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+--- Thread: fischer q.... - dransal (/showthread.php?tid=277844)
fischer q.... - dransal - ArchivalUser - 03-06-2008
A patient comes to the hospital with 1 to 2 hours of crushing substernal chest pain and ST-segment depression in V2-V4. He has a history of peptic ulcer disease and diabetes. He currently has melena. Which of the following will result in the greatest decrease in mortality?
(A) Angioplasty
(B) Metoprolol
© Captopril
(D) Nitrates
(E) Emergency bypass
(F) Tirofiban
(G) Heparin
(H) Aspirin
0 - ArchivalUser - 03-06-2008
A..
0 - ArchivalUser - 03-06-2008
right..
0 - ArchivalUser - 03-06-2008
E .ST depression why angioplasty please explain cricoid
0 - ArchivalUser - 03-06-2008
maddr,
seems like pt is having an acute MI...
you can have MI with ST depression....
diabetics can present with just SOB and no CP....& would be having an MI...
correct management calls for relieve of occlusion and to decrease O2 demand...
PUD is relative C/I to thrombolytic use, whereas active bleed as absolute C/I...
so the next best thing to relieve an oclusion is Angioplasty...
go down the treatment paln....one by one.....
don't jump to the last resort right in the begining....
i hope this helps...
i am sure dransal has a much better explaination for you....
0 - ArchivalUser - 03-06-2008
explanation...
The patient is presenting with unstable angina and a major contraindication to the use of anticoagulants. Angioplasty is the better way to open the artery and prevent further clot formation. Aspirin, heparin, thrombolytics, and the glycoprotein IIb/IIIa inhibitors, such as tirofiban or eptifibatide, cannot be used in patients with serious gastrointestinal bleeding. Beta-blockers will improve mortality but not as much as opening up the blood vessel with angioplasty. Emergency bypass is only performed in the rare case in which anticoagulants and angioplasty either don't work or are contraindicated and the patient is having worsening chest pain and signs of progression to congestive failure.
0 - ArchivalUser - 03-06-2008
thanks