2.0 Resuscitation Emergency Medicine Mcq Book Et Al.

Front 1

Which is incorrect regarding Adult resuscitation?
A. ETCO2 detection is the ,most reliable method for verifying tracheal intubation
B. Waveform capnography is the most specific and sensitive way to confirm AND monitor ETT position.
C. Non invasive Ventilation ( NIV) decreases the need for intubation in APO
D. The minute ventilation setting in intubated asthma should be between 10-20 L/min

Back 1

D. < 10 L/min

Front 2

In regards to ADult resuscitation, which is incorrect?
A. The 2010 ILCOR and ARC Guidelines recommend a Universal compression ratio of 15: 2, regardless of the number of rescuers.
B. A pulse check should not be performed after delivery of a shock in cardiac arrest.
C. Biphasic defibrillator waveforms are more effective at terminating VF at lower energy levels.
D. Biphasic defibrillators are superior to monophasic defibrillators in the elective cardioversion of AF.

Back 2

A. 30:2

Front 3

Which is incorrect regarding Adult resuscitation?
A. One of the main aims of resuscitation in cardiac arrest with a non shockable rhythm is the delivery of good quality CPR.
B. Atropine is no longer recommended for PEA
C. Vasopressors do not improve survival to Hospital discharge
D. In VF, Adrenaline is given after the first shock, then every second cycle.

Back 3

D. Adrenaline is given :
1. After the second shock
2. Every second cycle [ 4 minutes]

Front 4

which is incorrect regarding Adult resuscitation ?
A. If the 5 minute time frame of perimortem C-section is exceeded, Caesarian section SHOULD still be considered
B. Aortacaval decompression has no evidence to support it.
C. In hypothermic arrest, defibrillation should not be attempted until the core temperature is > 30 degrees.
D. Endotracheal intubation is safe in severe hypothermia.

Back 4

C. 3 stacked shocks should be delivered without regard for the core temperature- but subsequent shocks should wait until the core temperature is > 30 degrees.

Front 5

Which is incorrect regarding Adult resuscitation?
A. Warming of oxygen and fluids , up to 40 degrees celcius, is safe and effective in severe hypothermia resuscitation.
B. It is recommended that IV medications can be given in severe hypothermia / hypothermic arrest with temperature below 30 degrees.
C. Therapeutic hypothermia involves cooling to 32-34 degrees for 12-24 hours.
D. The infusion of cold saline at 4 degrees celcius is carried out over 2 hours at a volume fo 30mL/kg

Back 5

B. Withold IV medications if the core temperature is below 30 degrees.

Front 6

In regards to Adult resuscitation, which statement is incorrect?
A. Under 24 hours post cardiac arrest and coma, there are no clinical neurological signs that reliably predict poor outcome.
B. In Emergency transcutaneous pacing [ TCP] Electrical pacing capture occurs when a pacer spike is followed by a Wide QRS complex , consistent ST segment and slurred T wave.
C. In Transcutaneous pacing, mechanical capture is achieved with the presence of both an arterial pulse, and blood pressure.
D. In TCP { above }, the pacing output is set at an output that is 10% higher than the threshold of initial mechanical capture.

Back 6

D. 10% Higher than the initial ELECTRICAL capture.

Front 7

In regards to Adult resuscitation and septic shock, which is incorrect ?
A. Lactic acidosis is defined as a blood lactate > 5mmol/L with pH < 7.35
B. The initial lactate elevation corresponds to the severity of shock.
C. Adrenaline is recommended if septic shock is poorly responsive to noradrenaline [or dopamine]
D. Trendelenburg positioning is a benign, but unsupported technique in the management of hypotension.

Back 7

D. It does not appear to have improvements in cardiac index or blood pressure AND:
it may have effects on:
1. Lung ventilatory mechanics
2. Pulmonary gas exchange
3. Increasing intracranial pressure {increased CVP]

Front 8

In regards to Adult resuscitation, which is incorrect?
A. A central venous oxygen saturation of > 70% ( ScvO2) is a defined physiological endpoint for Goal-directed resuscitation.
B. Metaraminol is a potent and selective direct acting alpha agonist
C. Hypertonic saline can be used to lower intracranial pressure in traumatic brain injury.
D. "Permissive hypotension" is advocated in patients with (potentially) ongoing, uncontrolled internal haemorrhage.

