AEMCA - Advanced Emergency Medical Care Assistant Cardiovascular Emergencies Questions and Answers

Question 1

A 68-year-old male presents with sudden onset of severe tearing chest pain that radiates to his back. He has a history of uncontrolled hypertension. His vital signs are BP 210/110 mmHg, HR 110 bpm, and RR 22 breaths/min. There is a noticeable difference in blood pressure between his right and left arms. Which of the following conditions is most likely?

Accepted Answer

Aortic Dissection

Answer

The classic presentation of an aortic dissection includes a sudden onset of severe, tearing or ripping chest pain that often radiates to the back, between the shoulder blades. A significant finding is a variation in blood pressure between the arms. The patient's history of uncontrolled hypertension is a major risk factor.

Question 2

You are treating a 75-year-old female with a history of congestive heart failure (CHF) who presents with severe dyspnea, crackles in all lung fields, and pitting edema in her lower extremities. Which of the following prehospital interventions is most appropriate for managing her acute pulmonary edema?

Accepted Answer

Administering nitroglycerin and applying Continuous Positive Airway Pressure (CPAP)

Answer

For a patient with acute cardiogenic pulmonary edema secondary to CHF, the treatment goals are to reduce preload and afterload and improve oxygenation. Nitroglycerin is a vasodilator that reduces preload, and CPAP provides continuous pressure to keep alveoli open, improving gas exchange by pushing fluid out of the alveolar space.

Question 3

According to the Ontario Advanced Life Support Patient Care Standards (ALS PCS), which of the following is a primary indication for administering Acetylsalicylic Acid (ASA) in the prehospital setting?

Accepted Answer

Chest pain or discomfort suggestive of acute coronary syndrome (ACS)

Answer

ASA is an antiplatelet agent crucial in the early management of Acute Coronary Syndrome (ACS). Its primary role is to prevent the aggregation of platelets, which can worsen an occlusion in a coronary artery. Ontario guidelines specify its use for patients with chest pain or discomfort suggestive of ACS, unless contraindicated.

Question 4

A 55-year-old male is found to be in a perfusing, wide-complex bradycardia with a heart rate of 38 bpm. He is pale, diaphoretic, and has a blood pressure of 80/50 mmHg. According to AEMCA-level protocols, which intervention should be prioritized after establishing IV access and administering oxygen?

Accepted Answer

Immediate application and initiation of transcutaneous pacing (TCP)

Answer

In a patient with symptomatic, unstable bradycardia, particularly with a wide QRS complex or high-degree AV block, transcutaneous pacing (TCP) is the treatment of choice and should not be delayed. While Atropine may be considered, it is often ineffective in wide-complex bradycardias or high-degree blocks, making TCP the more definitive and immediate treatment.

Question 5

Which of the following defines a hypertensive emergency, distinguishing it from hypertensive urgency?

Accepted Answer

The presence of acute end-organ damage.

Answer

A hypertensive emergency is defined by a severe elevation in blood pressure (e.g., SBP >180 or DBP >120) that is associated with evidence of new or worsening target end-organ damage, such as stroke, myocardial infarction, acute renal failure, or pulmonary edema. Hypertensive urgency involves a similar BP elevation but without the acute end-organ damage.

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA - Advanced Emergency Medical Care Assistant Cardiovascular Emergencies Questions and Answers