11.

A 77 years old lady weighing 60kg presents with dizziness associated with chest
pain and nausea. She suffered one episode of severe \myocardial infarction 8 months
ago. Her BP is 60/30mmHg, RR 15/min, GCS 15/15. Cardiac monitor shows

The rhythm shown is

A.
B.
C.
D.

Sinus bradycardia
First degree heart block
Second degree heart block Mobitz type 1
Complete heart block

12. The treatment for this patient should include

i.
ii.
iii.
iv.

Oxygen, morphine, transcutaneous pacing

Oxygen , morphine, lignocaine
Oxygen, morphine, isoprenaline infusion
Oxygen, morphine, atropine

A. ii, iii
B. i, iii, iv
C. i
D. all of above
13. Application of cricoid pressure during rapid sequence induction
A. closing of the oropharynx
B. improve view of vocal cord
C. closing of the esophagus to prevent aspiration
D. lifting the tongue will prevent from tongue fall back

14. Regarding chain of survival in hospital cardiac arrest (IHCA). Which of the following
is in the correct sequence?

i.
ii.
iii.
iv.
v.
A.
B.
C.
D.

Immediate high quality CPR

Recognition and activation of the emergency response system
Rapid defibrillation
Advanced life support postarrest care
Surveillance and prevention
v, ii, iii, i , iv
v, ii, i, iii, iv
iii, iv, ii, v, i
ii, iii, v, iv, i

15. Regarding vasopressin

A.
B.
C.
D.

is preferable to adrenaline during CPR

dose is 40 units given after every dose of adrenaline
significantly improve outcome if administered early during CPR
has no benefit when use during cardiac arrest

16. Treatment for this rhythm includes

A.
B.
C.
D.

IV Adrenaline 1mg bolus

IV Magnesium Sulphate 2gm bolus over 10 minutes
IV Adenosine 300mg bolus over 1 hour then 600mg over 23 hours
Synchronized cardioversion if patient unstable

17. Regarding lignocaine

A.
B.
C.
D.

Can be use in either supraventricular or ventricular arrthymias.

Is beneficial in refractory PEA
Maximum dose is 5mg/kg
Is in Class 1 in Vaughan Williams classification

18. Syncronized cardioversion

A.
B.
C.
D.

Is used only for atrial dysrhythmias

Delivers a shock between the peak and then end of the T wave
Is used only for rhythms with a ventricular response of < 60/ minute
Delivers a shock few milliseconds after the highest part of the R wave

19. The benefit of allowing chest recoil includes

A.
B.
C.
D.

Avoid injury to sternum and ribs

To allow intrapleural pressure back to normal
To reduce the intrathoracic pressure
To improve oxygen delivery to the brain

20. A 25 years old G1P0 at 32 weeks had an MVA with severe head injury. She had
cardiac arrest when arrived at emergency department. How can we improve the quality
of chest compression in this patient?
A.
B.
C.
D.

Put patient in anti trendelenburg position while doing CPR

Use manual left uterine displacement to improve venous return
Put a firm wedge at right flank area to avoid aortocaval compression
Increase the depth of compression more than 6cm