Circulation and Chest Pain MCQ ALS for Pacific Family Medicine pre-course test. This is an open book exam, and candidates may refer to the Youtube videos, ALS handbook, or other resources. However, candidates may not ask other candidates for their answers - this is cheating! OK Question Title * 1. Please enter your name in the textbox ... OK Question Title * 2. Choose the one most correct answer.The circulation is initially assessed by examining ... Capillary refill. Blood pressure. Pulse rate. All of the above. OK Question Title * 3. Which one or more of the following statements is/are FALSE regarding Ventricular fibrillation (VF) ... VF is the most common cause of sudden cardiac death. If not treated, VF is invariably fatal. Early defibrillation as soon as a defibrillator is available gives best outcomes. CPR is definitive treatment of VF. OK Question Title * 4. Which one of the following statements is FALSE.The emergency management of Ventricular Tachycardia (VT) depends on: The clinical state of the patient. Whether this is monomorphic or polymorphic VT. Whether this is transient or sustained VT. May include the use the anti-arrhythmic drug Amiodorone and cardioversion. OK Question Title * 5. Which one of the following statements is currently TRUE? Over the past 50 years, Australians dying from heart attack has declined from 31% to 12%. The initial treatment of heart attack presenting with acute chest pain is Morphine, Oxygen, Nitrates, and Aspirin (MONA). All patients presenting with chest pain who have normal serial ECG's and negative Troponins can be reassured and sent home with timely outpatient follow up. Troponin is an enzyme found in heart muscle which can be detected minutes from the onset of myocardial damage using an iStat machine. OK Question Title * 6. Which one of the following statements is FALSE in a patient presenting with chest pain? The first priority is to identify or exclude a potential life threatening cause. Many conditions may present with chest pain from causes both within and outside the thoracic cavity, including psychiatric disorders. Acute Coronary Syndrome (ACS) is a synonym for acute myocardial infarction which includes ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (non-STEMI). Thoracic aortic dissection is an uncommon life threatening condition caused by an intimal tear separating the layers of the wall of the thoracic aorta. OK Question Title * 7. Which one of the following statements is FALSE. The symptoms and signs of a thoracic aortic dissection may include: A sudden onset of severe tearing chest pain. BP difference between the arms with the right arm greater than the left arm. Systolic murmur along the left sternal edge. Widening of the mediastinum on CXR. OK Question Title * 8. Which one of the following statements is TRUE?A patient with a STEMI (ST elevation myocardial infarction): Should have the ECG transmitted (by fax, email or text message) to the referral hospital and the further management discussed by phone. As soon as Troponins confirm the diagnosis should have an emergency Percutaneous Intervention (PCI) performed where available. As soon as Troponins confirm the diagnosis should receive fibrinolysis if PCI is unavailable and less than 12 hours from onset (and no contra-indications to fibrinolysis). In addition to aspirin, should immediately commence a second antiplatelet (such as clopidogrel), heparin, betablocker, and either ACE or ARB. OK Question Title * 9. Which one of the following statements is FALSE ?ABSOLUTE contra-indications to fibrinolysis include the following: Ischaemic stroke within past 3 months. Pregnancy. Suspected aortic dissection. Previous intra-cranial haemorrhage. OK DONE