QUESTION EXAMPLES ECG

Transcription

1 ACEM Fellowship VAQ Examination QUESTION EXAMPLES ECG

2 ECG 1: A 16 year old boy with a congenital heart problem presents to your ED with syncopal episodes. An ECG is taken. Describe and interpret his ECG (100%) ECG

3 ECG 2: A 20 year old man is brought to your ED by ambulance after being found collapsed at home following a large polypharmacy drug overdose that included Venlafaxine. He has been intubated and received 500mls of normal saline prior to arrival. The time of ingestion is not known. Observations An ECG is performed. a. Describe and interpret his ECG (30%) b. Outline your treatment (70%) ECG

4 ECG 3: A 76 year old woman presents to your emergency department with one hour of severe chest pain. a. Describe and interpret the ECG (50%) b. Outline your management (50%) ECG

5 ECG 4: An 80 year old woman presents with a 2 day history of increasing shortness of breath. She has a history of treated hypertension Her observations are: a. Describe and interpret her ECG (100%) ECG

6 ECG 5: A nurse presents you with the ECG of a 4 year old girl who is currently asymptomatic. Observations include: a. Describe and interpret the ECG (50%) b. Outline the findings in normal paediatric ECGs beyond the neonatal period (50%)

7 ECG 6: An 87 year old man is referred to your emergency department from a nursing home with acute deterioration. His observations are: Describe and interpret his ECG (100%)

8 ECG 7: A 50 year old man presents following an episode of palpitations and syncope. At the time of the ECG shown he is asymptomatic. a. Describe and interpret his ECG (100%)

9 ECG 8: A 54 year old man presents to your rural emergency department with chest pain. An initial ECG reveals an inferior STEMI. Fifteen minutes after receiving intravenous thrombolysis the following ECG is taken. a. Describe and interpret his ECG (100%)

10 ECG 9: A 64 year old man presents to your emergency department with chest pain and shortness of breath. a. Describe and interpret his ECG (100%)

11 ECG 10: A 46 year old man is brought to your emergency department by ambulance following an overdose of unknown medications. He has had a brief generalized seizure en route. On arrival his observations are: a. Describe and interpret his ECG (50%) a. Outline your treatment (50%)

12 ECG 11: A 35 year old woman presents to the emergency department with onset of palpitations. Her observations are: a. Describe and interpret his ECG (100%)

13 ECG 12: An 82 year old man, who lives alone, presents to the emergency department following being found collapsed at home. He says he takes tablets for his heart but cannot recall their names. a. Describe and interpret his ECG (100%)

14 ECG 13: A 54 year old man with no prior medical history presents to your emergency department with one hour of chest pain. He is anxious and diaphoretic. His observations are: a. Describe and interpret his ECG (100%)

15 ECG 14: A 64 year old man is being evaluated in your emergency department after an episode of chest pain which has now resolved. a. Describe and interpret his ECG (100%)

16 ECG 15: A 57 year old woman presents with an episode of 8 hours central chest pain which resolved spontaneously two hours ago. She has a past history of type 2 diabetes mellitus and is on no regular medication. Her vital signs are normal. Describe and interpret her ECG (100%)

17 ECG 16: A 36 year old woman presents with palpitations for an hour. She is pain free and normotensive. Describe and interpret her ECG (100%)

18 ECG 17: A 72 year old woman is brought to your Emergency Department after a syncopal episode. a. Describe and interpret her ECG (50%) b. Outline your disposition considerations (50%)

19 ECG 18: A 35 year old man is brought to your Emergency Department following two seizures. His observations are: Describe and interpret his ECG (100%)

20 ECG 19: An 82 year old man is brought to your emergency department after having been found on the floor of his home. He was last seen by his neighbor 18 hours earlier. a. Describe and interpret his ECG (50%) b. Outline the investigations you would perform (50%)

21 ECG 20: A 50 year old man presents with shortness of breath and sharp central chest pain of 24 hours duration. He has no past medical history and is on no medication. Describe and interpret his ECG (100%)

