COPR Cardiovascular Emergencies and ECG Interpretation

Question 1

Which ECG finding best supports a diagnosis of ST-elevation myocardial infarction (STEMI)?

Accepted Answer

ST-segment elevation in two or more contiguous leads

Answer

STEMI is identified by new ST-segment elevation in two or more anatomically contiguous leads, which indicates transmural myocardial injury.

Question 2

A patient has an irregularly irregular rhythm with no distinct P waves and a variable ventricular rate. Which rhythm is this most consistent with?

Accepted Answer

Atrial fibrillation

Answer

Atrial fibrillation produces chaotic atrial activity, so there are no discernible P waves and the ventricular response is irregularly irregular.

Question 3

A paramedic finds an adult in witnessed pulseless ventricular fibrillation. What is the priority intervention?

Accepted Answer

Immediate defibrillation alongside high-quality CPR

Answer

VF is a shockable rhythm, and early defibrillation combined with high-quality chest compressions gives the best chance of survival.

Question 4

ST elevation in leads II, III and aVF most likely indicates infarction of which myocardial wall?

Accepted Answer

Inferior wall

Answer

Leads II, III and aVF view the inferior wall of the heart, which is usually supplied by the right coronary artery.

Question 5

Which situation is a contraindication to administering nitroglycerin to a patient with chest pain?

Accepted Answer

Recent use of a phosphodiesterase-5 inhibitor such as sildenafil

Answer

Combining nitrates with PDE-5 inhibitors can cause profound, life-threatening hypotension. Nitroglycerin is also avoided when the patient is hypotensive or has a suspected right ventricular infarct.

COPR - Canadian Organization of Paramedic Regulators Examination Practice Test

COPR - Canadian Organization of Paramedic Regulators Examination Practice Test

COPR Cardiovascular Emergencies and ECG Interpretation