Coronary artery disease: Clinical (To be retired)

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Coronary artery disease: Clinical (To be retired)

Medical and surgical emergencies

Cardiology, cardiac surgery and vascular surgery

Advanced cardiac life support (ACLS): Clinical (To be retired)

Supraventricular arrhythmias: Pathology review

Ventricular arrhythmias: Pathology review

Heart blocks: Pathology review

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Pericardial disease: Clinical (To be retired)

Valvular heart disease: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Shock: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Cholinomimetics: Direct agonists

Cholinomimetics: Indirect agonists (anticholinesterases)

Muscarinic antagonists

Sympathomimetics: Direct agonists

Sympatholytics: Alpha-2 agonists

Adrenergic antagonists: Presynaptic

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Loop diuretics

Thiazide and thiazide-like diuretics

Calcium channel blockers

cGMP mediated smooth muscle vasodilators

Class I antiarrhythmics: Sodium channel blockers

Class II antiarrhythmics: Beta blockers

Class III antiarrhythmics: Potassium channel blockers

Class IV antiarrhythmics: Calcium channel blockers and others

Positive inotropic medications

Antiplatelet medications

Dermatology and plastic surgery

Blistering skin disorders: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Burns: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Parathyroid conditions and calcium imbalance: Clinical (To be retired)

Adrenal insufficiency: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Insulins

Mineralocorticoids and mineralocorticoid antagonists

Glucocorticoids

Gastroenterology and general surgery

Abdominal pain: Clinical (To be retired)

Appendicitis: Clinical (To be retired)

Gastrointestinal bleeding: Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Inflammatory bowel disease: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Gallbladder disorders: Clinical (To be retired)

Pancreatitis: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Hernias: Clinical (To be retired)

Bowel obstruction: Clinical (To be retired)

Abdominal trauma: Clinical (To be retired)

Laxatives and cathartics

Antidiarrheals

Acid reducing medications

Hematology and oncology

Blood products and transfusion: Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Anticoagulants: Heparin

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Thrombolytics

Infectious diseases

Fever of unknown origin: Clinical (To be retired)

Infective endocarditis: Clinical (To be retired)

Pneumonia: Clinical (To be retired)

Tuberculosis: Pathology review

Diarrhea: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Meningitis, encephalitis and brain abscesses: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Antituberculosis medications

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications

Azoles

Echinocandins

Miscellaneous antifungal medications

Anthelmintic medications

Antimalarials

Anti-mite and louse medications

Nephrology and urology

Hypernatremia: Clinical (To be retired)

Hyponatremia: Clinical (To be retired)

Hyperkalemia: Clinical (To be retired)

Hypokalemia: Clinical (To be retired)

Metabolic and respiratory acidosis: Clinical (To be retired)

Metabolic and respiratory alkalosis: Clinical (To be retired)

Toxidromes: Clinical (To be retired)

Medication overdoses and toxicities: Pathology review

Environmental and chemical toxicities: Pathology review

Acute kidney injury: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Seizures: Clinical (To be retired)

Headaches: Clinical (To be retired)

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Spinal cord disorders: Pathology review

Anticonvulsants and anxiolytics: Barbiturates

Anticonvulsants and anxiolytics: Benzodiazepines

Nonbenzodiazepine anticonvulsants

Migraine medications

Osmotic diuretics

Antiplatelet medications

Thrombolytics

Opioid agonists, mixed agonist-antagonists and partial agonists

Opioid antagonists

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Venous thromboembolism: Clinical (To be retired)

Acute respiratory distress syndrome: Clinical (To be retired)

Pleural effusion: Clinical (To be retired)

Pneumothorax: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Glucocorticoids

Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Assessments

Coronary artery disease: Clinical (To be retired)

USMLE® Step 2 questions

0 / 20 complete

Questions

USMLE® Step 2 style questions USMLE

of complete

A 60-year-old man is brought to the emergency department because of crushing substernal chest pain for the past 45 minutes. The patient received 325 mg of aspirin in the ambulance. Medical history includes diabetes mellitus type 2 and asthma, for which the patient takes albuterol as needed. Other medications include carvedilol and sildenafil. The patient’s temperature is 36.8°C (98°F), pulse is 99/min, respirations are 18/min, and blood pressure is 160/90 mm Hg. The patient appears diaphoretic. An ECG is obtained and shown below:  


Reproduced from: Wikimedia Commons  

Which of the following is the most appropriate next step in management?  

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Antonella Melani, MD

Tanner Marshall, MS

Coronary artery disease can lead to myocardial ischemia which is when the myocardium isn’t getting a sufficient blood supply; so there isn’t enough oxygen to meet the heart’s demands.

And coronary artery disease is characterized by a type of chest pain called angina pectoris, which can be due to either vasospastic disease and atherosclerotic disease.

Vasospastic disease, also called Prinzmetal angina, is when for unclear reasons there’s transient vasoconstriction of a coronary artery, leading to transient ischemia.

These attacks generally occur at rest, during the night or early morning, and occur in clusters.

Atherosclerotic disease is when a coronary artery narrows due to build up of atherosclerotic plaque, and it can be further divided into stable angina, unstable angina, and myocardial infarction.

Unstable angina and myocardial infarction are collectively called acute coronary syndrome.

Patients with stable angina don’t feel pain at rest, but they do feel chest pain during intense physical exercise, because that’s when the myocardium has increased oxygen demand, which leads to transient or demand ischemia.

The chest pain stops when the exercise stops, so these patients often just rest rather than going to the emergency department or ED.

Now, angina is considered unstable if it presents at rest, or if it becomes more frequent, lasts longer, or occurs with less exertion than previous episodes of angina.

Elsevier

Copyright © 2023 Elsevier, except certain content provided by third parties

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