JoAnn Smith, 68 years old/Acute Coronary
Syndrome (ACS) Myocardial Infarction (MI) CASE
STUDY LATEST 2024 GRADED A+ (SOLVED)
Fibrinolytic therapy may be administered if the STEMI patient is not at a - ANSWER:
PCI-capable hospital or is not able to receive PCI within 120 minutes of first medical
contact.
What is the specified time frame for not receiving PCI and fibrinolytics that should be
used instead? - ANSWER: 120 minutes
Patients with bleeding should not be treated with - ANSWER: clopidogrel
signs/symptoms of a heart attack - ANSWER: -Chest pain or pressure that lasts more
than a few minutes
-Shortness of breath
-Increased CK-MB level
The pain can be in one or both - ANSWER: arms, the back, neck, jaw or stomach.
Shortness of breath is common with - ANSWER: ACS
Which of the following medications should not be given to the patient due to
increased mortality? - ANSWER: Procardia
The glycoprotein IIb/IIIa receptor antagonists are not safe to use in patients with -
ANSWER: major risk for bleeding, low platelets, uncontrolled hypertension and
within a short period of any major surgery as they can increase bleeding risk.
Abciximab - ANSWER: ReoPro
Eptifibate - ANSWER: Integrillin
Tirofiban - ANSWER: Aggrastat
Clopidogrel P2Y Inhibitors - ANSWER: Plavix
Prasugrel- P2Y12 Inhibitors - ANSWER: Effient
Ticagrelor- P2Y12 Inhibitors - ANSWER: Brilinta
Cangrelor - P2Y12 Inhibitors - ANSWER: Kengreal
Alteplase- Fibrinolytic - ANSWER: t-PA, rt-PA, Activase
, Tenecteplase- Fibrinolytic - ANSWER: TNKase
Reteplase - ANSWER: r-PA, Retevase
Clopidogrel is a prodrug that is converted to its active form by - ANSWER: CYP 2C19.
Which of the following medications work by blocking the binding of fibrinogen, von
Willebrand factor, and other ligands at the glycoprotein IIb/IIIa receptor? - ANSWER:
Eptifibatide
Eptifibatide is a - ANSWER: glycoprotein IIb/IIIa receptor antagonist.
Aspirin doses greater than 100 mg reduce the effectiveness of - ANSWER: ticagrelor
and should be avoided.
Naproxen has been shown to have the - ANSWER: lowest cardiovascular risk of the
NSAIDs (other than aspirin of course).
ReoPro is a protein and should not be - ANSWER: shaken during reconstitution.
Reopro requires filtering - ANSWER: during administration and platelets must be
monitored
ReoPro is not - ANSWER: available orally.
ReoPro is an - ANSWER: irreversible inhibitor.
Dalteparin is an - ANSWER: anticoagulant
Clopidogrel is a prodrug that is converted by the - ANSWER: CYP 2C19 enzyme to an
active metabolite.
The metabolism of clopidogrel to its active metabolite can be impaired by - ANSWER:
genetic variations in CYP 2C19 and by concomitant medications that interfere with
CYP2C19.
Avoid use with strong or moderate CYP 2C19 inhibitors, - ANSWER: including
omeprazole (and esomeprazole).
Which of the following patients should be placed on statin therapy post MI? -
ANSWER: All patients who are S/P MI
Beta blockers reduce - ANSWER: myocardial oxygen demand
Beta blockers should be given to all patients without - ANSWER: contraindications
who present with UA/NSTEMI within 24 hours.
Syndrome (ACS) Myocardial Infarction (MI) CASE
STUDY LATEST 2024 GRADED A+ (SOLVED)
Fibrinolytic therapy may be administered if the STEMI patient is not at a - ANSWER:
PCI-capable hospital or is not able to receive PCI within 120 minutes of first medical
contact.
What is the specified time frame for not receiving PCI and fibrinolytics that should be
used instead? - ANSWER: 120 minutes
Patients with bleeding should not be treated with - ANSWER: clopidogrel
signs/symptoms of a heart attack - ANSWER: -Chest pain or pressure that lasts more
than a few minutes
-Shortness of breath
-Increased CK-MB level
The pain can be in one or both - ANSWER: arms, the back, neck, jaw or stomach.
Shortness of breath is common with - ANSWER: ACS
Which of the following medications should not be given to the patient due to
increased mortality? - ANSWER: Procardia
The glycoprotein IIb/IIIa receptor antagonists are not safe to use in patients with -
ANSWER: major risk for bleeding, low platelets, uncontrolled hypertension and
within a short period of any major surgery as they can increase bleeding risk.
Abciximab - ANSWER: ReoPro
Eptifibate - ANSWER: Integrillin
Tirofiban - ANSWER: Aggrastat
Clopidogrel P2Y Inhibitors - ANSWER: Plavix
Prasugrel- P2Y12 Inhibitors - ANSWER: Effient
Ticagrelor- P2Y12 Inhibitors - ANSWER: Brilinta
Cangrelor - P2Y12 Inhibitors - ANSWER: Kengreal
Alteplase- Fibrinolytic - ANSWER: t-PA, rt-PA, Activase
, Tenecteplase- Fibrinolytic - ANSWER: TNKase
Reteplase - ANSWER: r-PA, Retevase
Clopidogrel is a prodrug that is converted to its active form by - ANSWER: CYP 2C19.
Which of the following medications work by blocking the binding of fibrinogen, von
Willebrand factor, and other ligands at the glycoprotein IIb/IIIa receptor? - ANSWER:
Eptifibatide
Eptifibatide is a - ANSWER: glycoprotein IIb/IIIa receptor antagonist.
Aspirin doses greater than 100 mg reduce the effectiveness of - ANSWER: ticagrelor
and should be avoided.
Naproxen has been shown to have the - ANSWER: lowest cardiovascular risk of the
NSAIDs (other than aspirin of course).
ReoPro is a protein and should not be - ANSWER: shaken during reconstitution.
Reopro requires filtering - ANSWER: during administration and platelets must be
monitored
ReoPro is not - ANSWER: available orally.
ReoPro is an - ANSWER: irreversible inhibitor.
Dalteparin is an - ANSWER: anticoagulant
Clopidogrel is a prodrug that is converted by the - ANSWER: CYP 2C19 enzyme to an
active metabolite.
The metabolism of clopidogrel to its active metabolite can be impaired by - ANSWER:
genetic variations in CYP 2C19 and by concomitant medications that interfere with
CYP2C19.
Avoid use with strong or moderate CYP 2C19 inhibitors, - ANSWER: including
omeprazole (and esomeprazole).
Which of the following patients should be placed on statin therapy post MI? -
ANSWER: All patients who are S/P MI
Beta blockers reduce - ANSWER: myocardial oxygen demand
Beta blockers should be given to all patients without - ANSWER: contraindications
who present with UA/NSTEMI within 24 hours.
