BCPS Exam Questions With Complete Solution

BCPS Exam Questions With Complete Solution TIMI score - CORRECT ANSWERS 1. Age >= 65. 2. Aspirin use in the last 7 days (patient experiences chest pain despite ASA use in past 7days) 3. At least 2 angina episodes within the last 24hrs 4. ST deviation on ECG 5. Elevated serum cardiac biomarkers 6. Three or more risk factors for CAD 7. Prior coronary stenosis of >/=50% Enoxaparin dosing in ACS - CORRECT ANSWERS 30mg IVB if <75 yo 1mg/kg q12h Fondiparinux Dosing in ACS - CORRECT ANSWERS 2.5mg SQ daily until PCI or for duration of hospitalization C/I in CrCl <30 UFH dosing in ACS - CORRECT ANSWERS Bolus 60mg/kg (max 4000 units) Maintenance 12mg/kg/hr (Max 1000 units/hr) Bivalrudin (Angiomax) MOA - CORRECT ANSWERS Direct Thrombin Inhibitor Bivalirudin dosing in early invasive therapy - CORRECT ANSWERS 0.1 mg/kg LD 0.25mg/kg/hr until PCI or planned angiography Bivalirudin dosing in PCI - CORRECT ANSWERS 0.75mg/kg IVB 1.75mg mg/kg/hr until PCI Goal time to PCI - CORRECT ANSWERS 120 minutes Goal time to thombolytic - CORRECT ANSWERS 30 min door to needle time Fibrinolytic therapy - CORRECT ANSWERS Alteplase Tenecteplase Retaplase Alteplase dosing - CORRECT ANSWERS <67 kg: 15mg IVP over 1-2 min, then 0.75 mg/kg (max 50mg) IV over 30 min, then 0.5mg/kg (max 35) over 1h >67kg: 15mg IVP, then 50mg over 30 min, then 35mg over 1h Retaplase dosing - CORRECT ANSWERS 10 units IVP, repeat in 30 min Tenectaplase dosing for <60kg - CORRECT ANSWERS 30mg IVP Tenectaplase dosing for 60-69kg - CORRECT ANSWERS 35mg IVP Tenectaplase dosing for 70-79 - CORRECT ANSWERS 40mg IVP Tenectaplase dosing for 80-89kg - CORRECT ANSWERS 45mg IVP Tenectaplase dosing for >90kg - CORRECT ANSWERS 50mg IVP Absolute contraindications in fibronolysis - CORRECT ANSWERS 1. Prior hemorrhagic stroke 2. Ischemic stroke in the last 3 mo 3. Active internal bleed 4. Considerable facial/head trauma in the last 3 mo 5. Severely uncontrolled HTN 6. Spinal/Cranial surgery past 2 mo 7. Intracranial neoplasm 8. AV malfunction P2Y12 Inhibitors - CORRECT ANSWERS Clopidogrel Ticagrelor Prasugrel Clopidogrel PCI dosing/NSTE - CORRECT ANSWERS 300-600mg LD 75 mg daily Ticagrelor PCI dosing/NSTE - CORRECT ANSWERS 180mg once 90mg BID Prasugrel PCI dosing - CORRECT ANSWERS 60mg LD 10mg daily Planned surgery hold times - CORRECT ANSWERS Clopidogrel 5 days Prasugrel 7 days Ticagrelor 5 days Urgent surgery hold tims - CORRECT ANSWERS Ticagrelor/ Clopidogrel 24h at least GPIIbIIIa inhibitors - CORRECT ANSWERS Abciximab