MRCEM 2 Category: Cardiology

mrcem2-0146

A 28-year-old woman presents after experiencing a syncopal episode earlier in the day. She fainted while jogging on the treadmill at her local gym. She regained consciousness quickly and currently feels completely fine. Upon examination, she has a slim physique, normal heart sounds without any additional sounds or murmurs, clear lungs, and a soft abdomen. She is originally from Thailand and mentions that her mother passed away suddenly in her 30s.

Her ECG reveals:
– Right bundle branch block pattern
– Downward-sloping ‘coved’ ST elevation in leads V1-V3
– Widespread upward-sloping ST depression in other leads

What is the SINGLE most likely diagnosis?

mrcem2-0132

You are called to cardiac arrest in the resus area of your Emergency Department. As part of your management, a dose of amiodarone is administered.
Amiodarone should be administered at which of the following points during a pediatric VF arrest?

mrcem2-0133

You evaluate the ECG of a 62-year-old male who has come in with episodes of Presyncope. What is the most suitable threshold to utilize in differentiating between a normal and prolonged QTc?

mrcem2-0134

A 32 year old with a documented peanut allergy is currently receiving treatment for an anaphylactic reaction. What are the most likely cardiovascular manifestations that you would observe in a patient experiencing an episode of anaphylaxis?

mrcem2-0124

A 70-year-old woman comes in complaining of a rapid heartbeat and difficulty breathing. She has a past medical history of a kidney transplant. Her rhythm strip reveals supraventricular tachycardia.
What is the most suitable initial dosage of adenosine to administer to her?

mrcem2-0125

You are managing a 62-year-old male patient presenting with symptomatic bradycardia. Despite multiple administrations of atropine, there has been no improvement in the patient’s condition. Which two medications would be the most suitable options to consider next for treating this rhythm?

mrcem2-0126

You are summoned to a cardiac arrest in the resuscitation area of your Emergency Department. The patient is experiencing ventricular fibrillation, and adrenaline is being administered as part of the cardiac arrest protocol.
Which ONE statement is accurate regarding the utilization of adrenaline in this arrest?

mrcem2-0127

You are called to a VF cardiac arrest in the resus area of your Pediatric Emergency Department.
Epinephrine should be administered at which of the following points during a pediatric VF arrest?

mrcem2-0128

You are summoned to a cardiac arrest in the resuscitation area of your Emergency Department. The patient is experiencing asystole, and adrenaline is given as part of the cardiac arrest protocol.
Which ONE statement is NOT TRUE regarding the utilization of adrenaline in cardiac arrest?

mrcem2-0129

You are summoned to the resuscitation bay to provide assistance with a 72-year-old patient who is undergoing treatment for cardiac arrest. After three shocks, the patient experiences a return of spontaneous circulation.

What are the recommended blood pressure goals following a return of spontaneous circulation (ROSC) after cardiac arrest?