WorksheetsCVD Prevention and Cardiac Risk Factors
Total questions: 145
Worksheet time: 1hrs 13mins
Which statement best describes a primary role of EMS in preventing cardiovascular disease (CVD) in the community?
Provide public education on risk factors and lifestyle change
Conduct long-term cardiac rehabilitation exercise classes weekly
Dispense antihypertensive medications during home wellness checks
Administer hospital-based thrombolytics for acute myocardial infarction
Which pair correctly lists the two broad categories of cardiac risk factors?
Acute and chronic risk factors
Genetic and environmental risk factors
Behavioral and pharmacologic risk factors
Modifiable and non-modifiable risk factors
Which is classified as a modifiable risk factor with proven impact on CVD?
Advancing age over sixty years
Male sex assigned at birth
Family history of premature coronary disease
Hypertension managed by lifestyle and therapy
Which item is most accurately categorized as a likely modifiable contributor to CVD?
Biologic sex influencing hormone levels
Inherited hypercholesterolemia from parents
Chronic stress affecting blood pressure control
Increasing age associated with arterial changes
Which is a non-modifiable cardiac risk factor emphasized in prevention counseling?
Sedentary lifestyle with minimal activity
Cigarette smoking behavior pattern
Genetics and parental history of disease
Diet high in processed foods
Public education to reduce CVD risk should prioritize which paired strategies?
Offer advanced ECG interpretation workshops only
Promote emergency department checkups monthly
Distribute free multivitamins at community fairs
Teach risk factor modification and symptom recognition
Which misconception most likely misclassifies a risk factor as non-modifiable when it is modifiable?
Recognizing race cannot be changed by lifestyle
Accepting family history cannot be changed
Knowing age cannot be changed at any time
Believing high blood pressure cannot be changed
Which scenario best illustrates early EMS activation education for suspected heart attack?
Teach residents to call 911 immediately for chest pressure
Encourage people to wait two hours to reassess symptoms
Suggest scheduling a clinic visit within one to two days
Advise driving themselves to urgent care for evaluation
Which list contains only modifiable risk factors for CVD prevention programs?
Male sex, age, genetics, family history
Smoking, diabetes, high cholesterol, hypertension
Age, sex, race, parental history of heart disease
Race, age, male sex, postmenopausal status
Which counseling message aligns with addressing likely modifiable contributors?
Manage stress, improve diet, and reduce obesity
Rely on age-related trends to guide behavior
Focus solely on race as a risk determinant
Accept genetic risks and ignore lifestyle change
Cardiac automaticity refers to the ability of cardiac cells to:
Respond only to skeletal muscle input
Contract only when hormones are present
Require motor neurons for each contraction
Self-generate impulses without external stimulation
Which structure is the primary pacemaker under normal conditions?
Purkinje network in papillary muscles
Bundle of His in ventricular myocardium
Atrioventricular node in interventricular septum
Sinoatrial node located in right atrium
If the SA node fails, the expected heart rate is most likely:
Between sixty and one hundred beats per minute
Between fifteen and twenty beats per minute
Between forty and sixty beats per minute
Between one hundred and one hundred twenty beats
Which factor is NOT listed as a determinant of stroke volume?
Cardiac contractility influencing force
Heart rate as an independent factor
Afterload opposing ejection pressure
Preload affecting ventricular filling
Cardiac output is best defined as:
The oxygen content delivered to tissues
The volume ejected per beat in systole
The pressure difference across capillaries
Heart rate times stroke volume per minute
Which pressure component is described as the highest and oscillatory with systolic and diastolic peaks?
Venous pressure with lowest oscillations
Capillary pressure with minimal pulsations
Atrial pressure during passive filling
Arterial pressure measured in large arteries
Which statement about systolic blood pressure is accurate?
Lowest pressure in venous system without oscillations
Maximum arterial pressure during ventricular contraction
Minimum arterial pressure at end of ventricular diastole
Mean pressure within capillaries during rest
Which definition best describes stroke volume in cardiac physiology?
