BCPS Acute Care In Cardiology Exam
Questions And Answers
Which is preferred: PCI or lyric therapy? - ANSWER PCI
Ideal door to PCI time - ANSWER < 90 min
Ideal door to needle lytic time - ANSWER < 30 min
Appropriate for ischemia guided strategy - ANSWER - no elevated trip
- lower risk
- preference based on absence of high-risk features
- preferred if not a good candidate for revascularization
Appropriate for early invasive strategy - ANSWER - diagnostic angiography with intent
to perform revascularization
- refractory angina
- hemodynamic or electrical instability
MONA-B - ANSWER Morphine, Oxygen, Nitroglycerin, Aspirin, Beta-Blocker
Morphine dose - ANSWER 1 - 5 mg q 5 - 30 min
Who gets oxygen? - ANSWER - if O2 sat < 90
- resp distress
- high-risk for hypoxemia
, Nitroglycerin - ANSWER - 0.4 mg q 5 min x3 doses
- IV 5 mcg/min
Caution NTG - ANSWER RV failure
Aspirin - ANSWER 162 - 325 mg ASAP
CI for BB - ANSWER HF, low output, risk for cardiogenic shock
When to administer BB - ANSWER PO within 24h
Which P2Y12 inhibitor is reversible? - ANSWER Ticagrelor
Which P2Y12 inhibitor binds allosterically? - ANSWER Ticagrelor
Which enzyme metabolizes clopidogrel? - ANSWER 2C19
Which enzyme metabolizes Ticagrelor? - ANSWER 3A4
Which P2Y12 inhibitor has the longest onset of action? - ANSWER Clopidogrel (2 - 6
hours)
Surgery hold times for P2Y12 inhibitors - ANSWER Clopidogrel - 5 days
Prasugrel - 7 days
Ticagrelor - 3 days
Boxed warning for Ticagrelor - ANSWER Do not exceed 100 mg daily aspirin
Questions And Answers
Which is preferred: PCI or lyric therapy? - ANSWER PCI
Ideal door to PCI time - ANSWER < 90 min
Ideal door to needle lytic time - ANSWER < 30 min
Appropriate for ischemia guided strategy - ANSWER - no elevated trip
- lower risk
- preference based on absence of high-risk features
- preferred if not a good candidate for revascularization
Appropriate for early invasive strategy - ANSWER - diagnostic angiography with intent
to perform revascularization
- refractory angina
- hemodynamic or electrical instability
MONA-B - ANSWER Morphine, Oxygen, Nitroglycerin, Aspirin, Beta-Blocker
Morphine dose - ANSWER 1 - 5 mg q 5 - 30 min
Who gets oxygen? - ANSWER - if O2 sat < 90
- resp distress
- high-risk for hypoxemia
, Nitroglycerin - ANSWER - 0.4 mg q 5 min x3 doses
- IV 5 mcg/min
Caution NTG - ANSWER RV failure
Aspirin - ANSWER 162 - 325 mg ASAP
CI for BB - ANSWER HF, low output, risk for cardiogenic shock
When to administer BB - ANSWER PO within 24h
Which P2Y12 inhibitor is reversible? - ANSWER Ticagrelor
Which P2Y12 inhibitor binds allosterically? - ANSWER Ticagrelor
Which enzyme metabolizes clopidogrel? - ANSWER 2C19
Which enzyme metabolizes Ticagrelor? - ANSWER 3A4
Which P2Y12 inhibitor has the longest onset of action? - ANSWER Clopidogrel (2 - 6
hours)
Surgery hold times for P2Y12 inhibitors - ANSWER Clopidogrel - 5 days
Prasugrel - 7 days
Ticagrelor - 3 days
Boxed warning for Ticagrelor - ANSWER Do not exceed 100 mg daily aspirin