Megacode Scenario 7
Instructions: Evaluate the case and use your knowledge of ACLS algorithms to answer each question. You will receive a score at the end of the test. You may repeat this simulation as often as you like, until you are confident in your ability to intervene effectively in similar situations. There are 20 questions in this simulation.
1. You are working in the emergency room when a man, aged 55 years, arrives accompanied by his wife. He complains of left-sided chest pain that radiates to his left shoulder and arm. His wife states that the patient vomited once and has been sweating since then. Based on these symptoms, you should suspect:
2. For a patient with ACS you would initiate all of the following measures within the first 10 minutes except:
3. The ECG has been completed and has been handed to you. What is your interpretation based on this ECG?
4. What is the recommended time frame within which the ECG should be read and analysed when a patient presents with chest pain?
5. Why is the time frame for diagnosis kept to within 10 minutes?
6. A patient with chest pain has been in the ED for 15 minutes. Which of the following interventions need not be completed in this time frame?
7. All of the following are a possible modes of reperfusion therapy in patients with ACS except:
8. Which of the following groups of drugs play an important role in managing a patient with ACS in the emergency setting?
9. Which of the following ECG abnormalities helps to further streamline the management of the patient suffering from ACS?
10. Your patient has an ST segment elevation MI. What is the longest acceptable ‘door to needle’ (fibrinolysis) time?
11. What is the target door-to-balloon inflation time in patients with ACS?
12. Patients who have suffered an acute coronary event often suffer sudden cardiac death (SCD). What is the most common underlying cause of SCD?
13. Given that ECG findings are diagnostic and PCI is not available within 90 minutes of first medical contact, what is the preferred time frame within which fibrinolytic therapy should be administered in a patient suffering from STEMI?
14. All the following are indications to perform an invasive strategy (i.e. PCI) to achieve reperfusion rather than fibrinolytic therapy except:
15. Which of the following are relative contraindications for using nitroglycerine in patients suffering from ACS?
16. All the following are absolute contraindication to the fibrinolytic except?
17. Which of the following is the most common arrhythmia seen during the first four hours after myocardial infarction?
18. The most commonly used analgesic in patients suffering from ACS is:
19. In patients suffering from ACS, the minimum target SpO2 should be:
20. What is the recommended dose of aspirin administered to a patient with probable ACS?
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