Resistance opposing ventricular ejection
Blood ejected by the heart each contraction
Pressure in arteries during ventricular contraction
Blood pumped by the heart each minute
Cardiac output is calculated using which formula?
CO equals HR times SV
CO equals SV divided by HR
CO equals BP minus SV
CO equals HR plus BP
Which factor directly increases stroke volume according to Starling’s law?
Lower heart rate at rest
Higher systemic vascular resistance
Earlier AV valve closure timing
Greater ventricular preload before systole
Afterload primarily refers to which hemodynamic concept?
Resistance the heart must overcome to eject blood
Volume of blood returning during diastole
Total blood pumped in one minute
Pressure measured at end of ventricular diastole
Which change would most likely decrease stroke volume, all else equal?
Increased peripheral vascular resistance
Moderate increase in preload
Enhanced myocardial contractility
Reduced intrathoracic pressure
Which statement about systolic arterial pressure is most accurate?
It is the maximum arterial pressure during ventricular systole
It is measured when semilunar valves are closed
It is the minimum arterial pressure during ventricular diastole
It remains lower than capillary hydrostatic pressure
During atrial systole, which event appears on the ECG?
QRS complex indicating atrial repolarization
P‑wave indicating atrial depolarization
Isoelectric line indicating AV opening
T‑wave indicating atrial contraction
Which pairing correctly matches ventricular phases with ECG findings?
Ventricular diastole with P‑wave
Ventricular diastole with QRS complex
Ventricular systole with T‑wave
Ventricular systole with QRS complex
Which component is NOT part of arterial blood pressure classification?
Arterial pressure as commonly called blood pressure
Diastolic arterial pressure magnitude
Systolic arterial pressure magnitude
Capillary pressure oscillations by systole/diastole
Which statement best characterizes diastolic pressure?
Pressure in arteries when ventricles relax and fill
Pressure in arteries when ventricles actively contract
Unaffected by systemic vascular resistance changes
Highest of the three circulatory pressures always
Systemic vascular resistance and blood flow have which relationship?
Inverse: higher resistance lowers flow
Direct: higher resistance raises flow
Variable: higher resistance sometimes raises flow
Independent: resistance does not change flow
Which scenario would most likely reduce preload to the heart?
Supine position increasing venous return
Slow HR allowing greater ventricular filling
Venodilation improving end‑diastolic volume
Increased intrathoracic pressure reducing venous return
Which neurotransmitters primarily mediate sympathetic effects on the heart and vessels?
Epinephrine and norepinephrine
Serotonin and histamine
GABA and glutamate
Acetylcholine and dopamine
What is the direct effect of acetylcholine on the heart during parasympathetic activation?
Increases stroke volume markedly
Raises heart rate and preload
Lowers heart rate and contractility
Causes coronary vasoconstriction
Sympathetic activation typically changes peripheral resistance in which way?
Biphasic with initial fall
Decreases via vasodilation
Unchanged due to autoregulation
Increases via vasoconstriction
Which relationship between vessel diameter and resistance is correct?
Diameter increases, resistance increases
Resistance independent of diameter
Diameter increases, resistance decreases
Diameter decreases, resistance decreases
Cardiac output is best represented by which equation?
CO equals heart rate times stroke volume
CO equals preload minus afterload
CO equals SV divided by peripheral resistance
CO equals contractility plus venous return
According to Starling's law, increasing venous return most directly leads to which effect?
Reduced contractility due to afterload
Lower stroke volume from reduced preload
Greater stroke volume from stronger contraction
Unchanged stroke volume despite stretch
Poiseuille’s law states that flow through a vessel is proportional to which variable?
First power of vessel length
Fourth power of vessel radius
Square of blood viscosity
Square root of blood pressure
Which statement best explains why larger arteries transport more blood than capillaries?
