ALS RCUK MIDTERM EXAM WITH
QUESTIONS AND ANSWERS 2025
UPDATE.
STEMI is always associated with chest pain - ANS False
STEMI rarely causes VF - ANS False
ST depression in leads V1-3 - ANS Posterior STEMI
new left bundle branch block - ANS STEMI
Transcutaneous pacing electrical capture - ANS 50-100 mA
Transcutaneous pacing in hyperkalaemi - ANS May be unsuccessful
Movement artefact may inhibit the pacemaker - ANS True
Electrical capture and generation of qrs complex ensures return of pulse - ANS False
Self adhesive pads or ecg electrodes - ANS Electrodes
Where to apply adhesive electrodes for 3 lead monitoring - ANS Over bone (minimise artefact)
Normal PR interval time - ANS 0.12-0.20 seconds (3-5 small boxes)
Normal QRS complex - ANS less than 0.12 seconds (3 small boxes)
Immediate entry of water into lungs in drowning - ANS False
What happens initially in drowning - ANS Laryngospasm and breath holding
High chance of good outcome in drowning - ANS Less than 10mins
Low chance of good outcome in drowning - ANS More than 25 mins
Following submersion, order of cardiac and respiratory arrest - ANS Respiratory then cardiac
Prophylactic antibiotics in drowning - ANS No benefit
Asystole - shockable - ANS No
PEA - calcium chloride? - ANS 5ml 10% solution IV
, Asystole - drug - ANS Adrenaline 1mg IV
PEA - drug - ANS Calcium chloride 5ml 10% solution
Hypoxaemic? - ANS Pao2 should only be 10 less than FiO2
Acidaemia - ANS <7.35
Alkalaemia - ANS >7.45
Metabolic acidosis - ANS base deficit < - 2mmol/L
Metabolic alkalosis - ANS base deficit > +2mmol/L
PaO2 increased and pH low - ANS Respiratory acidosis
PaO2 decreased and pH increased - ANS Respiratory alkalosis
Base excess and bicarbonate increased - ANS metabolic compensation (chronic problem)
cardiac arrest common rhythms - ANS PEA and asystole
VF/pVT in cardiac arrest % - ANS 20%
VF/pVT - drug - ANS amiodarone IV 300mg
severe hypovolaemia cardiac arrest rhythm - ANS PEA
best time to decide about DNACPR - ANS before they become acutely unwell
if you think a patient should be 'for CPR'... - ANS still need to discuss with patient
do you document 'for CPR' - ANS yes
DNACPR - with ICD, should shock function be deactivated? - ANS no
adrenaline effects - ANS alpha and beta-adrenergic effects
adrenaline - long term benefits in cardiac arrest - ANS none
adrenaline - increases systemic vasoconstriction - ANS yes
adrenaline - improves coronary and cerebral perfusion pressures - ANS true
ventricular rate - ANS 60-100 bpm
QUESTIONS AND ANSWERS 2025
UPDATE.
STEMI is always associated with chest pain - ANS False
STEMI rarely causes VF - ANS False
ST depression in leads V1-3 - ANS Posterior STEMI
new left bundle branch block - ANS STEMI
Transcutaneous pacing electrical capture - ANS 50-100 mA
Transcutaneous pacing in hyperkalaemi - ANS May be unsuccessful
Movement artefact may inhibit the pacemaker - ANS True
Electrical capture and generation of qrs complex ensures return of pulse - ANS False
Self adhesive pads or ecg electrodes - ANS Electrodes
Where to apply adhesive electrodes for 3 lead monitoring - ANS Over bone (minimise artefact)
Normal PR interval time - ANS 0.12-0.20 seconds (3-5 small boxes)
Normal QRS complex - ANS less than 0.12 seconds (3 small boxes)
Immediate entry of water into lungs in drowning - ANS False
What happens initially in drowning - ANS Laryngospasm and breath holding
High chance of good outcome in drowning - ANS Less than 10mins
Low chance of good outcome in drowning - ANS More than 25 mins
Following submersion, order of cardiac and respiratory arrest - ANS Respiratory then cardiac
Prophylactic antibiotics in drowning - ANS No benefit
Asystole - shockable - ANS No
PEA - calcium chloride? - ANS 5ml 10% solution IV
, Asystole - drug - ANS Adrenaline 1mg IV
PEA - drug - ANS Calcium chloride 5ml 10% solution
Hypoxaemic? - ANS Pao2 should only be 10 less than FiO2
Acidaemia - ANS <7.35
Alkalaemia - ANS >7.45
Metabolic acidosis - ANS base deficit < - 2mmol/L
Metabolic alkalosis - ANS base deficit > +2mmol/L
PaO2 increased and pH low - ANS Respiratory acidosis
PaO2 decreased and pH increased - ANS Respiratory alkalosis
Base excess and bicarbonate increased - ANS metabolic compensation (chronic problem)
cardiac arrest common rhythms - ANS PEA and asystole
VF/pVT in cardiac arrest % - ANS 20%
VF/pVT - drug - ANS amiodarone IV 300mg
severe hypovolaemia cardiac arrest rhythm - ANS PEA
best time to decide about DNACPR - ANS before they become acutely unwell
if you think a patient should be 'for CPR'... - ANS still need to discuss with patient
do you document 'for CPR' - ANS yes
DNACPR - with ICD, should shock function be deactivated? - ANS no
adrenaline effects - ANS alpha and beta-adrenergic effects
adrenaline - long term benefits in cardiac arrest - ANS none
adrenaline - increases systemic vasoconstriction - ANS yes
adrenaline - improves coronary and cerebral perfusion pressures - ANS true
ventricular rate - ANS 60-100 bpm
