Acute Medical Presentations — Flashcards

Flashcard 61: 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 62: What are the ECG findings in hypokalaemia?

Answer: U have no Pot (K+) and no T, but a long PR and a long QT (small or absent T waves) - U waves - Small or absent T waves - Long PR - ST Depression - Long QT

Flashcard 63: Difference between presentation of Myocarditis and Pericarditis?

Answer: • **Pericarditis:** Pleuritic chest pain (relieved by sitting forward), pericardial friction rub, and diffuse ST-elevation on ECG. • **Myocarditis:** Features of heart failure (dyspnea, edema), arrhythmias, and **elevated cardiac enzymes (Troponin)** with global/regional wall motion abnormalities on Echo.

Extra: Clinical Note: In practice, these often overlap as **myopericarditis**. The presence of elevated troponins or new ventricular dysfunction (HF symptoms) is the key clinical indicator that the myocardium is involved, rather than just the pericardial sac.

Flashcard 64: What can reduce BNP levels?

Answer: • ACE inhibitors • ARBs • Diuretics

Flashcard 65: QRS of 0.14 seconds and 130 HR?

Answer: • Broad complex tachycardia

Flashcard 66: What is the appropriate treatment for Torsades de Pointes?

Answer: • IV magnesium sulfate

Flashcard 67: If a patient treated with PCI for MI experiences persistent pain or hemodynamic instability, what surgical intervention is recommended?

Answer: Coronary artery bypass graft (CABG) surgery

Extra: Emergency CABG is recommended if Percutaneous Coronary Intervention (PCI) fails or if there are complications like coronary artery perforation, persistent ischemia/pain, or hemodynamic instability that cannot be managed percutaneously post-PCI.

Flashcard 68: What management can Complete Heart Block warrant?

Answer: • Transvenous pacing -> risk factor for asystole *When an emergency flexible pacing wire is placed through the [Internal Jugular/Subclavian Vein] to the right ventricle to correct life-threatening bradycardias

Flashcard 69: What is this?

Answer: • Wellen's syndrome *high-grade stenosis in the LAD *Pt pain may have resolved at the time, and trop = normal/minimially elevated **Biphasic or deep T wave inversion in Leads V2-3 Minimal ST Elevation • no Q waves

Flashcard 70: ACS may present with atypical chest pain in?

Answer: Females, Diabetics, and Elderly patients

Extra: Atypical presentations of Acute Coronary Syndrome (ACS) include dyspnea, fatigue, nausea, or epigastric pain instead of classic retrosternal chest pressure. These are most commonly seen in women, individuals with diabetes mellitus (due to neuropathy), and the elderly.