DPD Amir Sam 2

Question 1

Which limb leads show ST elevation in an anterior MI?

Answer 1

V3-4

Question 2

Which limb leads show ST elevation in an lateral MI?

Answer 2

I, aVL, V5-6

Question 3

Which limb leads show ST elevation in an inferior MI?

Answer 3

II, III, aVF

Question 4

What are the types of tachycardia?

Answer 4

Sinus tachycardia
SVT
VT
AF
Atrial flutter

Question 5

What is the pattern of atrial flutter?

Answer 5

Sawtooth

Question 6

What is the treatment for atrial flutter?

Answer 6

Similar to AF

Question 7

What is the distinct characteristic of VT?

Answer 7

Broad QRS complexes

Question 8

What is 1st degree HB?

Answer 8

Prolonged P-R interval

Question 9

What is 2nd degree HB?

Answer 9

P wave not followed by a QRS complex

Question 10

What is 3rd degree HB?

Answer 10

Complete dissociation between P and QRS complexes

Question 11

What is LVH by voltage criteria?

Answer 11

Deep S in V1 or 2
Tall R in V5 or 6
Total is greater than 7 large squares

Question 12

How do you manage a Pt with pulseless VT?

Answer 12

Defibrillate

Question 13

How do you manage a Pt with VT and no haemodynamic compromise?

Answer 13

IV amiodarone
Treat underlying cause
ICD (implantable cardioverter defibrillator)

Question 14

What are the causes of LVH?

Answer 14

Hypertension

Aortic stenosis

Question 15

65F SOB for a few hrs
Orthopnoea
Hx 2x MIs
DH- aspirin, simvastatin, ramipril, bisoprolol
Temp 36.5, raised JVP, HS 1+2+3, fine crackles on auscultation, peripheral oedema

What is the diagnosis?

Answer 15

Congestive heart failure

Question 16

What is a third heart sound?

Answer 16

Rapid ventricular filling

Question 17

What can cause a third heart sound?

Answer 17

Congestive heart failure

Question 18

What is the characteristic sound heard in atrial septal defects?

Answer 18

Splitting of the heart sounds

Question 19

What is a fourth heart sound?

Answer 19

Ventricular hypertrophy

Question 20

What is the most appropriate management for a Pt with cHF?

A. Sit them up + 60-100% O2
B. BiPAP
C. CPAP
D. 24% O2
E. Intubate and ventilate

Answer 20

A. Sit them up + 60-100% O2

Question 21

What is the management of acute HF?

Answer 21

Sit up
Oxygen
Frusemide (IV)
Treat the underlying cause

SOFT

Question 22

When would you give a Pt BiPAP in an acute presentation?

Answer 22

When the Pt has respiratory acidosis

Question 23

When would you give a Pt CPAP in an acute presentation?

Answer 23

When the Pt has pulmonary oedema

Question 24

Why shouldn’t you give oral frusemide to a Pt with peripheral oedema?

Answer 24

They will also have gut oedema

Absorption of the diuretic will be poor

Question 25

``` 78M Unconscious Not breathing No carotid pulse Temp 29 ECG shows VF ``` What should you do first to treat the Pt?

Answer 25

Warm them up

Question 26

What is the ALS algorithm for a Pt with VF/pulseless VT?

Answer 26

``` Shock them CPR (2 mins) Assess rhythm Give adrenaline every 3-5 mins Amiodarone after 3 shocks Correct reversible causes ```

Question 27

What is the ALS algorithm for a Pt with asystole/pulseless electrical activity?

Answer 27

CPR (2 mins) Give adrenaline every 3-5 mins Correct reversible causes

Question 28

What are the causes of | HHHHTTTT

Answer 28

``` Hypothermia Hypoxia Hypovolaemia Hypo/hyperkalaemia Tamponade Tension PT Thromboembolic Toxic/metabolic ```

Question 29

30F URTI Pleuritic chest pain Better when leaning forwards Widespread ST elevation (saddle shape) What is the diagnosis?

Answer 29

Pericarditis

Question 30

What are the causes of pleuritic chest pain?

Answer 30

``` Pericarditis Pneumothorax Pulmonary embolism Pneumonia Pleural pathology 5xP Sub-diaphragmatic pathology (eg SD abscess) ```