Name: _______________________________
Competency Milestones Booklet: Required
Case: DJ is a 67 y/o male that presents to the
ED having a 30-minute episode of chest pain,
which began while he was walking down his
driveway. The pain was described as a “pins and
needles” sensation. The pain radiated down both
arms, he became diaphoretic and dyspneic. The
pain was not pleuritic and resolved shortly after
resting. The previous day he had a similar
episode. He denies nausea, vomiting, fever,
cough or any GI complaints. He denies recent
upper respiratory infections. Hx: hypertension
and hypercholesterolemia; has not smoked in
many years and denise drug use. His present
meds atenolol and lovastatin. Family hx: brother
had a CABG at 50 y/o. No allergies. On
physical exam: anxious, thin male that looks
appropriate for age, all systems unremarkable.
VS: BP 160/96, Pulse 60, RR 18, Pox 98%
(room air) and temp. 37.3oC. While in the ED he
says that his pain is returning.
1.
2.
3.
4.
What is DJ probable diagnosis at this time?
a. acute MI
b. GERD
c. unstable angina
d. stable angina
e. musculoskeletal pain
Which one of the following platelet
inhibitors and/or thrombolytic is indicated at
this time for DJ?
a. aspirin
b. enteric coated aspirin
c. heparin (unfractionated)
d. coumadin
e. low molecular weight heparin
Which one of the following is not a possible
disposition for DJ?
a. home
b. CCU
c. catheterization lab
d. sestamibi cardiac scan
e. serve patient dinner
Patient presents to the ED with a rapid
pulse. Patient placed on a CR monitor and
displays VT. Vital signs stable. Which one
of the following is the drug of choice?
a. diltiazem
b. epinephrine
c. amiodarone
d. adenosine
e. atropine
SPM200 Skills Lab 7: Abnormal ECG Interpretation and Treatment
Pre-test (Updated: 1/6/10)
5.
After responding to a “code blue” on the
post surgical unit, the patient is being placed
on a monitor and it displays a narrow
complex with no pulse. Patient is in PEA.
Which of the following is the first drug of
choice?
a. atropine
b. epinephrine
c. amiodarone
d. lidocaine
e. vasopressin
6.
You are a second year medical student in the
ED and EMS brings in a patient with the
following complaints: chest pain and low
BP. Monitor displays VT but vital signs are
unstable. Which one of the following is the
treatment of choice?
a. epinephrine
b. synchronized cardioversion (shock)
c. IV fluids
d. atropine
e. amiodarone
7.
You are a second year medical student in the
ED and consulted to determine the best
treatment for a patient in A-fib with unstable
vital signs. Which one of the following is
the best treatment at this time?
a. fluids
b. epinephrine
c. synchronized cardioversion (shock)
d. wait for a cardiology consult
e. give no treatment and it will pass
8.
After responding to a “code blue” on the
telemetry unit, the patient is placed on a CR
monitor and it displays asystole. Which of
the following is the first drug of choice?
a. atropine
b. epinephrine
c. amiodarone
d. lidocaine
e. vasopressin
9.
9. After responding to a “code blue” on the
post surgical unit. CPR in progress. Patient
is on a monitor and it displays a Ventricular
Fibrillation (VF) with no pulse. Which of
the following is the best treatment of
choice?
a. atropine
b. epinephrine
c. amiodarone
d. defibrillation at 200J biphasic
e. vasopressin
Name: _______________________________
SPM200 Skills Lab 7: Abnormal ECG Interpretation and Treatment
Pre-test (Updated: 1/6/10)