ABEM Cardiovascular & Respiratory Emergencies — Questions and Answers

Question 1: What is the first step in managing a cardiac arrest?

Call family
Initiate CPR (Correct answer)
Administer glucose
Apply cold packs

Correct answer: Initiate CPR

In managing a cardiac arrest, the immediate priority is to restore circulation and oxygenation to the brain and other vital organs. Initiating cardiopulmonary resuscitation (CPR) without delay is the critical first step, as it provides artificial circulation and breathing until advanced medical help arrives or a defibrillator can be used. Early CPR significantly improves the chances of survival and neurological outcomes.

Question 2: Which rhythm requires defibrillation?

Asystole
Sinus rhythm
Ventricular fibrillation (Correct answer)
Bradycardia

Correct answer: Ventricular fibrillation

Ventricular fibrillation (VF) is a chaotic electrical activity in the ventricles that prevents the heart from pumping blood effectively, leading to cardiac arrest. Defibrillation, which delivers an electrical shock, is the definitive treatment for VF because it aims to reset the heart's electrical activity, allowing a normal rhythm to resume. Asystole, a flatline rhythm, indicates no electrical activity and does not respond to defibrillation.

Question 3: What indicates respiratory distress?

Sneezing
Cyanosis and effort (Correct answer)
Dry mouth
Itching

Correct answer: Cyanosis and effort

Respiratory distress is characterized by visible signs that indicate difficulty breathing and inadequate oxygenation. Cyanosis, a bluish discoloration of the skin or mucous membranes, signifies low oxygen levels, while increased effort (e.g., nasal flaring, retractions, accessory muscle use) shows the body struggling to breathe. These are critical indicators requiring immediate medical attention.

Question 4: What is a common asthma treatment?

Aspirin
Albuterol (Correct answer)
Insulin
Atropine

Correct answer: Albuterol

Albuterol is a short-acting beta-agonist (SABA) bronchodilator commonly used to treat asthma symptoms. It works by relaxing the smooth muscles in the airways, opening them up and making it easier to breathe. This medication provides rapid relief for acute asthma attacks and is a cornerstone of asthma management.

Question 5: Why give aspirin in MI?

For pain only
Reduces clotting (Correct answer)
Decreases sugar
Lowers temperature

Correct answer: Reduces clotting

Aspirin is given in cases of myocardial infarction (MI) because it is an antiplatelet agent. It works by inhibiting platelet aggregation, which helps to prevent the formation of new blood clots and reduces the growth of existing clots in the coronary arteries. This action is crucial in limiting heart muscle damage during a heart attack.

Question 6: What is used to assess stroke?

BLS
FAST exam (Correct answer)
APGAR
ABCDE

Correct answer: FAST exam

The FAST exam (Face drooping, Arm weakness, Speech difficulty, Time to call emergency services) is a widely recognized and simple mnemonic used to quickly assess for common signs of a stroke. This rapid assessment helps identify potential stroke victims, enabling prompt medical attention and improving outcomes. Early recognition and treatment are critical for stroke management.

Question 7: What is pulmonary embolism symptom?

Nausea
Sudden dyspnea (Correct answer)
Sore throat
Rash

Correct answer: Sudden dyspnea

Pulmonary embolism (PE) occurs when a blood clot blocks an artery in the lungs, leading to impaired blood flow and oxygen exchange. Sudden onset of dyspnea (shortness of breath) is a classic and often the most prominent symptom of PE, as the body struggles to get enough oxygen. This symptom, especially when acute and unexplained, warrants immediate investigation for PE.

Question 8: What confirms pneumothorax?

Ultrasound
Chest x-ray (Correct answer)
EKG
Blood sugar

Correct answer: Chest x-ray

A pneumothorax, or collapsed lung, occurs when air leaks into the space between the lung and chest wall, causing the lung to partially or fully collapse. A chest x-ray is the primary diagnostic imaging tool used to confirm a pneumothorax, as it clearly visualizes the presence of air in the pleural space and the collapsed lung tissue.

Question 9: What to check before intubation?

Start IV
Check tools (Correct answer)
Call nurse
Give pain meds

Correct answer: Check tools

Before intubation, it is critical to perform a thorough 'check tools' or 'check equipment' step to ensure all necessary equipment is present, functional, and correctly sized. This includes verifying the laryngoscope blade and light, endotracheal tube, stylet, suction, and ventilation device. This preparation prevents delays and complications during the procedure, which can be life-threatening.

ABEM Cardiovascular & Respiratory Emergencies

What is the first step in managing a cardiac arrest?