A woman had an MI. She was breathless and is put on oxygen mask and GTN, her chest pain has
improved. Her HR 40bpm. ECG shows ST elevation in leads I, II, III. What is your next step?
- a. LMWH
- b. Streptokinase
- c. Angiography
- d. Continue current management
- e. None
0 voters
Ans. The key is B. Streptokinase. This is wrong key. Correct key is C. Angiography. [Now a days PCI is
considered to have much better outcome than thrombolysis].
A 45 year old man who is diabetic and hypertensive but poorly compliant has chronic SOB
(shortness Of Breath), develops severe SOB and chest pain. Pain is sharp, increased by breathing
and relieved by sitting forward. What is the single most appropriate dx?
- a. MI
- b. Pericarditis
- c. Lung cancer
- d. Good pastures syndrome
- e. Progressive massive fibrosis
0 voters
Ans. The key is B. Pericarditis. [Nature of pain i.e. sharp pain increased by breathing and relieved by
sitting forward is suggestive of pericarditis].
[Nature of pericardial pain: the most common symptom is sharp, stabbing chest pain behind the
sternum or in the left side of your chest. However, some people with acute pericarditis describe their
chest pain as dull, achy or pressure-like instead, and of varying intensity.
The pain of acute pericarditis may radiate to your left shoulder and neck. It often intensifies when you
cough, lie down or inhale deeply. Sitting up and leaning forward can often ease the pain].