Shorter length makes flow negligible
Higher pressure makes capillaries expand
Capillaries have laminar flow exclusively
Larger radius lowers resistance dramatically
A patient with loss of blood shows cool, pale, and clammy extremities mainly because sympathetic activation causes what?
Peripheral vasoconstriction shunting blood centrally
Increased venous pooling in extremities
Reflex bradycardia reducing cardiac demand
Cutaneous vasodilation increasing heat loss
Which change would most reduce pressure needed to pump blood through a vessel?
Lengthening the vessel substantially
Decreasing vessel radius slightly
Increasing blood viscosity slightly
Increasing vessel radius modestly
Which finding best characterizes cardiogenic shock in the field?
Dyspnea with rales and hypotension plus tachycardia
Sudden syncope with normal lung sounds and normotension
Fever with bradycardia and stable blood pressure
Wheezing with hypertension and slow regular pulse
First-line vasoactive support noted for cardiogenic shock in this material is
Dopamine infusion at 2–20 mcg/kg/min
Epinephrine bolus at 1 mg every 3–5 min
Norepinephrine infusion at 0.05–0.1 mcg/kg/min
Dobutamine bolus at 5 mcg/kg single dose
Classic symptom cluster of acute myocardial infarction most likely includes
Positional chest pain improved by leaning forward
Cool pale clammy skin with chest pain radiating and nausea
Brief stabbing chest pain relieved immediately by rest
Fever with sharp chest pain worse on deep inspiration
Angina in this content is typically described as
Exertion induced pain relieved by rest or nitroglycerin
Constant sharp pain unaffected by activity or posture
Severe tearing back pain radiating to the abdomen
Localized chest wall tenderness worse with palpation
Key signs of left-sided congestive heart failure emphasized here are
Dyspnea, rales, tachycardia, atrial arrhythmias, pink sputum
Peripheral edema, JVD, ascites, right upper quadrant pain
Sharp pleuritic chest pain worse with deep breathing
Stridor, dysphagia, unequal arm pressures, hoarseness
Primary treatment bundle listed for left-sided CHF exacerbation is
Antibiotics, diuretics, and chest tube therapy
Aspirin, heparin, and beta-blocker therapy
Oxygen, nitroglycerin, and morphine therapy
IV fluids, epinephrine, and steroids therapy
Right-sided CHF findings in the notes include
Peripheral edema, JVD, ascites, and RUQ pain
Pink frothy sputum, rales, tachycardia, orthopnea
Hypotension, cool clammy skin, anxiety or doom
Pulsing abdominal mass with flank pain and nausea
Thoracic aortic aneurysm is most associated with
Trauma with rib fractures as main etiology
Atherosclerosis and hypertension as major causes
Infection as the predominant single cause
Congenital valve disease as universal cause
A hallmark presentation of thoracic aortic aneurysm or dissection described is
Sudden tearing pain radiating to neck, back, shoulders
Dull epigastric ache relieved by antacids and food
Sharp localized chest pain reproducible with pressure
Colicky right upper quadrant pain after fatty meals
Abdominal aortic aneurysm most commonly presents with
Pulsing abdominal mass with lower back or flank pain
Sharp pleuritic chest pain worse with deep breathing
Substernal pressure radiating to left arm and jaw
Localized sternal bruising following blunt trauma
Immediate management priority for suspected AAA per the notes is
Administer high-dose nitrates to relieve chest pressure
Ambulate patient to reduce risk of thromboembolism
Give large fluid boluses to raise blood pressure aggressively
Prevent blood pressure from increasing and prepare for surgery
Arteriosclerosis versus atherosclerosis distinction best captured by
Arteriosclerosis is general arterial hardening; atherosclerosis is plaque buildup
Arteriosclerosis is acute; atherosclerosis is solely infectious
Arteriosclerosis is plaque rupture; atherosclerosis is calcium deposition
Arteriosclerosis affects veins; atherosclerosis affects capillaries
Right-sided heart failure pathophysiology emphasized is
Right ventricle fails causing systemic venous congestion
Aortic regurgitation causing increased coronary perfusion
Left ventricle fails causing pulmonary vessel backup
Mitral valve stenosis causing decreased systemic flow
Left-sided heart failure causes highlighted include
Myocardial infarction, valvular disease, chronic hypertension
Costochondritis and musculoskeletal strain
Cholecystitis, pancreatitis, and peptic ulcer disease
Pulmonary embolism, pneumothorax, and pleurisy
Chest pain pattern most consistent with pericarditis in this material is
Dull pressure-like pain unrelenting despite rest or nitro
Sudden severe pleuritic pain from pulmonary artery blockage
Sharp localized pain reproducible with chest wall pressure
Sharp stabbing pain that worsens with deep breaths and lying flat
Which chest pain feature most strongly suggests thoracic aortic dissection?
