Category: ALSMCQ PILLS

ALSMCQ ECG

Posted by on in 9. Defibrillation, ALSMCQ PILLS

A 64-year-old man presented to the Emergency Department with epigastric pain and vomiting. He does not have fever, and he is haemodynamically stable with good saturation on room air. The CT abdomen evidences gallstone pancreatitis. However, on arrival to the ward, the nurse finds an ECG that the surgical team has not looked at (image below), with a Troponin result of 18. Which of the following options is/are CORRECT in the management of this patient?:

a) Call "Cardiac Arrest" for help: TRUE/FALSE.

b) Repeat ECG: TRUE/FALSE.

c) Start ACS (Acute Coronary Syndrome) treatment with aspirin, clopidogrel and atorvastatin: TRUE/FALSE.

d) T wave inversion can be seen in Pancreatitis and a negative troponin rules out ACS: TRUE/FALSE.

ALS COVID-19

Posted by on in ALSMCQ PILLS, Cardiac Arrest in Special Circumstances

A 64-year-old woman is admitted to Intensive Care with acute respiratory failure due to coronavirus disease 2019 (COVID-19). She is severely hypoxaemic (O2 Saturation 67%) and requires intubation and mechanical ventilation. She is not considered for ECMO (extracorporeal membrane oxygenation) and two hours after proning the patient suffers a cardiac arrest. Which of the following statements are CORRECT regarding cardiopulmonar resuscitation in prone position?:

a) Chest compressions can be started by compressing the spine in between the scapulae aiming for a diastolic pressure of 35 mmHg on the arterial line: TRUE/FALSE.

b) If the cardiac arrest rhythm is shockable, attempt defibrillation by placing the defibrillator pads in a bi-axillary position: TRUE/FALSE.

c) If initial attempts at resuscitation are unsuccessful turn the patient supine to facilitate resuscitation: TRUE/FALSE.

d) Disconect the ventilator and start bag ventilation at 10 breaths per minute: TRUE/FALSE.

ALS and Morphine

Posted by on in 4. Acute Coronary Syndromes, ALSMCQ PILLS

A 51 year – old woman who is profusely diaphoretic and hypertensive reports crushing substernal chest pain and severe shortness of breath. She has a history of hypertension. She chewed 2 low – dose aspirins at home and is now receiving oxygen in the ambulance. Which treatment is appropriate?:

a) Morphine and then nitroglycerin, but only if morphine fails to relieve the pain: TRUE / FALSE.

b) Nitroglycerin and then morphine, but only if ST elevation is > 2 mm and no contraindications exist: TRUE / FALSE.

c) Nitroglycerin and then morphine, but only if nitroglycerin fails to relieve the pain and no contraindications exist: TRUE / FALSE.

d) Nitroglycerin only because chronic hypertension is a contraindication for morphine: TRUE / FALSE.

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ALS Pulmonary Embolism

Posted by on in ALSMCQ PILLS

Which of the following is/are not considered high risk factors for pulmonary embolism?:

a) Postpartum: TRUE / FALSE.

b) Oral contraceptives: TRUE / FALSE

c) Quimiotherapy: TRUE / FALSE

d) Spinal cord injury: TRUE / FALSE

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Adrenaline in ALS

Posted by on in ALSMCQ PILLS, Content

Indicate the correct administration of adrenaline 1 mg in the following scenarios:

a) A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock.

b) A patient presents pulseless electrical activity after the first shock.

c) An unconscious patient with a palpable pulse of 40 bpm.

d) Patient suffers an anaphylactic reaction with shock and airway swelling.

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