Free AEMT Cardiovascular Emergencies Questions and Answers — Questions and Answers
Question 1: Acute Coronary Syndrome (ACS) is defined as patients with angina, shortness of breath, chest, epigastric, arm, or jaw pain or discomfort and may be associated with diaphoresis, nausea, shortness of breath or difficulty breathing.
- TRUE (Correct answer)
- FALSE
Correct answer: TRUE
Acute Coronary Syndrome (ACS) is a broad term encompassing conditions caused by sudden, reduced blood flow to the heart. Its presentation is indeed characterized by symptoms like angina (chest pain), shortness of breath, and referred pain to the epigastrium, arms, or jaw. These symptoms are often accompanied by diaphoresis (sweating), nausea, and difficulty breathing, making the given definition accurate.
Question 2: Patient that meet the STEMI inclusion criteria shall be transported to the closest Cardiac Intervention Center by air or ground as long as the delivery time is not more than _________ greater than transport to the nearest ED.
- 15 minutes
- 10 minutes
- 45 minutes (Correct answer)
- 60 minutes
Correct answer: 45 minutes
In the management of STEMI (ST-elevation myocardial infarction), timely reperfusion therapy is critical. Guidelines often specify a maximum allowable transport time to a specialized Cardiac Intervention Center (CIC) compared to the nearest emergency department (ED). A common threshold is 45 minutes, meaning if transport to a CIC would exceed the nearest ED by more than 45 minutes, alternative strategies like fibrinolytic therapy at the nearest ED should be considered.
Question 3: What is criteria on a EKG strip for a STEMI?
- ST elevation greater than 1 mm in two or more contiguous leads and a QRS complex that is narrower than 0.12 seconds.
- Posterior MI: ST depression greater than 1 mm in V1 and V2 with an R/S ratio of greater than equal to one and a narrow QRS complex.
- New Left Bundle Branch Block: If a previous EKG showed a narrow QRS complex and the current EKG shows a wide QRS complex.
- All of the above (Correct answer)
Correct answer: All of the above
The criteria for diagnosing a STEMI on an EKG are multifaceted and include several key indicators. Significant ST elevation (typically >1mm in two or more contiguous leads) is a primary sign. Posterior MIs have specific EKG findings like ST depression in V1-V2. A new Left Bundle Branch Block (LBBB) can also obscure typical STEMI findings and is considered a STEMI equivalent in the appropriate clinical context, making 'All of the above' the correct answer.
Question 4: If a patient can not be delivered to a Cardiac Intervention Center within 45 minutes, a Fibrinolytic Therapy Checklist should be completed for STEMI and the patient should be transported to the nearest ED.
- TRUE (Correct answer)
- FALSE
Correct answer: TRUE
If a patient with STEMI cannot be transported to a Cardiac Intervention Center for primary percutaneous coronary intervention (PCI) within the recommended timeframe (e.g., 45 minutes greater than transport to the nearest ED), then fibrinolytic therapy becomes the preferred reperfusion strategy. In such cases, a Fibrinolytic Therapy Checklist is completed to assess eligibility and contraindications, and the patient is transported to the nearest ED for administration.
Question 5: If a patient does not meet the criteria for fibrinolytic therapy, consultation should be done with the nearest Cardiac Intervention Center and the nearest ED to determine the most appropriate receiving facility.
- TRUE (Correct answer)
- FALSE
Correct answer: TRUE
When a STEMI patient does not meet the criteria for fibrinolytic therapy (due to contraindications or other factors), it necessitates a careful decision regarding the most appropriate receiving facility. Consultation with both the nearest Cardiac Intervention Center (for potential PCI if feasible) and the nearest Emergency Department (for supportive care and further assessment) is crucial to ensure the patient receives the best possible care pathway.
Question 6: What is the criteria that a patient must meet for the Fibrinolytic Therapy Checklist for STEMI?
- 18 years or older
- Sign and symptoms of STEMI
- 45 minutes
- All of the above (Correct answer)
Correct answer: All of the above
The Fibrinolytic Therapy Checklist for STEMI includes specific inclusion criteria to ensure the therapy is appropriate and safe. These typically include the patient being 18 years or older, presenting with signs and symptoms consistent with STEMI, and being within a specific time window from symptom onset (often related to the 45-minute transport threshold for PCI). Therefore, all listed options are generally part of the inclusion criteria.
Question 7: What is the exclusion criteria that a patient must meet for the Fibrinolytic Therapy Checklist for STEMI?
- Active internal bleeding within the last 21 days
- Known bleeding disorder
- Within 3 months of intracranial surgery, serious head trauma, or stroke
- All of the above (Correct answer)
Correct answer: All of the above
Fibrinolytic therapy carries a significant risk of bleeding, so strict exclusion criteria are in place to prevent severe complications. Active internal bleeding, known bleeding disorders, and recent intracranial surgery, serious head trauma, or stroke are all major contraindications due to the high risk of intracranial hemorrhage or exacerbating existing bleeding. Therefore, all the listed items are critical exclusion criteria.
Free AEMT Cardiovascular Emergencies Questions and Answers
Acute Coronary Syndrome (ACS) is defined as patients with angina, shortness of breath, chest, epigastric, arm, or jaw pain or discomfort and may be associated with diaphoresis, nausea, shortness of breath or difficulty breathing.