Tearing pain radiating to back
Sharp pain worse with cough
Burning pain after large meal
Pressure pain radiating to jaw
Pericarditis classically presents with pain that is best described as
Sharp stabbing worse with deep breaths
Dull pressure constant and severe
Crushing heavy improved by rest
Burning epigastric after fatty foods
A patient has sudden pleuritic chest pain and shortness of breath. Which cause is most likely?
Costochondritis with rib swelling
Pulmonary embolism causing pleurisy
GERD with acid reflux pain
Pericarditis with viral etiology
Which finding most favors musculoskeletal chest pain from costochondritis?
Stabbing pain radiating to shoulder blade
Diffuse pressure not relieved by rest
Localized sharp pain reproducible by pressure
Sudden dyspnea with pleuritic chest pain
Which symptom profile best matches MI rather than noncardiac causes?
Burning epigastric pain after meals
Sharp chest wall pain with deep breaths
Severe unrelenting chest pain radiating to arm
Localized tenderness over rib cartilage
In females, particularly postmenopausal, MI may present atypically with
Positional chest pain improved leaning forward
Sudden tearing interscapular pain
Nausea and epigastric discomfort
Pleurodynia relieved by coughing
Which ECG change supports a diagnosis of acute MI?
ST elevation with pathological Q waves
Narrow QRS with upright P before each QRS
Irregular rate with multiple sawtooth P waves
Gradually lengthening PR with dropped QRS
An elderly woman with weakness and nausea has left jaw pain but no chest pressure. Best initial action?
Reassure and observe for changes
Obtain a 12‑lead ECG without delay
Administer antacid and reassess
Perform only chest wall palpation
Which is a common secondary cause of sinus tachycardia that should be treated first?
Congenital long QT syndrome
Stable atrial flutter rhythm
First‑degree AV block
Dehydration reducing blood volume
A hypoxic COPD patient develops tachycardia primarily because
Electrolyte loss suppresses conduction
Direct myocardial ischemia always present
Vagus nerve overstimulation slows rate
Body increases heart rate to compensate
Which rhythm characteristic fits normal sinus rhythm?
Inverted P waves with narrow QRS, 60 bpm
No P waves, irregularly irregular rhythm
Upright P before every QRS, 60–100 bpm
Variable PR intervals with dropped beats
Which description best matches accelerated junctional rhythm?
Rate 100–150 bpm, irregular, sawtooth P waves
Rate 40–60 bpm, regular, upright P before each QRS
Rate 60–100 bpm, regular, inverted or absent P waves
Rate 0–60 bpm, regular, consistent PR interval
Which finding best defines normal sinus rhythm on ECG?
Wide QRS with no preceding P-wave
No clear P-waves, irregularly irregular rate
Inverted P-waves with narrow QRS, 60-100 bpm
Upright P before every QRS, 60-100 bpm
Sinus bradycardia is characterized by which rate range?
