WBR0361

Author	PageAuthor::Neeraja Danda M.B.B.S
Exam Type	ExamType::USMLE Step 2 CK
Main Category	MainCategory::Internal medicine
Sub Category	SubCategory::Cardiovascular
Prompt	[[Prompt::A 60 year old male who developed sudden chest pain associated with excessive sweating while having his lunch is brought to the emergency department . Electrocardiogram shows ST segment depression in leads V2-V4. Aspirin, Oxygen, Morphine and nitrates are given.Which of the following therapeutics are associated with a major mortality benefit in this patient?]]
Answer A	AnswerA::Thrombolysis
Answer A Explanation	AnswerAExp::'''Incorrect''' Thrombolysis is never the treatment of choice in Non ST elevation or ST depression Myocardial infarction
Answer B	AnswerB::Exercise tolerance testing
Answer B Explanation	AnswerBExp::'''Incorrect''' Exercise tolerance testing is performed to assess if the patient’s heart muscle getting enough oxygen in exertion. It does not confer any mortality benefit.
Answer C	AnswerC::Nitroglycerine
Answer C Explanation	AnswerCExp::'''Incorrect''' Nitroglycerine is useful but does not have clear mortality benefits
Answer D	AnswerD::Heparin, Glycoprotein IIb, IIIa inhibitors
Answer D Explanation	AnswerDExp::'''Incorrect''' Option D is also correct but E includes angioplasty as well which makes it the best option
Answer E	AnswerE::Heparin, Glycoprotein IIb , IIIa inhibitors and Angioplasty
Answer E Explanation	AnswerEExp::Heparin, Glycoprotein IIb, IIIa inhibitors like Abciximab, tirofiban , Epifibatide and Angioplasty offer a significant mortality benefit in Non ST elevation myocardial infarction or ST depression infarctions.
Right Answer	RightAnswer::E
Explanation	[[Explanation::Heparin, Glycoprotein IIb, IIIa inhibitors like Abciximab, tirofiban , Epifibatide and Angioplasty offer a significant mortality benefit in this patient. Educational Objective: Heparin, Glycoprotein IIb, IIIa inhibitors like Abciximab, tirofiban , Epifibatide and Angioplasty offer great mortality benefits in ST depression or Non ST elevation myocardial infarction. References: page 49 Master the boards Step 3 2009 edition, Page 69 Master the boards Step 2 CK second edition Educational Objective: References: ]]
Approved	Approved::Yes
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