Cardio. 2 ~ Extended Matching

Question 1.

Options List:

A.) Endocardial Cushion Defect

B.) Eisenmenger complex

C.) Hypoplastic Left Heart Syndrome

D.) Patent Ductus Arteriosus

E.) Tetralogy of Fallot

F.) Total Anomalous Pulmonary Venous Return

G.)Transposition of the Great Arteries

 

Lead-in Statement:

For each clinical scenario select the most likely congenital cardiac abnormality

Stems:

  1. A 7 day old baby presents with difficulty feeding. On exam he has central cyanosis, a RR of 60 bpm, clear chest and a loud ejection systolic murmur. His CXR shows a boot-shaped heart an ECG shows right axis deviation.

Show Answer

Answer: E
  1. A 1 day old baby presents floppy and only poorly responding. She is grey, has a RR of 80, central CRT of >6 seconds, weak peripheral pulses, a single heart sound and systolic ejection murmur.

Show Answer

Answer: C 
  1. A 3 month old baby presents with failure to thrive and increasing difficulty feeding and now sweating whilst feeding. On exam he has a RR of 60, moderate intercostal and subcostal recession, scattered crackles throughout his lungs and a loud machinery murmur at the upper left sternal border.

Show Answer

Answer: D
  1. A 15 year old boy with a known Ventricular Septal Defect presents with increasing shortness of breath. He has central cyanosis, RR of 40, clear chest and a loud systolic murmur

Show Answer

Answer: B

Author: J Haire

Ref: Tintinalli p. 820-25


 

Question 2.

Options List:

A.) Conservative management

B.) Fibrinolysis

C.) PCI within 2 hours

D.) PCI within 30 minutes

E.) PCI within 60 minutes

F.) PCI within 90 minutes

G.) PCI within 3 hours

 

Lead-in Statement:

For each clinical scenario select the most appropriate action.

Stems:

  1. A 54 year old man presents with 30 minutes of central chest pain. His ECG shows an anteroseptal STEMI. PCI is available 24 hours a day within your centre.

Show Answer

Answer: E
  1. A 62 year old female presents with chest pain for 4 hours. Her ECG shows a lateral STEMI. You are in a regional centre and the nearest cardiac centre with PCI is 1.5 hours away.

Show Answer

Answer: C
  1. A 72 year old man presents with chest pain for 2 hours. His ECG shows an anterior STEMI. You are in a regional centre and the nearest cardiac centre with PCI is 1.5 hours away.

Show Answer

Answer: B
  1. A 67 year old female presents with chest pain for 7 hours. Her ECGS shows an anteroseptal STEMI. You are in a regional centre and the nearest cardiac centre with PCI is 3 hours away.

Show Answer

Answer: B
  1. A 59 year old man presents with chest pain for 1.5 hours. His ECG shows and anterior STEMI. You are in a centre with 24 hour PCI.

Show Answer

Answer: F

Author: J Haire

Ref: Australia and NZ Heart Foundation Management of ACS Guidelines 2006 & 2011 Addendum


 

One Comment:

  1. To the moderator: I believe that the answer to part 3 of Q2 in the man presenting to ED within 2hr with an anterior STEMI has an opportunity for PCI within 90min as opposed to the answer given of Thrombolysis.

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