A 52-year-old patient presents to the emergency department with ...

[CORALGRILL2014]

A 52-year-old patient presents to the emergency department with reports of substernal chest pain
 
  A history is taken; serum creatine kinase (CK) and lactate dehydrogenase (LDH) isoenzymes and serum lipid studies are ordered, as is a 12-lead ECG. Which of the following results is most significant in diagnosing an MI during the first 12 hours of chest pain?
 
  a. ECGinverted T waves
  b. Serum enzymeselevated LDH4
  c. Serum enzymeselevated CK-MB
  d. Patient historysubsternal chest pain

Question 2

The ventilator variable that causes inspiration is called the
 
  a. cycle.
  b. trigger.
  c. flow.
  d. pressure.

[diesoon]

Answer to Question 1

C
The creatine kinase (CK) muscle/brain (MB) biomarker (CK-MB) is released as a result of myocardial damage, and serum levels rise 4 to 8 hours after myocardial infarction (MI), peak at 15 to 24 hours, and remain elevated for 2 to 3 days. Serial samples are drawn routinely at 6- or 8-hour intervals, and three samples are usually sufficient to support or rule out the diagnosis of MI.

Answer to Question 2

B
The phase variable that initiates the change from exhalation to inspiration is called the trigger. Breaths may be pressure triggered or flow triggered based on the sensitivity setting of the ventilator and the patient's inspiratory effort or time triggered based on the rate setting of the ventilator.