BKAT STUDY QUESTIONS AND ANSWERS 2025
Questions with Correct Answers
1. What to do first if patient has chest pain?
Answer: Rest!
Rationale: The first priority is to reduce myocardial oxygen demand by stopping
activity. Rest helps decrease heart rate and workload.
2. ECG changes in an acute MI?
Answer: ST elevation in 2 or more contiguous leads. Ischemia due to full
thickness loss of muscle. EMERGENCY.
Rationale: ST-segment elevation indicates transmural injury and requires
immediate reperfusion therapy.
3. Which ECG leads are inferior leads?
Answer: II, III, aVF. RCA occlusion.
Rationale: Inferior leads reflect the inferior wall of the left ventricle, typically
supplied by the right coronary artery (RCA).
4. Which ECG leads are septal leads?
Answer: V1 & V2.
Rationale: Septal leads (V1, V2) face the interventricular septum.
5. Which ECG leads are anterior leads?
Answer: V1 – V4. LAD lesion.
Rationale: Anterior leads reflect the anterior wall, supplied by the left anterior
descending (LAD) coronary artery.
,6. Which ECG leads are lateral leads?
Answer: V5, V6, I, and aVL. Circumflex lesion.
Rationale: Lateral leads correspond to the lateral wall, often supplied by the left
circumflex (LCx) artery.
7. What are the cardiac enzymes used to diagnose myocardial infarction?
Answer: Troponins, CK-MB, and CK.
Rationale: Troponins are the most specific; CK-MB is more specific than total CK
for cardiac damage.
8. Describe the time course of changes in total CK after an MI.
Answer: Rise: 3-6 hours; Peak: 24 hours; Returns to normal: 3-4 days.
Rationale: CK begins to rise early, peaks at 24 hours, and normalizes within a few
days.
9. Describe the time course of changes in CK-MB after an MI.
Answer: Released after myocardial necrosis. Specific for myocardial damage.
Rise: 3-12 hours; Peak: 24 hours; Normal: 2-3 days.
Rationale: CK-MB is more cardiac-specific than total CK and follows a similar but
slightly shorter time course.
10. Describe Troponin I.
Answer: Protein found in cardiac muscle. High sensitivity. Rise: 3-12 hours;
Peak: 24 hours; Normal: 5-10 days.
Rationale: Troponin I is highly specific for myocardial injury and remains elevated
longer than CK-MB.
11. Describe Troponin T.
Answer: Protein found in cardiac muscle. High sensitivity. Rise: 3-12 hours;
Peak: 12-48 hours; Normal: 5-14 days.
, Rationale: Troponin T also has high sensitivity and stays elevated for up to two
weeks.
12. What are common conditions that cause a heart murmur?
Answer: Aortic dissection, aortic regurgitation (both acute & chronic), mitral
valve regurgitation (both acute & chronic), mitral valve stenosis.
Rationale: Structural valve abnormalities and aortic pathology can produce
turbulent blood flow audible as a murmur.
13. Name drugs that decrease afterload / systemic vascular resistance (SVR) /
pulmonary vascular resistance (PVR).
Answer: (Arterial Dilators) Nitroprusside, nitroglycerin, amrinone, alpha
(Regitine) & Ca channel blockers.
Rationale: These agents vasodilate arteries, reducing resistance and afterload.
14. Name drugs that increase afterload / SVR / PVR.
Answer: (Vasopressors) Epinephrine, norepinephrine, dopamine,
neosynephrine.
Rationale: These drugs constrict vessels, increasing systemic and pulmonary
vascular resistance.
15. What is the first-line treatment for ST-segment elevation MI (STEMI)?
Answer: Primary percutaneous coronary intervention (PCI) within 90 minutes.
Rationale: Rapid mechanical reperfusion is superior to thrombolytics when
available.
16. What is the target door-to-balloon time for STEMI?
Answer: 90 minutes.
Rationale: Guidelines recommend PCI within 90 minutes of arrival to reduce
mortality.
