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Question 1

Serial ECGs to monitor changes over time are given at:

Answer 1

• STAT • 2 hours • 4 hours

Question 2

What are the shockable rhythms:

Answer 2

• Ventricular fibrillation
• Pulseless ventricular tachycardia
• Atrial fibrillation

Question 3

What are the non-shockable rhythms:

Answer 3

• Asystole • Pulseless electrical activity

Question 4

Definitive sign of MI

Answer 4

Sudden chest pain unrelieved by drugs or rest.

Question 5

Cardiac enzyme markers reliably diagnostic of MI

Answer 5

• Troponins I & T (proteins found in the myocardium)
• Creatine kinase are enzymes where the amount released correlates with degree of infarction.
• Myoglobin is a protein found in muscle. Increases are not specific but a neg. result rules out MI.

Question 6

NSTEMI (non ST elevation MI) means:

Answer 6

Partially occluded MI leading to smaller areas of myocardial infarction.

Question 7

STEMI (ST elevation MI) means:

Answer 7

Fully occluded artery leading to more extensive areas of myocardial infarction.

Question 8

ABG’s

Normal pH:

Answer 8

7.35 - 7.45

Normal Hydrogen concentration

Question 9

ABG’s

Normal PaCO2

Answer 9

41-51 mmHg

Normal carbon dioxide concentration

Question 10

ABG’s

Normal PaO2

Answer 10

80-100 mmHg

Normal Oxygen concentration

Question 11

ABG’s

Normal HCO3

Answer 11

22-26 mmol/L

Normal Bicarbonate concentration

Question 12

ABG’s

Base excess

Answer 12

+2.0 to -2.0 mmol/L

A measure of buffering capacity

Question 13

ABG’s

Normal SaO2

Answer 13

98%

Normal Oxygen concentration

Question 14

Metabolic acidosis is characterised by a

Renal based

Answer 14

• Low pH <22 mmol/L
Most commonly due to renal failure.
Manifestations may be headache, confusion and drowsiness.

Question 15

Metabolic alkalosis is characterised by a

Renal based

Answer 15

• High pH >7.45
• High bicarbonate >26 mmol/L
Most common cause is vomiting or gastric suction.
May be due to meds especially long-term diuretics.
Manifestations may be respiratory depression, tachycardia.

Question 16

Respiratory acidosis is characterised by a

Respiratory based

Answer 16

• Low pH 42 mmHg
Always due to respiratory problem with inadequate excretion of CO2.
Manifestations may be increased pulse, respiratory rate and BP, mental changes (COPD, hypercapnic).

Question 17

Respiratory alkalosis is characterised by a

Respiratory based

Answer 17

• High pH >7.45
• PaCO2 <35 mmHg
Always due to hyperventilation.
Manifestations may be light-headedness and inability to concentrate.

Question 18

ROME

Respiratory, Opposite; Metabolic, Equal

Answer 18

pH ⬇️ and CO2 ⬇️ = Metabolic Acidosis
pH ⬆️ and CO2 ⬆️ = Metabolic Alkalosis
pH ⬇️ and CO2 ⬆️ = Respiratory Acidosis
pH ⬆️ and CO2 ⬇️ = Respiratory Alkalosis

Question 19

Intermittent claudication is when

Answer 19

supply does not equal demand. It is only caused by arterial supply failure.
There is • muscular cramping (ischaemic) type pain which is precipitated by exercise. It resolves within 10 minutes of rest. IT HAS TO BE REPRODUCIBLE. The area is dependent on which vessel is affected.