0-60 bpm with upright P for every QRS
60-100 bpm with variable P morphology
100-150 bpm with narrow QRS
>150 bpm with narrow QRS
A rhythm with upright P before every QRS, narrow QRS, and rate 120 bpm is most consistent with:
Ventricular tachycardia
Atrial flutter
Sinus tachycardia
Accelerated junctional
Wandering atrial pacemaker is best described as:
Wide QRS without preceding P-wave
Sawtooth multiple P-waves, usually regular
Changing P-wave shape with irregular rate
No P-waves with irregularly irregular rhythm
A premature atrial complex (PAC) appears as:
Early wide QRS with no P-wave
Dropped QRS after progressively longer PR
Early beat with upright P and narrow QRS
Inverted P-waves with narrow QRS
Which feature best identifies atrial flutter on ECG?
Regular narrow QRS with inverted P-waves
Wide, bizarre QRS every other beat
Irregularly irregular rhythm without P-waves
Multiple sawtooth P-waves for each QRS
Atrial fibrillation is most accurately described as:
No distinct P-waves with irregularly irregular rate
Sawtooth flutter waves with fixed conduction
Inverted P-waves with regular narrow QRS
Wide QRS with capture and fusion beats
Which description matches premature junctional complex (PJC)?
Dropped beat after fixed PR interval
Irregularly irregular rhythm without P-waves
Early beat without upright P-wave, narrow QRS
Early beat with upright P-wave, wide QRS
Typical rate for junctional escape rhythm is:
100-150 bpm with inverted P-waves
60-100 bpm with upright P before QRS
40-60 bpm with inverted/absent P-waves
20-40 bpm with wide QRS
Accelerated junctional rhythm usually has which rate?
>150 bpm, wide QRS, no P-waves
40-60 bpm, irregular, upright P-waves
100-150 bpm, irregular, sawtooth P-waves
60-100 bpm, regular, inverted/absent P-waves
Second-degree AV block type I (Wenckebach) is defined by:
Dissociation of P and QRS with wide complexes
Some P-waves not conducted with constant PR
Constant prolonged PR with all QRS conducted
Progressively lengthening PR until a QRS drops
Second-degree AV block type II (Mobitz II) shows:
Constant PR with intermittent non-conducted P-waves
Progressive PR prolongation then dropped QRS
No relationship between P-waves and QRS
Narrow QRS with inverted P-waves
Third-degree AV block is best recognized by:
PR interval fixed and >0.20 seconds
Atria and ventricles beating independently
Occasional dropped QRS with constant PR
Wide QRS without any P-waves at all
Premature ventricular contraction (PVC) is typically:
Wide, early QRS with no preceding P-wave
Narrow early QRS with upright P-wave
Dropped QRS after long PR interval
Narrow QRS with sawtooth baseline
Which term describes PVCs occurring every other beat?
Bigeminy
Run
Couplet
Trigeminy
Ventricular tachycardia is best characterized by:
Multiple sawtooth waves with normal QRS
Irregularly irregular rhythm without P-waves
>150 bpm with narrow QRS and irregular rate
150-200 bpm, wide QRS, regular fast rhythm
Torsades de pointes is described as:
Ventricular escape at 20-40 bpm
Irregularly irregular atrial tachycardia
Monomorphic narrow complex tachycardia
Polymorphic ventricular tachycardia
Pulseless electrical activity (PEA) is defined as:
No electrical activity with a flat line
Electrical activity without a pulse and not VF/VT
Irregular narrow rhythm with strong pulse
Fast wide rhythm with palpable pulse
Which is a common cause of PEA that should be treated immediately?
Asymptomatic sinus bradycardia
Stable first-degree AV block
Cardiac tamponade relieved by pericardiocentesis
Benign premature atrial contractions
Following an acute MI, life‑threatening arrhythmias can:
Occur almost immediately, even within 1 hour
Only occur several days after symptom onset
Rarely cause sudden death in early phase
Present late and never as VF or VT
During PEA management, the priority is to:
Treat the patient and underlying cause
Administer thrombolytics to all cases
Rely on monitor and ignore clinical exam
Perform defibrillation as first-line
Which set of lead groups primarily corresponds to the inferior wall of the left ventricle?