Questions with Correct Answers
1. What to do first if patient has chest pain?
Answer: Rest!
Rationale: The first priority is to reduce myocardial oxygen demand by stopping
activity. Rest helps decrease heart rate and workload.
2. ECG changes in an acute MI?
Answer: ST elevation in 2 or more contiguous leads. Ischemia due to full
thickness loss of muscle. EMERGENCY.
Rationale: ST-segment elevation indicates transmural injury and requires
immediate reperfusion therapy.
3. Which ECG leads are inferior leads?
Answer: II, III, aVF. RCA occlusion.
Rationale: Inferior leads reflect the inferior wall of the left ventricle, typically
supplied by the right coronary artery (RCA).
4. Which ECG leads are septal leads?
Answer: V1 & V2.
Rationale: Septal leads (V1, V2) face the interventricular septum.
5. Which ECG leads are anterior leads?
Answer: V1 – V4. LAD lesion.
Rationale: Anterior leads reflect the anterior wall, supplied by the left anterior
descending (LAD) coronary artery.
,6. Which ECG leads are lateral leads?
Answer: V5, V6, I, and aVL. Circumflex lesion.
Rationale: Lateral leads correspond to the lateral wall, often supplied by the left
circumflex (LCx) artery.
7. What are the cardiac enzymes used to diagnose myocardial infarction?
Answer: Troponins, CK-MB, and CK.
Rationale: Troponins are the most specific; CK-MB is more specific than total CK
for cardiac damage.
8. Describe the time course of changes in total CK after an MI.
Answer: Rise: 3-6 hours; Peak: 24 hours; Returns to normal: 3-4 days.
Rationale: CK begins to rise early, peaks at 24 hours, and normalizes within a few
days.
9. Describe the time course of changes in CK-MB after an MI.
Answer: Released after myocardial necrosis. Specific for myocardial damage.
Rise: 3-12 hours; Peak: 24 hours; Normal: 2-3 days.
Rationale: CK-MB is more cardiac-specific than total CK and follows a similar but
slightly shorter time course.
10. Describe Troponin I.
Answer: Protein found in cardiac muscle. High sensitivity. Rise: 3-12 hours;
Peak: 24 hours; Normal: 5-10 days.
Rationale: Troponin I is highly specific for myocardial injury and remains elevated
longer than CK-MB.
11. Describe Troponin T.
Answer: Protein found in cardiac muscle. High sensitivity. Rise: 3-12 hours;
Peak: 12-48 hours; Normal: 5-14 days.
, Rationale: Troponin T also has high sensitivity and stays elevated for up to two
weeks.
12. What are common conditions that cause a heart murmur?
Answer: Aortic dissection, aortic regurgitation (both acute & chronic), mitral
valve regurgitation (both acute & chronic), mitral valve stenosis.
Rationale: Structural valve abnormalities and aortic pathology can produce
turbulent blood flow audible as a murmur.
13. Name drugs that decrease afterload / systemic vascular resistance (SVR) /
pulmonary vascular resistance (PVR).
Answer: (Arterial Dilators) Nitroprusside, nitroglycerin, amrinone, alpha
(Regitine) & Ca channel blockers.
Rationale: These agents vasodilate arteries, reducing resistance and afterload.
14. Name drugs that increase afterload / SVR / PVR.
Answer: (Vasopressors) Epinephrine, norepinephrine, dopamine,
neosynephrine.
Rationale: These drugs constrict vessels, increasing systemic and pulmonary
vascular resistance.
15. What is the first-line treatment for ST-segment elevation MI (STEMI)?
Answer: Primary percutaneous coronary intervention (PCI) within 90 minutes.
Rationale: Rapid mechanical reperfusion is superior to thrombolytics when
available.
16. What is the target door-to-balloon time for STEMI?
Answer: 90 minutes.
Rationale: Guidelines recommend PCI within 90 minutes of arrival to reduce
mortality.
