ACLS Acute Coronary Syndromes 2

Question 1

A patient presents with chest pain and an ECG showing ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?

Accepted Answer

Right coronary artery

Answer

Left anterior descending artery

Answer

Left circumflex artery

Answer

Left main coronary artery

Question 2

Which of the following is the preferred reperfusion strategy for STEMI if PCI can be performed within 90 minutes of first medical contact?

Accepted Answer

Primary percutaneous coronary intervention

Answer

Fibrinolytic therapy

Answer

Coronary artery bypass grafting

Answer

Intravenous nitroglycerin infusion

Question 3

A patient with NSTEMI has ongoing chest pain despite aspirin, heparin, and nitroglycerin. What is the next best step?

Accepted Answer

Add a P2Y12 inhibitor such as ticagrelor or clopidogrel

Answer

Immediate fibrinolytic therapy

Answer

Discontinue heparin and observe

Answer

Administer atropine 0.5 mg IV

Question 4

Which biomarker is most specific for myocardial injury and is the preferred marker for diagnosing ACS?

Accepted Answer

Troponin I or Troponin T

Answer

Creatine kinase (CK-MB)

Answer

Myoglobin

Answer

Lactate dehydrogenase (LDH)

Question 5

A 58-year-old male presents with diaphoresis, nausea, and jaw pain but denies chest pain. His ECG shows new ST elevation. What is the most likely diagnosis?

Accepted Answer

STEMI with atypical presentation

Answer

Panic attack

Answer

Pericarditis

Answer

Pulmonary embolism

Question 6

What is the maximum single dose of aspirin recommended for initial ACS treatment in the prehospital or ED setting?

Accepted Answer

162–325 mg

Answer

81 mg

Answer

500 mg

Answer

650 mg

Question 7

Which of the following findings on ECG is most consistent with posterior STEMI?

Accepted Answer

ST depression with tall R wave in V1–V2

Answer

ST elevation in V1–V4

Answer

New left bundle branch block

Answer

Diffuse ST elevation with PR depression