Acute Coronary Syndrome Criteria and Cardiac Biomarkers
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Questions and Answers

What is the primary characteristic of Diastolic Heart Failure?

  • Enlarged heart ventricle
  • Stiff and noncompliant heart muscle (correct)
  • Decreased Ejection Fraction
  • Weak and flaccid heart muscle

Which term refers to the percentage of blood expelled from the left ventricle with every contraction?

  • Afterload
  • Contractility
  • Preload
  • Ejection Fraction (correct)

Which medication is used in the medical management of Heart Failure by decreasing preload and afterload through a dilation effect?

  • Digoxin
  • Dobutamine
  • Nitroglycerin
  • Milrinone (correct)

Why might patients switch from ACE inhibitors to ARBs in Heart Failure management?

<p>Due to ACE cough (B)</p> Signup and view all the answers

What is the primary function of Betablockers in Heart Failure management?

<p>Decrease constant stimulation of SNS (D)</p> Signup and view all the answers

Which medication for Heart Failure management is known for its potent vasodilator effects?

<p>Nitroprusside (C)</p> Signup and view all the answers

What should be monitored closely when administering Dobutamine as an IV infusion in Heart Failure?

<p>Tachyarrhythmias (A)</p> Signup and view all the answers

Which cardiac biomarker is the most specific for indicating cardiac damage in acute MI?

<p>Troponin (D)</p> Signup and view all the answers

What is the main purpose of reducing oxygen demand in a patient experiencing Acute Coronary Syndrome?

<p>To decrease workload on the heart (D)</p> Signup and view all the answers

Which medication is typically part of the MONA B protocol for managing Acute Coronary Syndrome?

<p>Morphine (B)</p> Signup and view all the answers

In systolic heart failure, what is the main characteristic of the heart muscle?

<p>Reduced ejection fraction (A)</p> Signup and view all the answers

For a patient with ACS, what is the recommended heart rate to reduce the workload on the heart?

<p>Less than 100 bpm (D)</p> Signup and view all the answers

What is the role of bed rest in managing Acute Coronary Syndrome?

<p>To prevent exertion and reduce oxygen demand (C)</p> Signup and view all the answers

Which enzyme peaks at about 24 hours post myocardial infarction but is less reliable than troponin as a cardiac-specific biomarker?

<p>Creatine Kinase - MB (C)</p> Signup and view all the answers

What is the primary function of Reperfusion therapy in managing Acute Coronary Syndrome?

<p>To restore blood flow to the heart muscle (A)</p> Signup and view all the answers

What are the general signs and symptoms of heart failure related to inadequate tissue perfusion?

<p>Cool extremities and altered mental status (B)</p> Signup and view all the answers

What is the timeframe within which beta-blocker therapy should be initiated post myocardial infarction according to the text?

<p>At least within 24 hours (A)</p> Signup and view all the answers

Which cardiac biomarker is considered less reliable than troponin in diagnosing an acute MI?

<p>Creatine Kinase - MB (A)</p> Signup and view all the answers

What is the primary purpose of bed rest for a patient experiencing Acute Coronary Syndrome (ACS)?

<p>To prevent exertion (A)</p> Signup and view all the answers

In systolic heart failure, which aspect of cardiac function is typically affected?

<p>Ejection fraction (C)</p> Signup and view all the answers

Among the components of MONA B for managing ACS, which one helps reduce the work on the heart?

<p>Oxygen (B)</p> Signup and view all the answers

In Acute Coronary Syndrome, what does a MAP above 65 aim to ensure?

<p>Vital organ perfusion (D)</p> Signup and view all the answers

Which cardiac biomarker indicates non-specific injury to the heart and is not a specific indicator of myocardial infarction?

<p>Myoglobin (B)</p> Signup and view all the answers

What is the primary goal of reducing oxygen therapy for a patient with Acute Coronary Syndrome (ACS)?

<p>To reduce oxygen demand on the heart (B)</p> Signup and view all the answers

Which therapy, when administered post-MI, should ideally commence within 24 hours of the myocardial infarction?

