03 S P M P On Acute Myocardial Infarction
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This document discusses the diagnosis and management of acute myocardial infarction (AMI). It provides details on: 1) The clinical presentation and diagnosis of AMI based on symptoms, signs, and electrocardiogram (ECG) findings. 2) Emergency treatments for AMI including aspirin, nitrates, oxygen, monitoring, and thrombolytic therapy when indicated. 3) Guidelines for thrombolytic therapy including indications, contraindications, dosing and monitoring for complications. 4) Additional measures needed during hospitalization and recovery from AMI including medications, lifestyle advice, and follow-up.
![SPMP ACUTE MYOCARDIAL INFARCTION Dr. S. Aswini Kumar. MD. A 45 year-old male patient is brought to the emergency department with the history of sudden onset of chest discomfort: III. 01. Diagnosis of Myocardial Infarction is based on following history EXCEPT: Retro-sternal pain of poorly localizing nature Extremely anxious relatives of the patient Constricting, burning or tightness in character Profuse sweating other autonomic symptoms Classical radiation of pain to left upper limb III. 02. Clinical examination of the patient should be done quickly to assess: Pulse rate in one minute Blood pressure Muffling of heart sounds Gallop rhythm & bilateral basal creps All of the above III. 03. Following investigations are to be ordered urgently the EXCEPT: 12 lead ECG X Ray Chest PA Random Blood Sugar CPK Mb or Trop T Serum electrolytes III. 04. ECG changes diagnostic of Acute MI are the following EXCEPT: ST elevation A new Q wave Deep S in V1 Tall peaked T wave T inversion III. 05. In Acute MI, the following will promptly relieve the chest pain: Glyceryl trinitrate S/L Tab.Aspirin 650 mg S/L Cap.Nifidipine 5mg S/L Absolute bed rest None of the above III. 06. The following emergency measures are taken EXCEPT: Admitting to ICCU and placing on a cardiac cot Continuous ECG lead monitoring Administer One tablet of Aspirin 325mg orally Give Morphine 3mg IV diluted in dextrose Tab.Digoxin 0.5mg stat. III. 07. Indications for thrombolytic therapy are the following EXCEPT: Patients received within 6 hours of chest pain ST ^ of 1mm in 2 contiguous limb leads ST ^ 2mm in 2 contiguous chest leads New RBBB New LBBB. III. 08. Contra indications for thrombolytic therapy include the following: A. Recent trauma or surgery B. Stroke or previous thrombolysis within 6m C. BP > 180/110 mm of Hg D. Suspected active internal bleeding E. All of the above III. 09. Relative contraindication for thrombolytic therapy are the following EXCEPT: ,[object Object],B. Diabetic retinopathy C. Active menstruation D. Prolonged CPR E. Myocardial infarction III. 10. The dose of Streptokinase is A. 1.5 Lakh Units over 1 hours given as S/C B. 1.5 Lakh Units over 2 hours given as I/M C. 1.5 Million Units over 1 hour as IV infusion D. 15 Million Units over 2 hour slow intra cardiac E. 15 Million units over 2 hours as IV infusion. III. 11. When administering streptokinase, one has to closely watch for following complications ,[object Object],B. Hypotension C. Anaphylaxis DAllergy E. All of the above III. 12. The success of fibrinolytic therapy can be assessed by the following: A. Relief from chest pain B. Decrease in ST elevation C. Appearance of reperfusion arrhythmias D. Reduction in infarction size by ECHO E. All of the above III. 13. Give the following drugs orally EXCEPT: ,[object Object]](https://image.slidesharecdn.com/03spmponacutemyocardialinfarction-090820020916-phpapp01/85/03-s-p-m-p-on-acute-myocardial-infarction-1-320.jpg)
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03 S P M P On Acute Myocardial Infarction
- 3. Tab.Enalapril 2.5 mg bid LV dysfunction
- 4. Cap.Nifedipine 5mg S/L three times daily
- 6. Reassurance
- 7. Light easily digestible semi solid food
- 8. Laxatives like cremaffin to avoid constipation
- 12. WPW Syndrome
- 15. Pericarditis
- 18. Metoprolol 25 mg BID
- 21. Weekly review in OPD