II, III, aVF
V1, V2, V3
I, aVL, V5
V7, V8, V9
Which coronary artery territory most commonly maps to the anterior wall lead group V1–V4?
Posterior descending
Left circumflex artery
Right coronary artery
Left anterior descending
ST-segment depression in two or more related leads with no ST elevation elsewhere most strongly indicates which process?
Myocardial ischemia
Early repolarization
Right ventricular infarction
Pericarditis
Pathological Q waves signify which of the following?
Ventricular hypertrophy
Atrial enlargement
Electrolyte imbalance
Myocardial infarction
Which finding is expected and not considered STEMI in left bundle branch block unless criteria are met?
Tall peaked T waves
ST depression only
Discordant ST elevation
Concave ST elevation
Concave ST elevation with diffuse leads and pleuritic pain most likely suggests which diagnosis rather than STEMI?
Pericarditis
Hyperkalemia
Pulmonary embolism
Brugada syndrome
A Q wave is considered pathological when it meets which criterion?
Duration > 0.04 s or depth > 1/3 R
Duration < 0.02 s and shallow
Present only in aVR lead
Wide but less than 0.02 s
In suspected inferior STEMI, which additional leads assess right ventricular involvement?
V4R, V8, V9
V1R, V2R, V3R
V7, aVL, aVR
V5R, aVR, aVL
Where is lead V9 placed for posterior assessment?
Left infraclavicular fossa
Right of sternum at V4 level
Mid-axillary at fifth space
Paraspinal line aligned with V8
Each small box on ECG paper represents what time interval?
0.20 seconds
0.10 seconds
0.02 seconds
0.04 seconds
Which statement best links lead groups with coronary arteries as shown in the diagram?
LAD with lateral leads
RCA with inferior leads
LCA with septal leads
RCA with anterior leads
The PR interval should normally be less than which value before suspecting heart block?
0.08 seconds
0.12 seconds
0.4 seconds
0.2 seconds
Injury due to prolonged ischemia typically produces which ECG change in two or more related leads?
ST-segment elevation
PR-segment depression
QT shortening
U-wave inversion
T-wave inversions across related leads without ST elevation most align with which category?
Hyperacute change
Electrode misplacement
Pericarditis
Ischemia
Historically, septal and anterior walls were separated as V1–V2 and V3–V4. In current interpretation, how are they grouped for localization?
V5–V6 considered septal
V3–V6 considered inferior
V1–V2 considered lateral
V1–V4 considered anterior
On standard ECG paper, the time represented by one small box is best described as which value?
0.1 seconds
0.02 seconds
0.04 seconds
0.2 seconds
Which statement correctly defines the PR interval’s normal upper limit for duration?
Less than 0.20 seconds
Less than 0.12 seconds
Less than 0.30 seconds
Less than 0.08 seconds
Atrial depolarization is represented on the ECG by which component?
The ST segment
The T wave
The QRS complex
The P wave
Which finding most suggests a junctional rhythm regarding P waves?
Notched wide P waves
Absent P waves
Tall peaked P waves
Inverted P waves
Which combination suggests Wandering Atrial Pacemaker?
Varying P-wave shapes with fixed PRIs
Absent P waves with fixed PRIs
Fixed P-wave shape with fixed PRIs
Varying P-wave shapes with varying PRIs
Which description best matches the physiological meaning of the QRS complex?
Atrial repolarization and covers ventricular depolarization
Ventricular repolarization and covers atrial depolarization
Atrial depolarization and covers ventricular repolarization
Ventricular depolarization and covers atrial repolarization
A normal QRS duration should be within which range?
0.12–0.18 seconds
0.14–0.20 seconds
0.02–0.06 seconds
0.08–0.12 seconds
When the QRS duration is greater than 0.12 seconds, which evaluation is most appropriate?
Assess for bundle branch block
Assume hyperkalemia immediately
Ignore if heart rate is normal
Diagnose atrial fibrillation
In lead V1, which QRS direction from the J-point suggests a Right Bundle Branch Block (RBBB)?