<p>Beta blockers (D)</p> Signup and view all the answers

What is the significance of having a heart rate less than 100 bpm in patients with Acute Coronary Syndrome?

<p>To minimize the workload on the heart (D)</p> Signup and view all the answers

Why is Troponin considered a more reliable cardiac biomarker compared to Creatine Kinase - MB in diagnosing ACS?

<p>Troponin remains elevated for up to 10 days. (B)</p> Signup and view all the answers

What is the hallmark characteristic of Diastolic Heart Failure?

<p>Stiff and noncompliant heart muscle (B)</p> Signup and view all the answers

Which term refers to the percentage of blood expelled from the left ventricle with every contraction?

<p>Ejection Fraction (B)</p> Signup and view all the answers

What is the GOLD STANDARD lab test for diagnosing Heart Failure?

<p>BNP (B)</p> Signup and view all the answers

Which medication class is used to reduce the constant stimulation of the sympathetic nervous system in Heart Failure?

<p>Beta-blockers (A)</p> Signup and view all the answers

What is the function of Milrinone (Primacor) in Heart Failure?

<p>Decrease cardiac workload (C)</p> Signup and view all the answers

What is a common side effect of Dobutamine infusion?

<p>Drop in blood pressure (C)</p> Signup and view all the answers

Which medication is considered a potent vasodilator used in Heart Failure?

<p>Nitroprusside (Niapride) (A)</p> Signup and view all the answers

What is the primary goal of administering oxygen therapy in pulmonary edema?

<p>To improve tissue perfusion by increasing oxygen delivery to cells (D)</p> Signup and view all the answers

What condition can lead to Flash Pulmonary Edema?

<p>Acute Myocardial Infarction (MI) (D)</p> Signup and view all the answers

In Cardiogenic Shock, what is the primary reason for inadequate tissue perfusion and organ failure?

<p>Inability of the heart to pump enough blood (C)</p> Signup and view all the answers

How can increasing the afterload help a hypotensive patient in cardiogenic shock?

<p>By increasing the pressure to get blood moving forward (A)</p> Signup and view all the answers

What is a common goal for circulatory support in cardiogenic shock patients?

<p>To achieve a mean arterial pressure (MAP) above 65 mmHg (C)</p> Signup and view all the answers

What is a potential complication of an Intra-Aortic Balloon Pump (IABP) placed too high into the aortic arch?

<p>Block circulation to the left arm (C)</p> Signup and view all the answers

Which medication can be used to lower excessive preload in cardiogenic shock?

<p>Diuretics (C)</p> Signup and view all the answers

What is the primary purpose of a Left Ventricular Assistive Device (LVAD)?

<p>To help the heart pump oxygenated blood to the body (C)</p> Signup and view all the answers

In cardiogenic shock, what action is recommended if the afterload is too low?

<p>Increase afterload using vasopressors (A)</p> Signup and view all the answers

In cardiogenic shock, what is one of the goals to reduce the effects?

<p>Decrease afterload (B)</p> Signup and view all the answers

What is the recommended MAP level in circulatory support for cardiogenic shock patients?

<p>Between 65-70 mmHg (B)</p> Signup and view all the answers

Which of the following medications can be used to support left ventricle in cardiogenic shock by lowering pressure and volume?

<p>Diuretics (C)</p> Signup and view all the answers

What is the primary purpose of a Left Ventricular Assistive Device (LVAD) in cardiogenic shock?

<p>Augment blood supply to the heart (D)</p> Signup and view all the answers

What is the function of the Impella Device in cardiogenic shock?

<p>Push blood from left ventricle to aorta (C)</p> Signup and view all the answers

What complication can occur with an Intra-Aortic Balloon Pump (IABP) if it is placed too high into the aortic arch?

<p>Loss of limb circulation to left arm (D)</p> Signup and view all the answers

'Pee it, Park it, Pump it' is a strategy used for managing which aspect of cardiogenic shock?

<p>Preload (B)</p> Signup and view all the answers

'NEVER titrate off up or down too fast' is an important reminder for which therapy in cardiogenic shock?

<p><b>Inotropic support</b> (A)</p> Signup and view all the answers

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