Acute Coronary Syndrome: ABFM practice questions

6 board-style questions on acute coronary syndrome in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 55-year-old man presents to the emergency department with crushing substernal chest pain radiating to his left arm for 40 minutes. He is diaphoretic and nauseated. Vital signs: BP 104/68 mmHg, HR 92 bpm, SpO2 96%. ECG shows 3 mm ST elevation in leads II, III, and aVF with reciprocal ST depression in leads I and aVL. Troponin is pending. What is the most critical immediate next step in management?

1. Administer thrombolytic therapy with tenecteplase
2. Wait for troponin results to confirm the diagnosis before deciding on treatment
3. Start a heparin drip and admit to the cardiac care unit for serial troponins
4. Activate the cardiac catheterization laboratory for primary percutaneous coronary intervention

Sample question 2

A 50-year-old woman with no prior cardiac history presents to the emergency department with acute-onset crushing chest pain and diaphoresis for 30 minutes. Her 12-lead ECG shows 4 mm ST-segment elevation in leads V1 through V4 with reciprocal ST depression in leads II, III, and aVF. Which coronary artery territory is most likely involved?

1. Right coronary artery (inferior wall)
2. Left circumflex artery (lateral wall)
3. Left anterior descending artery (anterior wall)
4. Posterior descending artery (posterior wall)

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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