A 54-year-old man is evaluated in the emergency room for an acute coronary syndrome that began 30 minutes ago. He has hypertension and T2DM for which he takes lisinopril and gliclazide. On examination, he is afebrile, BP 160/90 mmHg, HR 80/min, and RR 12/min. He has normal S1 and S2. Lungs are clear. An initial serum troponin is pending, ECG shows 3mm ST-segment elevation in leads V1-V4. Treatment is Initiated with aspirin, clopidogrel, B- blocker, and unfractionated heparin. Which of the following is the most appropriate next step in management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Percutaneous coronary intervention
3 mm ST elevation in V1–V4 = anterior STEMI; the diagnosis does not need troponin, so waiting for it (A) delays reperfusion. All STEMI patients need reperfusion, and primary PCI is preferred when available within 90–120 min. Fibrinolysis (C) is only for when PCI cannot be done in time; medical therapy alone (B) is inadequate for STEMI.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Do not wait for troponin: the approach is to initiate therapy without delaying revascularization.
✓ CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 10 -
B
ليش غلط
Medical therapy alone is not enough in STEMI: all patients should undergo PCI if readily available, which improves mortality.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 16 -
C
ليش غلط
Fibrinolysis is only considered when PCI is not available within 120 minutes; nothing here says PCI is unavailable.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 16 -
D
ليش صح
For STEMI, PCI is preferred to fibrinolysis if it can be done within 120 minutes (ideally 90), and it improves mortality.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 16
- المصدر
- Step-Up To Medicine 6th (IHD & ACS).pdf · p. 16
- المحاضرة
- Acute Coronary Syndrome · Cardiology · Module B
- ظهر في
- Cardio bank