WBR0361
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| Author | Neeraja Danda M.B.B.S |
|---|---|
| Exam Type | USMLE Step 2 CK |
| Main Category | Internal medicine |
| Sub Category | Cardiovascular |
| 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 | Thrombolysis |
| Answer A Explanation | Incorrect Thrombolysis is never the treatment of choice in Non ST elevation or ST depression Myocardial infarction |
| Answer B | Exercise tolerance testing |
| Answer B Explanation | 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 | Nitroglycerine |
| Answer C Explanation | Incorrect Nitroglycerine is useful but does not have clear mortality benefits |
| Answer D | Heparin, Glycoprotein IIb, IIIa inhibitors |
| Answer D Explanation | Incorrect Option D is also correct but E includes angioplasty as well which makes it the best option |
| Answer E | Heparin, Glycoprotein IIb , IIIa inhibitors and Angioplasty |
| Answer E Explanation | 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 | E |
| 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 |
| Approved | Yes |
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