Back 8

B. Indirect acting: stimulates release of noradrenaline from sympathetic nerve endings.

Front 9

Which of the following is NOT an indication for Emergency Department thoracotomy?
A. Severe hypotension [ < 60 mmHg ] and evidence of pericardial tamponade
B. Severe hypotension + Signs of life in the ED + intrathoracic haemorrhage
C. Signs of life [ GCS > 3] + Any ECG activity without measurable blood pressure.
D. Patient in extremis following thoracic trauma, with associated severe head injury.

Back 9

D. Predictors of poor outcome:
No signs of life and :
1. Blunt trauma mechanism
2. pre hospital CPR > 5 min
3. Associated severe head injury +/- multisystem injury.
** Signs of life = Electrical ECG activity / GCS > 3 / Evidence of pupillary/corneal /gag reflex

Front 10

Which is incorrect regarding resuscitation?
A. Mortality from PE can be reduced from 60% (untreated) to < 30% if promptly treated
B. Persistent hypotension in massive PE is treated with aggressive fluid resuscitation ( > 2-3L) prior to inotropic support.
C. The death rate from PE is nearly 60% among haemodynamically unstable patients.
D. Unequivocal signs of Right ventricular overload with bedside ultrasound in massive pE is an indication for thrombolysis

Back 10

B. PE with shock should have fluid loading up to 1L - Right ventricle is already pressure overloaded-excessive fluids may worsen RV failure as pe Starling's Law

Front 11

Which is incorrect regarding Vasopressors and inotropes and their actions on receptors?
A. Adrenaline B1 > B2 > A1
B. Noradrenaline has alpha only effects
C. Isoprenaline B1 and B2 [ B1 > B2 ]
D. Noradrenaline has Alpha > beta effects

Back 11

B. Alpha 1 and 2 [ ++++ and + ]
Beta 1 and 2 [ ++ and + ]

Front 12

Ultrasonographic signs of pericardial tamponade include all of the following except?
A. Lack of respiratory variation in IVC / hepatic veins
B. Right ventricular systolic collapse
C. Right atrial collapse during ventricular systole
D. Right ventricular diastolic collapse

Back 12

B. Both the Right atrium and ventricle should be closely inspected for DIASTOLIC collapse

Front 13

Which is incorrect regarding Paediatric resuscitation?
A. All infants beyond the immediate perinatal period should be managed according to the PAEDIATRIC resuscitation GUIDELINES
B. The Paediatric compression: ventilation ratio is 15:2
C. With an LMA present - the compression rate for paediatric CPR is 70 /min [ allowing for a pause for ventilations]
D. The ILCOR guidelines recommend LMA over BVM during the initial part of resuscitation, prior to ETT.

Back 13

D. BVM > LMA
LMA if BVM unsuccessful

Front 14

which is incorrect regarding Paediatric resuscitation?
A. Cardiorespiratory arrest is often preceded by a period of recognisable deteriorating respiratory function.
B. The initial cardiac rhythm seen in arrest is severe bradycardia / asystole
C. The incidence of primary VF in Children is only 20%
D. The circulation should be assessed by palpation of a carotid / brachial or femoral pulse.

Back 14

C. 10%

Front 15

Which is incorrect regarding Paediatric resuscitation?
A. The depth of compression is 4 cm in infants
B. The depth of compression in Children is 5 cm : 1/3 of the AP diameter.
C. 50% of the compression cycle should be devoted to relaxation of the chest-to enable recoil of the chest wall.
D. The 2 thumb technique is not recommended for infant chest compressions

Back 15

D. Either 2 thumb or 2 finger chest compressions can be performed
The 2 thumb technique is the "strongly preferred" technique for healthcare rescuers.

Front 16

Which is incorrect regarding resuscitation?
A. Bone marrow may be reliably used for Biochemical analysis - but not for venous blood analysis.
B. Cricoid pressure has not been shown to decrease aspiration risk.
C. Cricoid pressure in the intubation of infants and children can be discontinued if it impedes intubation.
D. The size of the ETT tube for a newborn > 3000G is an uncuffed 3.0 mm

Back 16

D. 3.5 mm