Practise 97 single best answer questions on cardiology for the MRCEM SBA exam. Every question comes with a detailed explanation, so you learn why the right answer is right and why the others are wrong.
Chest pain is one of the most common presentations in the emergency department, and cardiology questions test the decisions you make in the first hour. Examiners focus on time-critical pathways: when to reperfuse, which drugs to give and which to avoid, and how to spot the mimics that kill.
A 58-year-old woman presents to a district general hospital with 1 hour of severe central chest pain radiating to her jaw. Her ECG shows ST elevation in II, III and aVF with reciprocal depression in I and aVL. The hospital has no on-site PCI, and transfer to the nearest PCI centre will take at least 2.5 hours. She has no contraindications to fibrinolysis.
What is the most appropriate immediate management?
A. Transfer to a PCI centre for angiography within 48 hours
B. Give thrombolysis and arrange rescue PCI if needed
C. Start oxygen therapy
D. Arrange CT coronary angiography
E. Give aspirin only and observe
Answer: B. Primary PCI is preferred only if it can be delivered within 120 minutes of the time fibrinolysis could be given. A transfer of 2.5 hours exceeds that, so she should be thrombolysed now, then transferred for rescue PCI if reperfusion fails.
Try 20 free sample questions to see the style and explanations, then choose the plan that suits you.