Question 1 Heavy Smoker male patient 62 years old, presented by acute retrostern

Question 1
Heavy Smoker male patient 62 years old, presented by acute retrosternal burning chest pain for 3 hours, followed by dyspnea, orthopnea, respiratory distress, hypotension, which of the following is the most important investigation:
Select one:
a.
BNP
b.
Echocardiography
c.
12 leas ECG
d.
Cardiac troponin
Question 2
Female patient 60 years old, presented by dyspnea, orthopnea, respiratory distress, o/e: blood pressure:105/75mmHg, HR:105b/m, SaO2:93+ACU-, all of the following are correct except:
Select one:
a.
IV frusemide
b.
IV nitrates
c.
Oxygen supplementation
d.
IV morphine
Question 3
Female patient 65 years old, known to have ischemic cardiomyopathy, EF+AD0-33+ACU-, ECG:left bunle brach block, after improvement of pulmonary edema, which of the following is considered to be appropriate for HF treatment ??
Select one:
a.
All of the above
b.
Biventricular pacing
c.
ACE inhibitors administration
d.
Spironolactone administration
Question 4
Male patient 68 years old, known to have ischemic cardiomyopathy, presented by severe pulmonary edema, with refractory hypoxia, but hemodynamically stable all of the following are correct to correct hypoxia except:
Select one:
a.
Further doses of IV frusemide (40-80mg)
b.
Increase dose of nitrates.
c.
IV antibiotics
d.
CPAP
Question 5
Female patient 70 years old, with history of diabetes, hypertension, presented by pulmonary edema to ED, which of the following is considered to be high risk features:
Select one:
a.
Blood pressure 170/100 mmHg
b.
Serum Creatinine 1.2 mg/dl
c.
Elevated troponin I
d.
Serum Sodium 133 mmol/l
Question 6
Heavy Smoker male patient 60 years old, presented by dyspnea, orthopnea, respiratory distress, o/e: blood pressure:130/80mmHg, HR:110b/m, with raised JVP, S3 Gallop, SaO2 on room air was 95+ACU-, the most important next step:
Select one:
a.
IV verapamil
b.
Oxygen supplementation
c.
IV frusemide
d.
IV propranolol
Question 7
Male patient known to have IHD, presented by dyspnea, respiratory distress, o/e, there was raised rapid irregular pulse, raised JVP, bilateral basal crepitations, which of the following is correct:
Select one:
a.
IV digoxin
b.
All of the above
c.
IV furosemide
d.
Anticoagulation
Question 8
Male patient 68 years old, known to have ischemic cardiomyopathy, presented by severe pulmonary edema, all of the following can be a precipitating factor except:
Select one:
a.
Rapid AF
b.
Aortic dissection
c.
Severe hypertension
d.
Pulmonary embolism
Question 9
Male patient 65 years old, with history of uncontrolled diabetes, hypertension, presented by pulmonary edema to ED, all of the following are signs suggestive of pulmonary edema except:
Select one:
a.
S3 Gallop
b.
Rapid weak pulse
c.
Bilateral basal crepitations
d.
Collapse neck veins.

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