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

ST elevation in leads II, III, and aVF indicates an inferior STEMI, most commonly caused by occlusion of the right 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

Primary PCI is the preferred reperfusion strategy for STEMI when it can be performed within 90 minutes of first medical contact at a PCI-capable center.

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

Dual antiplatelet therapy with aspirin plus a P2Y12 inhibitor (ticagrelor, clopidogrel, or prasugrel) is indicated for NSTEMI management.

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

Cardiac troponin I and T are the most sensitive and specific biomarkers for myocardial injury and are the preferred markers for ACS diagnosis.

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

STEMI can present atypically with jaw pain, nausea, and diaphoresis without classic chest pain, particularly in diabetic patients and women.

ACLS Practice Test

ACLS Practice Test

ACLS Acute Coronary Syndromes 2