Isoelectric QRS from the J-point
QRS goes down from the J-point
QRS goes up from the J-point
Biphasic QRS from the J-point
In lead V1, which QRS direction from the J-point suggests a Left Bundle Branch Block (LBBB)?
Isoelectric QRS from the J-point
Biphasic QRS from the J-point
QRS goes up from the J-point
QRS goes down from the J-point
Which axis shift is associated with a left anterior hemiblock?
Axis 0 to +30 degrees
Axis −40 to −90 degrees
Axis +90 to +150 degrees
Axis 180 to 270 degrees
Which feature defines a pathological Q wave indicating prior infarction?
Always associated with wide T waves only
Always absent after acute injury without ST changes
Duration less than 0.04 seconds and less than one‑third of R
Duration greater than 0.04 seconds or deeper than one‑third of R
ST depression present in two related leads without ST elevation elsewhere most likely indicates which condition?
Pericarditis with global inflammation
Benign early repolarization pattern
Ischemia causing reversible O2 deprivation
STEMI due to acute occlusion
Which statement about ST elevation and STEMI is most accurate?
Any ST elevation indicates STEMI in LBBB
Concave ST elevation proves acute STEMI
ST elevation must appear in two related leads
ST elevation in one limb lead is sufficient
Which scenario best matches a discordant ST elevation that is not considered STEMI?
ST elevation with narrow QRS in sinus
ST depression with a positive QRS in LBBB
ST elevation with a negative QRS in LBBB
ST elevation with a positive QRS in LBBB
Which ECG change most strongly suggests hyperkalemia progressing toward torsades de pointes?
Flattened P waves with narrow QRS
Inverted T waves in lateral leads
ST elevation in contiguous anterior leads
Tall peaked T waves exceeding half QRS height
A common clinical cause of hyperkalemia in cardiac arrest is most directly linked to which condition?
Liver failure impairing ammonia metabolism
Hyperthyroidism increasing metabolic rate
Hyperventilation causing respiratory alkalosis
Acute kidney injury preventing potassium excretion
Which mechanism explains why sodium and water retention can worsen hyperkalemia’s cardiac effects?
Water follows glucose into cells reducing excitability
Magnesium displaces potassium at the membrane
Sodium follows water extracellularly affecting gradients
Chloride influx increases resting membrane potential
Which medication class can contribute to hyperkalemia and widened QRS complexes?
Beta agonists such as albuterol nebulizers
Thiazide diuretics such as hydrochlorothiazide
Antiplatelets including clopidogrel
Loop diuretics and certain medications like Lasix
Which intervention targets hypoxia among the Hs and Ts?
Chest compressions at higher rate
Rapid sequence intubation only
Immediate synchronized cardioversion
O2 and positive pressure ventilation
Which therapy is most appropriate for hypovolemia as a reversible cause of arrest?
Fluids and vasopressors if non-hemorrhagic
Calcium chloride and sodium bicarbonate
Aspirin and nitroglycerin routinely
Antibiotics and antipyretics as needed
Which treatment is indicated for tension pneumothorax in the Hs and Ts framework?
Pericardiocentesis for decompression
Needle thoracostomy to relieve pressure
Therapeutic hypothermia after ROSC
Synchronized cardioversion for instability
Which pair is most appropriate for pulmonary embolism management listed under Hs and Ts?
Thrombolytics and surgical embolectomy
Heparin infusion and beta blockers
Antiplatelets and statins therapy
Bronchodilators and corticosteroids
Which toxin-antidote pairing is correctly matched from the list?
Opioids: naloxone reversal agent
Beta blockers: sodium bicarbonate
TCAs: glucagon infusion therapy
Cyanide: aspirin and nitroprusside
Which sign defines an unstable tachyarrhythmia requiring immediate cardioversion?
