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ACS pathophysiology and classificationDownloads

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Sample Questions

1

A 28-year-old male presents with sharp, stabbing chest pain that worsens when lying flat and improves when sitting forward. He reports a recent viral upper respiratory infection 2 weeks ago. On examination, a friction rub is heard on auscultation. His vital signs are stable. An ECG is most likely to show which of the following findings in this patient?

ADiffuse, concave ST-segment elevations

BPeaked T waves and ST-segment elevations in leads V1-V6

CSawtooth-appearance of P waves

DS waves in lead I, Q waves in lead III, and inverted T waves in lead III

EAlternating high and low amplitude QRS complexes

2

A 74-year-old man presents with complaints of sudden severe crushing retrosternal pain. The pain radiated to his left arm shortly after it began, and he was subsequently rushed to the emergency department for evaluation. His troponins and creatine kinase-MB (CK-MB) were elevated. Unfortunately, the patient died within the next 2 hours and an autopsy was performed immediately. The gross examination of the heart will show?

AWhite, patchy, non-contractile scar

BNormal heart tissue

CPallor of the infarcted tissue

DAbundant neutrophils

ERed granulation tissue surrounding the infarction

3

A 59-year-old man with angina pectoris comes to the physician because of a 6-month history of shortness of breath on exertion that improves with rest. He has hypertension and hyperlipidemia. Current medications include aspirin, metoprolol, and nitroglycerine. Echocardiography shows left ventricular septal and apical hypokinesis. Cardiac catheterization shows 96% occlusion of the left anterior descending artery. The patient undergoes angioplasty and placement of a stent. The patient's shortness of breath subsequently resolves and follow-up echocardiography one week later shows normal regional contractile function. Which of the following is the most accurate explanation for the changes in echocardiography?

AMyocardial scarring

BUnstable angina pectoris

CStress cardiomyopathy

DHibernating myocardium

ECardiac remodeling

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