1. SPMP Sudden Cardiovascular Collapse Dr. S. Aswini Kumar. MD, This is the most important medicaI emergency that can happen under any circumstance II. 01. A patient with Acute MI abruptly develops absent radial pulse, you will now suspect: Cardiogenic shock Acute LVF Acute Pulmonary embolism Intra Cerebral Hemorrhage Cardiac Arrest II. 02. You will now proceed to do the following physical examinations EXCEPT: Palpation of carotid pulse Measurement of BP Checking the pupillary reflexes Auscultating for heart sounds Checking responsiveness II. 03. You will now order the following emergency investigations immediately: Random Blood Sugar Serum electrolytes 12 lead ECG Chest X ray PA view None of the above II. 04. The cardiac monitor is likely to show one of the following cardiac rhythms EXCEPT: Ventricular fibrillation Pulseless Ventricular tachycardia Cardiac asystole Atrial fibrillation Pulseless Electrical Activity II. 05. External chest cardiac massage should be started immediately because: Other wise patient will go into Acute LVF Patient will develop cardiogenic shock Brain cannot sustain life without O2 for >4 minutes To show relatives that something is being done Defibrillation can be postponed II. 06. Ideal rate of doing External Chest Cardiac massage is: 40-60/min 70-80/min 120/min Alternating with artificial ventilation Once in 3 minutes II. 07. Following steps in performance of ECCM are correct EXCEPT: Hands are placed over lower sternum, 4 cm deep compressions are given The elbows are kept at an angle of 1300 The pressure is applied from the shoulder 30 cardiac compressions 2 assisted breaths II. 08. If the ECG monitor shows Ventricular fibrillation, you will give: Synchronized DC shock of 100 joules Synchronized DC shock of 300 joules Non-synchronized DC shock of 100 joules Non-synchronized DC shock of 200 joules Continue ECCM without giving DC shock II. 09. All are TRUE about technique of giving defibrillation EXCEPT: One paddle along right anterior axillary line Other paddle lateral to left anterior axillary line Conductive gel applied on it reduces impedance None including the one giving shock shall touch the cot Paddle buttons are pressed one after the other II. 10. In case of persistent VT or VF following may be considered EXCEPT: Injection Adrenaline 1mg IV q3-5min Inj. Vasopressin 40 units IV single dose Resume attempts to defibrillate with 300 or 360 joules Anti-arrhythmics like amiodarone Discontinue ECCM at this stage of cardiac resuscitation II. 11. All are TRUE regarding Intra-cardiac Adrenaline EXCEPT: Not routinely recommended Cardiac asystole is the only indication Given in 3rd left IC space 4 cm lateral LSB Increases myocardial & cerebral blood flow Repeated for 3 or 4 doses; not more II. 12. Techniques for establishing an airway are the following EXCEPT: Assess breathing first; then ensure open airway Insert an oropharyngeal airway Consider foreign body and remove it Do Endo-tracheal intubation quickly The concentration of oxygen given should be 80% II. 13. All of the following are shockable rhythms EXCEPT: Coarse ventricular Fibrillation Fine ventricular Fibrillation Pulseless Ventricular Tachycardia Supraventricular Tachycardia Cardiac Asystole II. 14. All of the following will confirm Cardiac asystole EXCEPT: Monitor shows a flat line This is verified in another lead The monitor power is on The lead connections are intact The monitor gain is down II. 15. All are TRUE about the administration of sodium bicarbonate EXCEPT: Not recommended for routine use Use based on clearly defined diagnosis Hyperkalemia is the indication Can be used in pre-existing alkalosis Dose is 1meq/kg intravenously II. 16. The maximum time allowed to interrupt CPR is: 10 seconds 30 seconds 60 seconds 120 seconds 180 seconds II. 17. Decision to terminate Advanced Cardiac Life Support depends on all EXCEPT: Individual situations Pre-arrest conditions Intra-arrest conditions Response to resuscitation Patient’s wishes