22 ECG 21: A 78 year old man is brought to your emergency department after collapsing at the local shopping centre that morning. He is now alert with no memory of the event. His observations are normal. a. Describe and interpret his ECG (50%) b. Outline the investigations prompted by his ECG (50%)

23 ECG 22: A 32 year old woman is brought to your emergency department by her friend who believes her to have taken a deliberate overdose earlier that morning. The patient is drowsy and denies this. Her observations are normal. a. Describe and interpret her ECG (50%) b. What drugs would you consider as potential ingestants? (50%)

24 ECG 23: A 70 year old man presents to the emergency department with presyncopal symptoms and central chest pain for the first time. a. Describe and interpret her ECG (50%) b. Outline your management (50%)

25 ECG 24: A 68 year old man presents with one hour of rapid palpitations. Two ECGs are shown ECG 1 and 2 are before and after his anti-arrhythmic drug treatment respectively. a. Describe and interpret ECG 1 (50%) b. Describe and interpret ECG 2 (50%) ECG 1

26 ECG 24 continued : ECG 2

27 ECG 25: A 54 year old man presents with one hour of severe central chest pain. His observations are: His 12 lead ECG is shown, with three additional right-sided praecordial leads. a. Describe and interpret her ECG (50%) b. Outline your treatment of his hypotension. (50%)

28 ECG 26: A 49 year old woman presents to your emergency department with central chest pain. Her observations are: a. Describe and interpret her ECG (50%) b. Outline your disposition considerations (50%)

29 ECG 27: A 78 year old man is brought to your emergency department after being found on the floor of his home. His only past medical history is of congestive cardiac failure, and he is unable to remember his medications. An ECG has been taken. Describe and interpret his ECG (100%)

30 ECG 28: A 64 year old woman presents with acute chest pain, dyspnoea at rest and palpitations. Her observations are: a. Describe and interpret her ECG (50%) b. List your treatment priorities. (50%)

31 ECG 29: A 30 year old female is brought to your ED by ambulance following a suspected drug overdose. a. Describe and interpret her ECG (50%) b. Outline your initial management in the ED. (50%)

32 ECG 30: A 72 year old man presents by ambulance to your ED with onset of tachycardia and shortness of breath. Describe and interpret his ECG (100%)

33 ECG 31: An 80 year old woman presents to your emergency department with palpitations and breathlessness for three days. She had undergone coronary bypass grafting two weeks earlier. a. Describe and interpret her ECG (50%) b. List the possible causes of her breathlessness. (50%)

34 ECG 32: A 40 year old man presents to the emergency department with a history of chest pain two hours previously. He is now pain free. a. Describe and interpret her ECG (50%) b. What investigations does this man need and why? (50%)

35 ECG 33: A 65 year old woman is brought to the emergency department following a collapse at home. She is pale with a BP of 75 mmhg (systolic), respiratory rate of 25/minute, a GCS of 13/15 and an SaO2 of 92% on 6 litres/ minute of oxygen. An ECG is performed. The ECG shows a bizarre broad complex rhythm at about 70 bpm with non capturing dual pacemaker spikes. a. Describe and interpret her ECG (50%) b. Outline your initial management priorities for this woman. (50%)

36 ECG 34: A 25 year old man is brought to the emergency department complaining of chest pain for 48 hours. a. Describe his ECG. (50%) b. List the possible causes. (50%)

37 ECG 35: A 74 year old woman with previous hypertension and type II diabetes presents with epigastric pain and distended abdomen. She is breathless. Her observations are as follows: SaO2 85% on room air, NIBP 90/55mmHg, Respiratory Rate 24/min and Temperature of 37.5oC. a. Describe and interpret her ECG (50%) b. List the treatment for this woman (50%)

38 ECG 36: This 23 year old man complains of palpitations and dizziness. His blood pressure is 70/50. a. Describe the ECG. (50%) b. How would you manage this man. (50%)

39 ECG 37: A 38 year old man collapses while playing squash. He spontaneously recovers during transport by ambulance. He has no known past medical problems. His observations are: BP 120/70, GCS 15, O2 sat 100% on 6L/min. An ECG is shown. a. Describe this ECG. (50%) b. Outline this patient s disposition and explain why. (50%)