Spmp Myocardial Infarction

Front 1

A 45 year-old male patient is brought to the emergency department with the history of sudden onset of chest discomfort:

We are talking about:

Back 1

Acute Myocardial Infarction

Front 2

III. 1.
Diagnosis of Myocardial Infarction is based on following history EXCEPT:

A. Retro-sternal pain of poorly localising nature

B. Extremely anxious relatives of the patient

C. Constricting, burning or tightness character

D. Profuse sweating & autonomic symptoms

E. Classical radiation of pain to left upper limb

Back 2

B. Extremely anxious relatives of the patient.

Front 3

III. 2.
Clinical examination of the patient should be done quickly to assess:

A. Pulse rate in one minute

B. Blood pressure

C. Muffling of heart sounds

D. Gallop rhythm & bilateral basal creps

E. All of the above

Back 3

E. All of the above

Front 4

III. 3.
Following investigations are to be ordered urgently the EXCEPT:

A. 12 lead ECG

B. X Ray Chest PA

C. Random Blood Sugar

D. CPK Mb or Trop T

E. Serum electrolytes

Back 4

B. X Ray Chest PA

Front 5

III. 4.
ECG changes diagnostic of Acute MI are the following EXCEPT:

A. ST elevation

B. A new Q wave

C. Deep S in V1

D. Tall peaked T wave

E. T inversion

Back 5

C. Deep S in V1

Front 6

III. 5.
In Acute MI, the following will promptly relieve the chest pain:

A. Glyceryl trinitrate S/L

B. Tab.Aspirin 650 mg S/L

C. Cap.Nifidipine 5mg S/L

D. Absolute bed rest

E. None of the above

Back 6

E. None of the above

Front 7

III. 6.
The following emergency measures are taken EXCEPT:

A. Admitting to ICCU and placing on a cardiac cot

B. Continuous ECG lead monitoring

C. Administer One tablet of Aspirin 325mg orally

D. Give Morphine 3mg IV diluted in dextrose

E. Tab.Digoxin 0.5mg stat.

Back 7

E. Tab.Digoxin 0.5mg stat.

Front 8

III. 7.
Indications for thrombolytic therapy are the following EXCEPT:

A. Patients received within 6 hours of chest pain

B. ST ^ of 1mm in 2 contiguous limb leads

C. ST ^ 2mm in 2 contiguous chest leads

D. New RBBB

E. New LBBB.

Back 8

D. New RBBB

Front 9

III. 8.
Contra indications for thrombolytic therapy include the following:

A. Recent trauma or surgery

B. Stroke or previous thrombolysis within 6m

C. BP > 180/110 mm of Hg

D. Suspected active internal bleeding

E. All of the above

Back 9

E. All of the above

Front 10

III. 9.
Relative contraindication for thrombolytic therapy are the following EXCEPT:

A. Peptic ulcer

B. Diabetic retinopathy

C. Active menstruation

D. Prolonged CPR

E. Myocardial infarction

Back 10

E. Myocardial infarction

Front 11

III. 10.
The dose of Streptokinase in acute myocardial infarction is:

A. 1.5 Lakh Units over 1 hours given as S/C

B. 1.5 Lakh Units over 2 hours given as I/M

C. 1.5 Million Units over 1 hour as IV infusion

D. 15 Million Units over 2 hour slow intra cardiac

E. 15 Million units over 2 hours as IV infusion.

Back 11

C. 1.5 Million Units over 1 hour as IV infusion

Front 12

III. 11.
When administering streptokinase, one has to closely watch for following complications

A. Bleeding

B. Hypotension

C. Anaphylaxis

D. Allergy

E. All of the above

Back 12

E. All of the above

Front 13

III. 12.
The success of fibrinolytic therapy can be assessed by the following:

A. Relief from chest pain

B. Decrease in ST elevation

C. Appearance of reperfusion arrhythmias

D. Reduction in infarction size by ECHO

E. All of the above

Back 13

E. All of the above

Front 14

III. 13.
Give the following drugs orally EXCEPT:

A. Tab.Metoprolol 50mg to correct tachycardia

B. Tab.Isosorbide dinitrate 10mg tid

C. Tab.Enalapril 2.5 mg bid LV dysfunction

D. Cap.Nifedipine 5mg S/L three times daily

E. Tab.Alprazolam 0.5mg HS for sedation

Back 14

D. Cap.Nifedipine 5mg S/L three times daily

Front 15

III. 14.
The following additional measures are needed in every case of Myocardial Infarction EXCEPT:

A. Quiet atmosphere

B. Reassurance

C. Light easily digestible semi-solid food

D. Laxatives like cremaffin to avoid constipation

E. Graded ambulation from day eight

Back 15

E. Graded ambulation from day eight

Front 16

III. 15.
Following dangerous arrhythmias are anticipated and dealt wwith immediately EXCEPT:

A. Ventricular Tachycardia

B. Ventricular Fibrillation

C. Supra-ventricular rhythm

D. WPW Syndrome

E. Complete heart block

Back 16

D. WPW Syndrome

Front 17

III. 16.
The following acute complications can occur in the first week of MI EXCEPT:

A. Cardiac failure

B. Cardiac Arrhythmias

C. Pericarditis

D. Dressler’s syndrome

E. Papillary muscle dysfunction

Back 17

D. Dressler’s syndrome

Front 18

III. 17.
While discharging the patient with MI the following advice should be given EXCEPT:

A. Stop smoking

B. Metoprolol 50mg BID

C. Ecospirin 150mg daily

D. Enalapril 2.5mg BID

E. Weekly review in OPD

Back 18

E. Weekly review in OPD