USMLE step 3 Study Guide: Updated A+ Guide Solution

Clues to ischemic disease (Ans- dull pain 15-30 minutes occurs on exertion substernal radiates to jaw or left arm PE findings for ischemic chest pain (Ans- S3 (dilated LV) S4 (hypertrophic LV) holosystolic murmur (MR) JVD Rales (CHF) Edema Gen: distressed, SOB, clutching chest. MI: diagnostic testing: 1. first test to do: 2. if choosing between testing and treatment: 3. first treatment to give: 4. Other tests to do: 5. most accurate test: (Ans- 1. EKG 2. treat first 3. ASA 4. CK-MB, troponins, stress test, echo, angiography 5. CK-MB Treatment for ACS: (Ans- Things that lower mortality: ASA-- instant platelet inhibitor PCI thrombolytics (if can't to PCI within 90 minutes or new LBBB) statins Clopidogrel (esp if asa allergy) lower mortality in some cases ace/arb (if low EF) don't lower mortality but should st