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WorksheetsACS Pathophysiology and Initial Management Questions
Total questions: 27
Worksheet time: 14mins
Which of the following best describes the primary pathophysiological mechanism of ACS?
Autoimmune destruction of cardiac myocytes
Rupture of an atherosclerotic plaque with subsequent thrombosis
Viral infection of the myocardium
Hypertensive-induced left ventricular hypertrophy
Which of the following is considered a major modifiable risk factor for atherosclerosis?
Age
Family history of CAD
Hypertension
Male sex
A patient presents with sudden-onset crushing chest pain radiating to the left arm and jaw, diaphoresis, and nausea. Which ACS subtype is most likely?
Unstable angina
NSTEMI
STEMI
Prinzmetal angina
In ACS, which of the following is the preferred reperfusion strategy if it can be performed within 90 minutes of first medical contact?
Oral beta-blockers
Primary percutaneous coronary intervention (PCI)
Thrombolytic therapy
CABG surgery
A 60-year-old male with ACS has risk factors including diabetes, hypertension, and smoking. Which type of plaque is most likely responsible for his ACS?
Fibrous plaque with thick cap
Lipid-rich plaque with thin fibrous cap
Calcified plaque only
Plaque without lipid core
What is the main rationale for using thrombolytic therapy in STEMI?
Reduce blood pressure
Dissolve the occlusive thrombus and restore coronary blood flow
Prevent arrhythmias
Reduce cholesterol levels
Which of the following best explains the rationale for using PPCI over thrombolytic therapy when available?
It's faster to perform
It causes more bleeding
It has a higher rate of complete reperfusion and lower risk of re-occlusion
It's cheaper
Delayed reperfusion in ACS primarily leads to:
Reduced cardiac enzyme release
Smaller infarct size
Greater myocardial damage and poor prognosis
Reduced risk of re-infarction
The primary mechanism of action of thrombolytic agents is:
Blocking platelet aggregation
Dissolving fibrin in blood clots
Lowering blood cholesterol
Reducing heart contractility
A patient with ACS is most likely to describe pain radiating to:
The abdomen
The right leg
The left arm or jaw
The lower back
Which of the following best describes the chest pain in ACS?
Sharp, stabbing pain relieved by deep breathing
Burning pain worsened by food intake
Pressure-like, radiating pain not relieved by rest
Localized tenderness over the chest wall
Which lipid abnormality most strongly contributes to atherosclerosis?
High HDL
Low LDL
High LDL
Low triglycerides
Diabetes mellitus increases the risk of atherosclerosis primarily by:
Increasing HDL cholesterol
Promoting endothelial dysfunction and inflammation
Lowering blood pressure
Decreasing platelet activity
Which lipid abnormality most strongly contributes to atherosclerosis?
High HDL
Low LDL
High LDL
Low triglycerides
Which of the following best describes the chest pain in ACS?
Sharp, stabbing pain relieved by deep breathing
Burning pain worsened by food intake
Pressure-like, radiating pain not relieved by rest
Localized tenderness over the chest wall
A patient with ACS is most likely to describe pain radiating to:
The abdomen
The right leg
The left arm or jaw
The lower back
Which ECG change is characteristic of a ST-Elevation Myocardial Infarction (STEMI)?
ST-segment depression
T-wave inversion
ST-segment elevation
U-wave prominence
The goal of reperfusion therapy in ACS is to:
Lower heart rate
Restore blood flow to ischemic myocardium
Decrease oxygen consumption
Reduce blood pressure
What is the recommended door-to-balloon time for primary PCI in STEMI management?
30 minutes
60 minutes
90 minutes
120 minutes
In NSTEMI cases, when is thrombolysis indicated?
When PCI is unavailable within 120 minutes
Never indicated
Only after failed PCI
Only in hemodynamically stable patients
When is thrombolytic therapy preferred over primary PCI?
When PCI is unavailable within 120 minutes
When PCI is readily available
In patients with high bleeding risk
In NSTEMI cases
The primary mechanism of action of thrombolytic agents is:
Blocking platelet aggregation
Dissolving fibrin in blood clots
Lowering blood cholesterol
Reducing heart contractility
The main purpose of early reperfusion therapy in STEMI is to:
Prevent arrhythmias
Limit myocardial necrosis and preserve heart function
Decrease cholesterol levels
Increase blood pressure
Delayed reperfusion in ACS primarily leads to:
Reduced cardiac enzyme release
Smaller infarct size
Greater myocardial damage and poor prognosis
Reduced risk of re-infarction
Which of the following best explains the rationale for using PPCI over thrombolytic therapy when available?
It’s faster to perform
It causes more bleeding
It has a higher rate of complete reperfusion and lower risk of re-occlusion
It’s cheaper
In reperfusion therapy, which clinical outcome is the best indicator of success?
Decreased pain only
Resolution of ST elevation on ECG and symptom relief
Increased heart rate
Elevated blood pressure
Which of the following events occurs first in the development of atherosclerosis?
Platelet aggregation
Smooth muscle migration
Endothelial injury
Plaque rupture
