ACLS Acute Coronary Syndromes 4

Question 1

A 65-year-old woman with diabetes presents with fatigue and dyspnea for 2 days. ECG shows ST depression in V4–V6 and troponin is elevated. What is the diagnosis?

Accepted Answer

NSTEMI

Answer

Elevated troponin with ischemic symptoms (even atypical) and ST depression confirms NSTEMI — troponin elevation distinguishes it from unstable angina.

Question 2

The TIMI risk score for NSTEMI/UA is used to guide treatment intensity. Which of the following is NOT a component of the TIMI risk score?

Accepted Answer

Female sex

Answer

Female sex is not a component of the TIMI risk score; the score includes age, CAD risk factors, known CAD, ST changes, elevated markers, and recent aspirin use.

Question 3

Which anticoagulant is preferred in NSTEMI patients managed with an early invasive strategy (planned PCI within 24 hours)?

Accepted Answer

Unfractionated heparin or bivalirudin

Answer

Unfractionated heparin (UFH) or bivalirudin is preferred for patients undergoing PCI due to reversibility and established cath lab protocols.

Question 4

Nitroglycerin is contraindicated in which of the following ACS scenarios?

Accepted Answer

Inferior STEMI with right ventricular infarction

Answer

Nitroglycerin is contraindicated in right ventricular infarction because preload reduction can precipitate severe hypotension in RV-dependent patients.

Question 5

A patient presents with ACS and is found to have a history of prior intracranial hemorrhage. Which antiplatelet agent should be AVOIDED?

Accepted Answer

Prasugrel

Answer

Prasugrel is contraindicated in patients with a history of stroke or TIA due to significantly increased risk of intracranial hemorrhage.

ACLS Practice Test

ACLS Practice Test

ACLS Acute Coronary Syndromes 4