FCCS (Fundamentals of Critical Care Support) Exam Latest with Complete Answers

Patients with STEMI who are hemodynamically stable and achieve successful reperfusion also should {{Correct Ans- also be considered for transfer to a PCI-capable facility. Antiplatelet and anticoagulant therapy is or is not continued after fibrinolysis and before transfer. {{Correct Ans- IS continued. ABSOLUTE contraindications for Fibronolytics for STEMI {{Correct Ans- - Prior intracranial hemorrhage -Known cerebral vascular lesion - Ischemic stroke within past 3 months - Allergy to the agent - Significant head or facial trauma within past 3 months - Known intracranial neoplasm - Suspected aortic dissection - Active internal bleeding or bleeding diathesis (except menstruation) - Intracranial or intraspinal surgery within past 2 months -Severe uncontrolled hypertension (unresponsive to urgent therapy) RELATIVE contraindications for fibrinolytics for STEMI {{Correct Ans- - Severe uncontrolled hypertension on presentation (blood pressure >180/110 mm Hg) - History of chronic, severe, poorly controlled hypertension - Ischemic stroke >3 months ago or intracerebral pathology - Current use of oral anticoagulants - Traumatic or prolonged (>10 min) cardiopulmonary resuscitation - Major surgery within past 3 weeks - Previous use of streptokinase/ anistreplase: allergy or prior exposure (>5 days ago) - Active peptic ulcer disease - Recent internal bleeding (within past 2-4 weeks) - Non compressible arterial or central venous puncture - Pregnancy BB and STEMI {{Correct Ans- Oral β-blockers should be initiated in the first 24 hours after the patient with STEMI has stabilized. Use of ACE inhibitors decreases the risk of death in all patients with STEMI. The greatest benefit is seen in those with___________________. {{Correct Ans- left ventricular dysfunction (ejection fraction <40%), anterior infarction, or pulmonary congestion. ** ACE inhibition should be started within the first 24 hours of the infarction with low doses of oral agents unless hypotension (systolic blood pressure <100 mm Hg) or other contraindications are present. - An angiotensin receptor blocker may be administered if the patient cannot tolerate an ACE inhibitor. CCBs and STEMI {{Correct Ans- Long-acting calcium channel blockers may be a useful secondary therapy for recurrent myocardial ischemia but are not appropriate for first-line treatment. - Dihydrous such as nicardipine / amlodipine are ok - Immediate-release nifedipine is contraindicated in treatment of an acute MI. - Diltiazem and verapamil (non dyhydrous) are contraindicated in patients with STEMI and left ventricular dysfunction and heart failure Cardiogenic shock in the setting of acute MI is an indication for {{Correct Ans- emergent revascularization - either percutaneous intervention or coronary artery bypass grafting In patients with 1- or 2-vessel disease, _____ is preferred: A. PCI B: CABG {{Correct Ans- A. PCI CABG is indicated for {{Correct Ans- LMCA disease, symptomatic or critical stenosis >70%, THREE vessel disease or decreased EF <40% Community-acquired acute bacterial meningitis in adults is most commonly caused by _____________________. {{Correct Ans- S pneumoniae or Neisseria meningitis Empiric tx of acute bacterial meningitis in adults {{Correct Ans- initial empiric therapy with a third generation cephalosporin (ceftriaxone or cefotaxime) provides adequate empiric coverage, with vancomycin added if penicillin-resistant S pneumoniae is suspected or confirmed