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Asked by Brittmk

Hi, please feel free to answer whichever questions in a simple form (even one question is appreciated). I’ve already read the textbooks/uptodate. Looking for straightforward answers to complex medical questions. Thank you! 

 

 

Here are my weekly questions: 

1. Difference between low-sensitivity and high-sensitivity troponin tests? (which is used in ED, serial troponins, etc)

2. What is the value in troponin to be significant? (initial, post) 

3. What is the preferred fibrinolytic therapy to give for STEMI’s? 

4. If a patient + for STEMI and onset within 2 hours, can they receive fibrinolytic therapy THEN get a stent? 

5. ACE vs ARB. I know this is simple and I have the JNC 8 guidelines, but if you could clarify I would appreciate it. 

6. Any change in discharge medications for STEMI, NSTEMI, unstable angina for a patient with CHF?

7. Could you (simply, if possible) explain right axis and left axis deviation? For some reason I’m not comprehending this concept. I understand R axis -> conduction towards right side caused by RVH, left block, COPD, and lateral wall MI. L axis -> cause by LVH, elev diaphragm, left anterior block, inferior wall MI. How do these changes appear on EKG or how would you find a deviation? 

 8. Pharm management of Afib? 1st line beta blockers but when would you give a calcium channel blocker, cardizem drip, or cardioversion? 

9. Left atrium enlargement is a contraindication in cardioversion, how do you identify L atrium enlargement? 

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