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NBME 20 Answers

nbme20/Block 2/Question#18 (30.5 difficulty score)
A 65-year-old man is brought to the emergency ...
ST-segment elevationπŸ”,πŸ“Ί
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 +5 
submitted by hayayah(1100),
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siTh anm si nisogwh ssx fo na MI.

atilIni peahs of mlrcoiaady onrcntiifa ldsea ot nialscdaduboer seocnrsi voigivnnl &tl; 5%0 of teh aldiarycmo scthskine r(dabueaicsdlon f)ncr;atiion EKG owssh s-gmSntTee risesenpod.

edtinnCuo ro reseev ahimeics 02t;(&g imen)stu esadl to nsulrmraat sonrecsi viinlongv msto fo the rdaiyalmco lwla nr(arluatms ncnfiar);ito EKG ohwss Snetgsem-T aio.eltvne

charcot_bouchard  May i know where do u read this +2  
mbourne  @hayayah, Although this is a bit outside of the realm of Step 1, I want to clarify a point. Early MI does not typically lead to ST-depression. Early MI will typically present with hyperacute T-waves with straightening of the ST segment, and then evolve towards more familiar "STEMI" morphology. Great image representation of MI EKG changes: https://4.bp.blogspot.com/-_UbS4PvbTZE/Wr0M27TZhUI/AAAAAAAABB0/-M8FSuvTKeEGkx-7HrEd45Fl0phb2-T8gCLcBGAs/s1600/Progression%2Bof%2BACO%2Bfinal_diagram.png ST depression from subendocardial ischemia can occur with supply/demand mismatch --> ISCHEMIA, but not Myocardial INFARCTION. +2  



 +1 
submitted by strugglebus(172),
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ST will sitfr reee;cdsa erwo,veh afetr 02 inm it iwll sreciean ea()leevt