NON-ST-Segment Elevation Myocardial

Infarction and Unstable Angina

Which of the following is true about
NSTEMI?
A. Evidence of myocyte necrosis
B. Increasing burden of diabetes and CKD in an aging population
C. Declining due to greater use of ASA, statins, and less smoking
D. Both A & B
Which of the following is true about
NSTEMI?
A. Evidence of myocyte necrosis
B. Increasing burden of diabetes and CKD in an aging population
C. Declining due to greater use of ASA, statins, and less smoking
(STEMI)
D. Both A & B

p. 1866
Which of the following is a not a process
that lead to thrombus formation?
A. Disruption of an unstable coronary plaque
B. Coronary arterial vasodilation
C. Gradual intraluminal narrowing
D. NOTA
Which of the following is a not a process
that lead to thrombus formation?

A. Disruption of an unstable coronary plaque

B. Coronary arterial vasodilation (vasoconstriction)
C. Gradual intraluminal narrowing
D. NOTA

p. 1866
The diagnosis of NSTE-ACS is based
largely on?
A. Clinical presentation
B. Cardiac enzymes
C. ECG
D. AOTA
The diagnosis of NSTE-ACS is based
largely on?
A. Clinical presentation
B. Cardiac enzymes
C. ECG
D. AOTA

p. 1866
Chest discomfort has atleast one of 3
features which includes:

A. Occurrence at rest (or with minimal exertion), lasting <10 min

B. Of relatively recent onset
C. Crescendo pattern
D. Both B & C
Chest discomfort has atleast one of 3
features which includes:
A. Occurrence at rest (or with minimal exertion), lasting <10 min
(>10min)
B. Of relatively recent onset
C. Crescendo pattern
D. Both B & C

p.1868
The major non-invasive tools used in the
evaluation of NSTEMI-ACS:

A. ECG
B. Cardiac biomarkers
C. Stress testing
D. AOTA
The major non-invasive tools used in the
evaluation of NSTEMI-ACS:

A. ECG
B. Cardiac biomarkers
C. Stress testing
D. AOTA

p.1868
The Thrombolysis in MI(TIMI) trial
includes the following except:

A. Age ≥ 65 years old

B. Known history of CAD or coronary stenosis of atleast 40%
C. Daily ASA use in the prior week
D. More than 1 anginal episode in the past 24H
The Thrombolysis in MI(TIMI) trial
includes the following except:

A. Age ≥ 65 years old

B. Known history of CAD or coronary stenosis of atleast 40%
( atleast 50%)
C. Daily ASA use in the prior week
D. More than 1 anginal episode in the past 24 h

p.1868
The only absolute contraindications to the use
of nitrates includes the following except:

A. hypotension
B. Recent use of a phosphodiesterase type 5 (PDE-5) inhibitor
C. Sildenafil
D. Vardenafil (within 48 h)
The only absolute contraindications to the use
of nitrates includes the following except:

A. hypotension
B. Recent use of a phosphodiesterase type 5 (PDE-5) inhibitor
C. Sildenafil
D. Vardenafil (within 48 h) (within 24 h)

Tadalafil (within 48 h)
p.1869
What is an inactive prodrug that is converted into an active
metabolite that causes irreversible blockade of the platelet
P2Y12 receptor?

A. ASA
B. Dabigatran
C. Clopidogrel
D. Ticlopidine
What is an inactive prodrug that is converted into an active
metabolite that causes irreversible blockade of the platelet
P2Y12 receptor?

A. ASA
B. Dabigatran
C. Clopidogrel
D. Ticlopidine

p.1869
When to avoid Beta blockers in patients
with UA and NSTEMI?

A. Heart rate <50 bpm

B. Shock
C. Left ventricular failure
D. AOTA
When to avoid Beta blockers in patients
with UA and NSTEMI?

A. Heart rate <50 bpm

B. Shock
C. Left ventricular failure
D. AOTA

p.1869
What is a novel, potent, reversible platelet P2Y12 inhibitor
that reduce the risk of cardiovascular death, total mortality or
MI?

A. Ticagrelor
B. Cangrelor
C. Prasugrel
D. Clopidogrel
What is a novel, potent, reversible platelet P2Y12 inhibitor
that reduce the risk of cardiovascular death, total mortality or
MI?

A. Ticagrelor
B. Cangrelor
C. Prasugrel
D. Clopidogrel

p.1870
Which of the following is not an oral antiplatelet drug?

A. ASA
B. Clopidogrel
C. Prasugrel
D. Cangrelor
Which of the following is not an oral antiplatelet drug?

A. ASA
B. Clopidogrel
C. Prasugrel
D. Cangrelor (IV antiplatelet)

p.1870
Which of the following is not an anti-
coagulant?

A. UFH
B. Fondaparinux
C. Enoxaparin
D. NOTA
Which of the following is not an anti-
coagulant?

A. UFH
B. Fondaparinux
C. Enoxaparin
D. NOTA

Anticoagulants: UFH, Fondaparinux, enoxaparin, Bivalirudin

p.1870
What is an anticoagulant that is used just
prior to and/ or during PCI?

A. Fondaparinux
B. UFH
C. Enoxaparin
D. Bivalirudin
What is an anticoagulant that is used just
prior to and/ or during PCI?

A. Fondaparinux
B. UFH
C. Enoxaparin
D. Bivalirudin

p.1871
Which of the following is correctly matched in the invasive
strategy or ischemia-guided strategy in patients with NSTE-
ACS?

A. Early invasive – within 24 h

B. Immediate invasive – within 4 h
C. Delayed invasive – within 24-72 h
D. AOTA
Which of the following is correctly matched in the invasive
strategy or ischemia-guided strategy in patients with NSTE-
ACS?

A. Early invasive – within 24 h

B. Immediate invasive – within 4 h (within 2 h)
C. Delayed invasive – within 24-72 h (within 25-72 h)
D. AOTA

p.1871
Source:

Harrison’s Principles of Internal Medicine, 20th ed

Chap. 268, p.1866-1871