SAQ-Cardiology

2003/1/SAQ8: A 67 year old male presents to your urban district emergency department 1 hour post onset of chest pain. His ECG reveals acute ST segment elevation of 3mm in leads V3, V4 and V5. He is treated with aspirin (300mg), reteplase (two 10 unit boluses 30 minutes apart), and unfractionated heparin (5000 unit bolus and 1000 units/hr infusion). Sixty minutes after the thrombolysis is administered the patient complains of increasing left sided chest discomfort and shortness of breath. A repeat CXR reveals a new large left-sided collection in the pleural space. His vital signs are currently heart rate 100, BP 85/55, RR 26 and O2 sat 92% on 6L per minute via Hudson mask. Outline your management of this situation. (100%)

2005/1/SAQ2: A 76 year old female with a history of controlled atrial fibrillation presents to the emergency department with severe abdominal pain of 2 hours duration. Describe your assessment of this patient. (100%)

1999/1/SAQ8: Discuss the strategies that can be used to minimise time to thrombolysis for acute myocardial infaction. (100%)

2001/2/SAQ2: A 70 y.o. male presents to your community hospital ED with a 24 hour history of intermittent chest pain. Pain is same as his AMI pain which occurred 12 months ago and was treated with thrombolysis. His ECG shows a new myocardial infarction.Discuss your management options. (100%)

worked answers

2010/1/SAQ6: An 82 year old man is brought to the emergency department following a brief collapse at home. He has a history of chronic renal failure and hypertension. His medications include an angiotensin converting enzyme inhibiting agent (ACEI), frusemide and metoprolol. He has no traumatic injuries from this episode. Examination reveals; HR:32/min, BP: 70/40mmHg, RR: 16/min, Temperature: 36oC, GCS: 14 (confused). His ECG demonstrates third degree atrioventricular block. Describe your management (100%)

2009/1/SAQ7:A 53 year old previously well man presents with a 6 hour history of palpitations. He is otherwise asymptomatic. His vitals signs are; BP: 120 / 80mmHg, RR: 22/min. ECG reveals atrial fibrillation with a rate of 130 /minute. His assessment does not reveal a cause for his arrhythmia. Discuss the management options for this patient. (100%)

examiner's comments

2009/1/SAQ4: A 55 year old man is brought to hospital by ambulance complaining of severe headache, vomiting and blurred vision. On initial examination his BP is 260 / 145, similar in both arms. His Glasgow Coma Score is 14. CT scan reveals no abnormality. Discuss the pharmacological treatment options for the treatment of his hypertension. (100%) 

examiner's comments

2008/2/SAQ1: A 52 year old woman presents with atypical chest pain and a normal ECG. What features on assessment would influence the disposition of this patient? (100%)

examiner's comments

2007/1/SAQ4: Compare and contrast the cardiac arrest algorithm for asystole between adults and children older than one year. (100%)

examiner's comments

2006/2/SAQ3: Describe the use of amiodarone in the emergency department, including its indications and limitations. (100%)

examiner's cooments