CEP Cardiac Care & Emergency Pharmacology 3 — Questions and Answers
Question 1: A patient is in pulseless electrical activity (PEA). Which of the 'H's' and 'T's' should be considered first in a drowning victim?
- Hyperkalemia and Tension pneumothorax
- Hypoxia and Hypothermia (Correct answer)
- Hypovolemia and Tamponade
- Hydrogen ion (acidosis) and Thrombosis
Correct answer: Hypoxia and Hypothermia
In drowning victims, hypoxia and hypothermia are the most likely reversible causes of PEA and should be addressed immediately.
Question 2: Which pharmacologic agent is the first-line treatment for symptomatic bradycardia due to increased vagal tone?
- Dopamine
- Epinephrine
- Atropine (Correct answer)
- Glucagon
Correct answer: Atropine
Atropine 0.5 mg IV is the first-line agent for symptomatic bradycardia caused by increased vagal tone, blocking muscarinic receptors to increase heart rate.
Question 3: A 45-year-old develops a wide-complex tachycardia at 160 bpm with a pulse and altered mental status. BP is 70/40 mmHg. What is the priority treatment?
- Adenosine 12 mg rapid IV push
- Amiodarone 150 mg over 10 minutes
- Synchronized cardioversion at 100 J (Correct answer)
- Lidocaine 1.5 mg/kg IV push
Correct answer: Synchronized cardioversion at 100 J
Unstable wide-complex tachycardia with hemodynamic compromise requires immediate synchronized cardioversion.
Question 4: What is the correct dose of adenosine for the first administration in SVT?
- 3 mg rapid IV push
- 6 mg rapid IV push (Correct answer)
- 12 mg rapid IV push
- 0.1 mg/kg rapid IV push
Correct answer: 6 mg rapid IV push
The initial dose of adenosine for SVT is 6 mg given as a rapid IV push followed immediately by a 20 mL normal saline flush.
Question 5: Calcium chloride is the preferred form of calcium in cardiac arrest because:
- It crosses the blood-brain barrier more effectively
- It contains three times more elemental calcium than calcium gluconate (Correct answer)
- It is less caustic to peripheral veins
- It has a faster onset of action orally
Correct answer: It contains three times more elemental calcium than calcium gluconate
Calcium chloride (10%) provides approximately three times more elemental calcium per mL than calcium gluconate, making it more potent for cardiac emergencies.
Question 6: A patient with known heart failure presents with acute pulmonary edema, BP 180/110, and SpO2 82%. Which combination is most appropriate?
- Furosemide IV, CPAP, nitroglycerin SL (Correct answer)
- Adenosine IV, high-flow O2, dopamine infusion
- Morphine IV, low-flow O2, furosemide IM
- Epinephrine IV, intubation, sodium bicarbonate
Correct answer: Furosemide IV, CPAP, nitroglycerin SL
Hypertensive acute pulmonary edema is treated with CPAP to improve oxygenation, nitroglycerin to reduce preload, and furosemide to promote diuresis.
Question 7: During a 12-lead ECG interpretation, ST elevation in leads V1-V4 with reciprocal depression in II, III, aVF indicates:
- Inferior wall STEMI
- Posterior wall STEMI
- Anterior wall STEMI (Correct answer)
- Lateral wall STEMI
Correct answer: Anterior wall STEMI
ST elevation in V1-V4 indicates anterior wall STEMI, typically involving the left anterior descending artery territory.
CEP Cardiac Care & Emergency Pharmacology 3
A patient is in pulseless electrical activity (PEA).
Which of the 'H's' and 'T's' should be considered first in a drowning victim?