Answer- Crushing chest pain, radiating to arm/jaw/back, sweating, nausea, dizziness, doom When can a myocardial infarction (MI) occur? - Answer- Often at rest or at night What is a silent myocardial infarction (MI)? - Answer- MI without obvious symptoms (common in diabetics) What are the three key diagnostic components of a myocardial infarction (MI)? - Answer- Symptoms, ECG changes, cardiac biomarkers What does ST elevation indicate on an ECG? - Answer- Myocardial injury (STEMI) What do ST depression or T wave inversion indicate on an ECG? - Answer- Ischaemia (NSTEMI) What do Q waves indicate on an ECG? - Answer- Infarction (necrosis) What is the most specific cardiac biomarker for myocardial infarction (MI)? - Answer- Troponin T When is troponin mainly used? - Answer- To diagnose NSTEMI when ECG is inconclusive What happens to metabolism during myocardial infarction (MI)? - Answer- Aerobic → anaerobic → lactic acidosis What ion imbalance occurs in myocardial infarction (MI)? - Answer- ↑ intracellular Na⁺ and Ca²⁺ → cell damage What causes arrhythmias in myocardial infarction (MI)? - Answer- Electrical instability due to ion imbalance - [K+]outside What replaces necrotic myocardium after myocardial infarction (MI)? - Answer- Collagen scar (weeks) 2 locations of MIs? - Answer- Transmural Subendocardial (most common) What is the most common early complication of myocardial infarction (MI)? - Answer- Arrhythmias; extra ventricular beats, ventricular tachy, VF, AF, sinus tachy, heartblock What is cardiogenic shock? - Answer- Severe pump failure causing hypotension and organ hypoperfusion What are the features of cardiogenic shock? - Answer- Hypotension, cold clammy skin, cyanosis, oliguria LV failure symptoms - Answer- Pulmonary oedema; Increase palm wedge pressure, lung base crackles What is the first drug given in suspected myocardial infarction (MI)? - Answer- Aspirin 300 mg (chewed) + another antiplatelet What are other immediate treatments in myocardial infarction (MI)? - Answer- Oxygen (if hypoxic), morphine, ECG monitoring, Urgent PCI, antiarrhythmics What is the key principle in myocardial infarction (MI) management? - Answer- Time is muscle