Altered mental status with low perfusion signs
Sinus tachycardia during mild exertion
Blood pressure consistently above 140 systolic
Asymptomatic palpitations without chest pain
A patient with bradycardia and complete heart block is categorized as unstable primarily because of which rationale?
Unstable requires chest pain exclusively
Presence of frequent PVCs alone defines unstable
Second and third degree blocks fall under unstable
High risk of electrolyte imbalance only
Stable angina is best described as which pattern of chest pain?
Occurs at rest and lasts over twenty minutes
Triggered by exertion and relieved quickly
Unrelated to activity and poorly responsive
Accompanied by syncope and hypotension
Which past medical therapy combination most strongly suggests a history of hypertension?
Beta blocker, calcium channel blocker, ACE inhibitor
Statin therapy, antiplatelet, SGLT2 inhibitor
Loop diuretic, nitrate, digoxin maintenance
Anticoagulant, amiodarone, potassium supplements
Calcium channel blocker monotherapy in history most specifically raises suspicion for which condition?
Atrial fibrillation rate control or hypertension
Acute coronary thrombosis reduction
Brugada syndrome arrhythmia prevention
Hyperthyroidism symptom management
Which statement accurately contrasts chronotropic and inotropic effects?
Both terms describe electrical conduction speed only
Chronotropy affects rate; inotropy affects contraction strength
Both terms describe afterload reduction mechanisms
Chronotropy affects contractile force; inotropy affects rate
Which drug effect pairing is correct for dromotropic agents?
Positive dromotropes slow SA node firing
Negative dromotropes raise heart rate
Negative dromotropes increase contractility
Positive dromotropes speed AV conduction
Which profile best describes dopamine’s cardiovascular actions?
Neutral chronotropy with negative dromotropy
Negative chronotropic with positive inotropy
Positive only inotropic with no other effects
Positive chrono, ino, and dromo combined
Why might dobutamine be preferred over dopamine in isolated left-sided heart failure with borderline blood pressure?
It causes bradycardia which improves filling time
It provides pure vasoconstriction without inotropy
It increases dromotropy significantly lowering BP
It offers strong inotropy with minimal tachycardia
Which statement best reflects beta blocker effects on cardiac function?
Positive inotropy with negative chronotropy
Negative chrono, ino, and dromo actions
Neutral chronotropy with positive dromotropy
Positive chronotropy and inotropy combined
Which medication grouping is most associated with post-ROSC hemodynamic support as hinted in the notes?
Magnesium and aspirin for vasoconstriction
Dopamine and norepinephrine for pressor support
Adenosine and atropine for rate acceleration
Amiodarone and lidocaine for anticoagulation
Which therapy requires synchronization with the R wave to avoid shocking during the vulnerable period of the QRS?
Synchronized cardioversion
Therapeutic hypothermia
Transcutaneous pacing
Unsynchronized defibrillation
For pulseless ventricular fibrillation, which electrical therapy is indicated first?
Unsynchronized defibrillation
Overdrive atrial pacing
Synchronized cardioversion
Transcutaneous pacing
Which rhythm is an indication for synchronized cardioversion rather than defibrillation?
Asystole
Pulseless V-tach
Pulseless V-fib
SVT with a pulse
Typical initial energy for synchronized cardioversion listed in the material is closest to which value?
10 joules
50 joules
120 joules
360 joules
Defibrillation energy for ventricular fibrillation in the notes falls within which range?
40–90 milliamps
20–40 joules
200–360 joules
5–10 milliamps
Transcutaneous pacing is primarily used to treat which scenario?
Atrial flutter without symptoms
SVT with a pulse
Pulseless torsades
Symptomatic bradycardia
During transcutaneous pacing, capture is typically achieved at what current before titrating down?
40–90 mA at 60–80 bpm
200–360 J immediately
2–4 mA at 30–40 bpm
1–2 J synchronized shocks
Which symptom supports the need for transcutaneous pacing in bradycardia?
Mild anxiety only
Warm extremities alone
Tachycardia without symptoms
Hypotension or shock
