Deck 2: Acute Coronary Syndrome

Question 1

Approximately one quarter of the patients who are having a myocardial infarction have a STEMI on their initial 12-lead ECG.

Answer 1

False

Question 2

Hypotension is a common side effect of nitroglycerin. In lower doses, nitroglycerin is a venodilator.

Answer 2

True

Question 3

Atypical presentations of ACS, when linked with cardiac-related events, are often termed ____, meaning the patient will develop these complaints rather than pain with ACS events.

A) coronary-related
B) angina-related
C) angina equivalents
D) coronary events

Answer 3

angina equivalents

Question 4

The most common pathophysiology of ACS involves gradual build-up over time of atherosclerotic plaque along the lumen of the coronary arteries.

Question 5

Patients with hyperventilation syndrome (HVS), also known as ____, markedly decrease their arterial pCO₂levels, causing a leftward shift in the oxyhemoglobin curve and hypocalcemia.

A) chest pain
B) psychogenic dyspnea
C) coronary artery spasm
D) coronary vasospasm

Question 6

Pericarditis is associated with a high fever of at least 102°F.

Question 7

In a(n) ____, there has been complete occlusion of the coronary artery and the 12-lead ECG reveals at least 1 mm elevation of the ST segments in at least two contiguous anatomical leads.

A) ST elevation myocardial infarction
B) QT elevation myocardial infarction
C) ischemic penumbra
D) QS elevation myocardial infarction

Question 8

The most common symptom reported by patients with ACS is ____.

A) chest pain
B) shortness of breath
C) dyspnea
D) diaphoresis

Question 9

____ occurs with exertion and goes away with rest.

A) Pericardial effusion
B) Unstable angina
C) Stable angina
D) Coronary vasospasm

Question 10

There are a number of factors that are thought to contribute to hyperventilation syndrome including panic disorders, agoraphobia, and stimulants such as caffeine.

Question 11

____ is cardiac pain secondary to ischemia that occurs as a result of the narrowing of the coronary arteries.

A) Angina pectoris
B) Psychogenic dyspnea
C) Pericarditis
D) Myocarditis

Question 12

The most specific enzyme for a myocardial infarction is ____.

A) CPK
B) myoglobin
C) CK-MB
D) troponin

Question 13

In a(n) ____ there is permanent damage to myocardial cells; however, at the time of presentation, the 12-lead ECG does not demonstrate ST segment elevations.

A) non-QT elevation myocardial infarction
B) angina attack
C) cocaine-related coronary attack
D) non-ST elevation myocardial infarction

Question 14

The goal of oxygen administration should be to maintain oxygen saturation greater than 95% in the normovolemic patient.

Question 15

Pain occurs when the amount of blood flowing through the narrowed or blocked coronary artery is less than the amount of acidic byproducts that build up in the myocardium.

Question 16

CK-MB is a subtype of creatine kinase that is more specific for myocardial cells, but is still found to a small extent in skeletal muscle.

Question 17

____ is an increased amount of fluid or blood in the pericardial sac surrounding the heart.

A) Pericardial effusion
B) Stenosis
C) Pulmonary hypertension
D) Thrombosis

Question 18

The Paramedic should be cautious about using the term "pain" or expecting the patient to use the word.

Question 19

____ is a generic term used to describe the symptom pattern related to coronary artery disease that, untreated, results in unstable angina and myocardial infarction.

A) Acute cardiac event
B) Acute coronary syndrome
C) Acute angina
D) Coronary arterial disorder

Question 20

Dissection of the thoracic aorta is a common condition that presents with sharp chest pain.

Question 21

Scarring of a cardiac valve is called ____ and may occur for a variety of reasons.

A) edema
B) regurgitation
C) hemoptysis
D) stenosis

Question 22

Nitroglycerin's action peaks at about ____ minutes.

A) one to three
B) three
C) five
D) six to seven

Question 23

____ is defined as an elevated pressure in the pulmonary vascular system.

A) Pulmonary congestion
B) Pulmonary hypertension
C) Pulmonary edema
D) Hyperpulmonary disease

Question 24

The ____ secure(s) the chordate tendineae (heart strings) that open the two leaflets of the mitral valve.

A) pulmonary muscles
B) inferior muscle bundle
C) papillary muscles
D) mitral muscles

Question 25

These patient populations who have an atypical presentation of acute coronary syndrome, such as women, elderly, and patients with diabetes, may be said to be experiencing a(n) "____________________" AMI.

Question 26

____ is an infection of the endocardial, or inner, layer of the heart, which includes the valves' tissue and the inner surface of the chambers.

A) Endocarditis
B) Pulmonary edema
C) Stenosis
D) Hemoptysis

Question 27

Aspirin (acetylsalicylic acid or ASA) interferes with the platelets' ability to bind to one another through suppression of the production of ____________________.

Question 28

____________________ is a procedure used to widen vessels narrowed by stenosis or occlusions.

Question 29

____ occurs when the amount of pericardial fluid in the pericardial sac becomes large enough to interfere with ventricular filling.

A) Cardiac thrombosis
B) Pericardial effusion
C) Pericardial tamponade
D) Hemoptysis

Question 30

Surrounding the damaged myocardium is an ischemic ____________________ consisting of adjacent myocardium that is ischemic, but not yet dead.

Question 31

____ is an inflammation of the myocardial tissue.

A) Pulmonary edema
B) Myocarditis
C) Stenosis
D) Hemoptysis

Question 32

A ____ refers to the upward heave of the heart.

A) thrill
B) reflux
C) crescendo
D) reflex

Question 33

Atypical presentations, when linked with cardiac-related events, are often termed ____________________ equivalents, meaning the patient will develop these complaints rather than pain with ACS events.

Question 34

____ involves an increasing frequency of symptoms over time and may indicate progressive coronary artery disease.

A) Unstable angina
B) Nonclassic
C) Atypical angina
D) Crescendo angina

Question 35

____ is a cough producing either frank blood or bloody sputum.

A) Regurgitation
B) Rales
C) Hemoptysis
D) Consumption