NR 571 UPDATED ACTUAL QUESTIONS
AND CORRECT ANSWERS COMPLETE
STUDY GUIDE GRADED A+
●● What is CKMB
Answer: CK isoenzyme specific to cardiac muscle tissue (MI)
●● When should CKMB be used?
Answer: for suspicion of secondary ischemia after an initial infarct
●● normal level for Troponin I
Answer: <0.04
●● normal level for CKMB
Answer: 3-5% of total CK
●● What is BNP
Answer: B-type natriuretic peptide
●● Normal BNP levels
Answer: <100 pg/mL
,●● Differential for chest pain
Answer: Consider:
Myocardium- angina, MI, myocarditis, heart failure
Pericardium- pericarditis
Aorta- dissecting aortic aneurysm
Trachea and bronchi- bronchitis
Parietal pleura- pericarditis, pneumonia, pneumothorax, pleural effusion,
pulmonary embolus
Chest wall- costochondritis, herpes zoster
Esophagus- reflux, esophageal spasm, esophageal tear
Referred pain from elsewhere- cervical arthritis, biliary colic, gastritis
Psych: anxiety attacks
●● Revascularization in under ____ minutes
Answer: 90
●● Initial diagnostics for chest pain
Answer: 12-lead EKG
Troponin q3h x3 at least
BNP - HF
CBC - baseline H&H and Plts
,PTT, PT/INR - baseline coagulation status
BMP - renal function and lytes
TSH, Mg, and Phos
ECHO
Cath
●● Requirements for STEMI dx
Answer: new ST elevation in 2 contiguous leads of >0.1 mV except
V2&V3
elevated troponin
●● STEMI findings in V2-V3
Answer: >0.2mV in >40yo M
>0.25 mV in <40 yo M
>0.15 mV in women
●● Difference between NSTEMI and unstable angina
Answer: NSTEMI involves Elevated Cardiac Bio markers (cell death)
●● NSTEMI & unstable angina tx
Answer: Dual antiplatelet therapy
Full-dose AC
, High-intensity statin
BB
Nitrates
oxygen
pain medication
●● Dual antiplatelet therapy
Answer: DAPT
Aspirin (325 x1 = daily 81mg)
AND
P2Y2 inhibitor
clopidogrel or ticagrelor
●● full dose AC
Answer: SQ lovenox 1mg/kg BID
if PCI planned of low GFR use heparin gtt
50-70 units/kg bolus plus 12units/kg/hr titrated to PTT 1.5-2.5 x baseline
●● High-intensity statin
Answer: atorvastatin 40-80 mg or rosuvastatin 20-40 mg
●● Considerations for BB avoiding BB use
AND CORRECT ANSWERS COMPLETE
STUDY GUIDE GRADED A+
●● What is CKMB
Answer: CK isoenzyme specific to cardiac muscle tissue (MI)
●● When should CKMB be used?
Answer: for suspicion of secondary ischemia after an initial infarct
●● normal level for Troponin I
Answer: <0.04
●● normal level for CKMB
Answer: 3-5% of total CK
●● What is BNP
Answer: B-type natriuretic peptide
●● Normal BNP levels
Answer: <100 pg/mL
,●● Differential for chest pain
Answer: Consider:
Myocardium- angina, MI, myocarditis, heart failure
Pericardium- pericarditis
Aorta- dissecting aortic aneurysm
Trachea and bronchi- bronchitis
Parietal pleura- pericarditis, pneumonia, pneumothorax, pleural effusion,
pulmonary embolus
Chest wall- costochondritis, herpes zoster
Esophagus- reflux, esophageal spasm, esophageal tear
Referred pain from elsewhere- cervical arthritis, biliary colic, gastritis
Psych: anxiety attacks
●● Revascularization in under ____ minutes
Answer: 90
●● Initial diagnostics for chest pain
Answer: 12-lead EKG
Troponin q3h x3 at least
BNP - HF
CBC - baseline H&H and Plts
,PTT, PT/INR - baseline coagulation status
BMP - renal function and lytes
TSH, Mg, and Phos
ECHO
Cath
●● Requirements for STEMI dx
Answer: new ST elevation in 2 contiguous leads of >0.1 mV except
V2&V3
elevated troponin
●● STEMI findings in V2-V3
Answer: >0.2mV in >40yo M
>0.25 mV in <40 yo M
>0.15 mV in women
●● Difference between NSTEMI and unstable angina
Answer: NSTEMI involves Elevated Cardiac Bio markers (cell death)
●● NSTEMI & unstable angina tx
Answer: Dual antiplatelet therapy
Full-dose AC
, High-intensity statin
BB
Nitrates
oxygen
pain medication
●● Dual antiplatelet therapy
Answer: DAPT
Aspirin (325 x1 = daily 81mg)
AND
P2Y2 inhibitor
clopidogrel or ticagrelor
●● full dose AC
Answer: SQ lovenox 1mg/kg BID
if PCI planned of low GFR use heparin gtt
50-70 units/kg bolus plus 12units/kg/hr titrated to PTT 1.5-2.5 x baseline
●● High-intensity statin
Answer: atorvastatin 40-80 mg or rosuvastatin 20-40 mg
●● Considerations for BB avoiding BB use
