BCEN Cardiac Emergencies 3

Question 1

A patient presents with palpitations and the ECG shows a narrow-complex tachycardia at 160 bpm with no visible P waves. Vagal maneuvers are ineffective. What is the next treatment?

Accepted Answer

Adenosine 6 mg rapid IV push

Answer

Amiodarone 150 mg IV over 10 minutes

Answer

Diltiazem 0.25 mg/kg IV

Answer

Synchronized cardioversion at 50 J

Question 2

Which ECG finding is most consistent with right ventricular infarction complicating an inferior STEMI?

Accepted Answer

ST elevation in right-sided lead V4R

Answer

ST elevation in V1-V4

Answer

New left bundle branch block

Answer

ST depression in leads I and aVL

Question 3

A patient with inferior STEMI and RV infarction develops hypotension. Which intervention is contraindicated?

Accepted Answer

Nitroglycerin administration

Answer

Normal saline 500 mL IV bolus

Answer

Norepinephrine infusion

Answer

Dopamine infusion

Question 4

Torsades de pointes is most commonly associated with which electrolyte abnormality?

Accepted Answer

Hypomagnesemia

Answer

Hypernatremia

Answer

Hyperkalemia

Answer

Hypercalcemia

Question 5

A patient with a history of Wolff-Parkinson-White (WPW) syndrome develops atrial fibrillation with a rapid ventricular response. Which drug is contraindicated?

Accepted Answer

Diltiazem

Answer

Procainamide

Answer

Ibutilide

Answer

Amiodarone

Question 6

A patient presents 2 hours after cocaine use with chest pain and diaphoresis. ECG shows ST elevation in V1-V4. Which medication should be avoided?

Accepted Answer

Non-selective beta-blockers

Answer

Aspirin

Answer

Nitroglycerin

Answer

Morphine

Question 7

Which finding on a 12-lead ECG indicates posterior MI?

Accepted Answer

Tall R waves and ST depression in V1-V2

Answer

ST elevation in V5-V6

Answer

ST elevation in leads I, aVL, and V6

Answer

ST elevation in leads II, III, and aVF