skip to main content

Non-ST-elevation myocardial infarction — USMLE Step 2 CK MCQ

Instant feedback + full explanation. One question, done properly.

ModerateInternal MedicineNon-ST-elevation myocardial infarctionUSMLE Step 2 CK

A 37-year-old African American woman comes to the urgent care clinic because of progressive symptoms. History and focused examination are notable for substernal pressure with elevated troponin and dynamic ST depression. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate pharmacotherapy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Aspirin, anticoagulation, high-intensity statin, and early invasive evaluation

The vignette describes Non-ST-elevation myocardial infarction, supported by substernal pressure with elevated troponin and dynamic ST depression. Aspirin, anticoagulation, high-intensity statin, and early invasive evaluation is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://professional.heart.org/en/guidelines-and-statements#stage-9-order-16