Acute Medical Presentations — Flashcards

Flashcard 51: What is adminstered to patients undergoing PCI with femoral access? _____

Answer: bivalirudin with bailout GPI

Flashcard 52: What are important questions to ask in a Falls History? 9

Answer: • Where was the patient when they fell? • When did they fall? • Did anyone else see the fall? (collateral) • What happened? Any associated features before/during/after • Why do you think they fell? • Have they fallen before? • Systems review • PMH (balance/gait/sight) • Social Hx

Flashcard 53: What ECG changes indicate an NSTEMI (in the absence of ST elevation)?\n_____ and T wave inversion

Answer: ST depression

Flashcard 54: If AF patients are considered for long-term rhythm control, delay cardioversion until _____ for a minimum of 3 weeks

Answer: they have been maintained on therapeutic anticoagulation

Flashcard 55: What is the initial antithrombin therapy for NSTEMI/unstable angina if patients are: - not at high risk of bleeding/ not having angiography immediately _____ - immediate angiography is planned, or creatinine >265 umol/L unfractionated heparin (UFH)

Answer: fondaparinux

Flashcard 56: What is given to patients undergoing PCI with radial access during procedure: _____

Answer: unfractionated heparin (UFH) with bailout glycoprotein IIb/IIIa inhibitor (GPI)

Flashcard 57: In acute ischemic stroke, antiplatelet therapy (Aspirin) should generally be initiated within _____ of symptom onset.

Answer: 24 to 48 hours

Extra: Note: If the patient receives IV thrombolysis (e.g., Alteplase), antiplatelet therapy must be delayed for at least 24 hours until a follow-up CT/MRI excludes intracranial hemorrhage.

Flashcard 58: What type of cardioversion does NICE recommend for those that have been in AF for over 48 hours: _____

Answer: electrical cardioversion over pharmacological

Flashcard 59: If a patient has been in AF for more than 48 hours then: _____ or perform a transoesophageal echo (TOE) to exclude a left atrial appendage (LAA) thrombus

Answer: Anticoagulation should be given for atleast 3 weeks prior to cardioversion

Flashcard 60: For those with a GRACE <3% and are opted for conservative management, what is the further drug therapy: - If low bleeding risk _____ - If high risk of bleeding aspirin + clopidogrel or aspirin alone

Answer: aspirin + ticagrelor