Thrombolysis for PE

Regarding thrombolysis for pulmonary embolism (PE):
a) ECG pattern: S1 Q3 T3 is an indication for thrombolysis.
b) If systemic hypotension is present, thrombolysis is contraindicated.
c) D-dimer is very helpful for diagnosis of PE but only a negative result is of any value.
d) Thrombolysis is first line treatment in non – massive PE.

AV block post – STEMI

A 61 year old woman is brought by ambulance after crushing central chest pain with radiaton to her left arm and ST elevation.  On admission she presents a cardiac arrest with an initial rhythm of pulseless electrical activity, but after adrenaline 1 mg IV she  shows signs of life and CPR is stopped.  She is now unresponsive with a heart rate of 38 bpm and complete heart block on the ECG.  Her blood pressure is 62/35 mmHg and O2 Sat 98% on 15 l O2 mask.  Which of the following statements is correct?:
a) The right coronary artery is the most likely artery affected.
b) Isoprenaline infusion would be indicated.
c) Atropine 1 mg IV should be administered repeatedly up to 3 mg until heart rate is restored.
d) Primary angioplasty is indicated.

Crushing central chest pain.

A 55 year – old man presents with 1 hour history of crushing central chest pain, nausea and sweating.  Pulse rate is 38 bpm, BP 75/45 mmHg.  You observe sinus bradycardia in ECG monitor.  You recommend:

a) Atropine 500 mcg iv should be administered.
b) Adrenaline infusion 20 – 100 mcg min is an option.
c) Analgesia with opiates is contraindicated.
d) Oxygenation 24% should be maintained until ABG results arrive.