15 free questions from the CinnaEMS cardiology and resuscitation bank (346 in the app). Tap an answer to check it. The rationale opens right away.
A patient describes cramping calf pain that comes on reliably after walking about one block and disappears within minutes of resting. This pattern is called:
Answer: A. Intermittent claudication
Intermittent claudication is exertional leg pain from narrowed arteries that cannot meet muscle demand, relieved by rest, much as stable angina is in the heart. It signals widespread atherosclerosis and higher coronary risk. Acute occlusion causes constant pain at rest, a deep vein thrombosis produces swelling, and neuropathy is not triggered by walking distance.
Midway through a resuscitation, end-tidal CO2 abruptly jumps from 16 to 42 mmHg without any change in compressor. What should the team do next?
Answer: A. Check for a pulse and signs of return of circulation
A sudden, sustained rise in end-tidal CO2 is often the earliest sign of ROSC as the heart begins moving blood through the lungs, so a pulse and rhythm check is warranted. Treating it as equipment failure or as a ventilation problem risks continuing compressions on a patient who now has circulation.
A patient with a recent myocardial infarction has cool clammy skin, bilateral crackles and a systolic pressure of 76. This is:
Answer: A. Cardiogenic shock — the pump itself has failed
Hypoperfusion plus pulmonary congestion after an infarction is pump failure: the damaged ventricle cannot move forward what it is receiving, so pressure falls while the lungs fill. Hypovolemia produces the same cool clamped skin but with clear lungs and flat neck veins, and it is the lung findings that separate the two.
In cardiogenic shock the body releases catecholamines that constrict peripheral vessels. Why does this compensation eventually worsen the patient's condition?
Answer: A. It raises afterload, increasing the work of the already failing ventricle
Vasoconstriction keeps the pressure up for the brain and heart, but it also raises afterload, so a damaged ventricle must work harder and consume more oxygen while ejecting less. The cycle deepens the ischemia. Catecholamines speed the heart rather than slowing it, and venous constriction tends to preserve preload rather than empty the ventricles.
A patient with a left ventricular assist device is alert, talking and has warm, pink skin, but you cannot palpate a radial pulse. What is the best interpretation?
Answer: A. A continuous-flow device may leave no palpable pulse
Most modern assist devices pump continuously, so there is little pulsatile flow and a pulse may be absent even with good perfusion. Judge perfusion by mental status, skin and capillary refill, and contact the device coordinator listed on the equipment. Starting compressions on an alert, well-perfused patient is the tempting error — pulselessness alone does not mean arrest here.
You suspect an aortic dissection in a patient who is alert with a blood pressure of 168/94. Which action is most consistent with good care?
Answer: A. Keep him calm and still and carry him rather than let him walk
The goal is to avoid anything that raises heart rate or blood pressure and increases shear stress on the torn aortic wall: calm reassurance, minimal exertion, oxygen as needed, IV access and prompt transport. Aspirin is withheld when dissection is suspected because an antiplatelet agent can worsen bleeding, and fluid is reserved for true hypotension rather than given to a hypertensive patient.
A patient with chest pain asks whether his pain is his heart because pressing on his chest makes it worse. What is the best understanding of reproducible chest wall tenderness?
Answer: A. It does not rule out a dangerous cause, so assess and treat as cardiac
Although tenderness favors a chest wall source, a meaningful minority of patients with acute coronary syndrome or other serious causes also have tenderness. Field providers cannot exclude life threats on one finding, so the patient is assessed and managed for the dangerous possibilities. Treating tenderness as proof of a benign cause is the classic anchoring error.
A regular rhythm at 50 per minute has narrow QRS complexes, and in lead II each QRS is preceded by an inverted P wave with a PR interval of 0.08 seconds. This pattern is most consistent with:
Answer: A. A junctional escape rhythm with retrograde atrial activation
An impulse starting in the AV junction travels backward into the atria, so the P wave is inverted in lead II and appears just before, hidden within, or just after the QRS; when it precedes the QRS the PR is short (under 0.12 seconds). A rate of 40 to 60 fits a junctional escape. Sinus bradycardia with first-degree block would show upright P waves and a long PR, and an idioventricular rhythm would have wide QRS complexes.
A dialysis patient who missed two treatments is weak, with peaked T waves, a widening QRS and ST elevation in V1 and V2. What is the most likely cause of the ST changes?
Answer: A. Hyperkalemia mimicking an injury pattern
Hyperkalemia can produce peaked T waves, QRS widening and a pseudo-infarction ST elevation in the right precordial leads that resolves as potassium is corrected. The context of missed dialysis and the T-wave morphology point there, not to an LAD occlusion. Uremic pericarditis causes diffuse elevation rather than peaked T waves with a widening QRS.
A healthy 24-year-old has concave ST elevation with a notched J point in several leads, feels well and has no risk factors. This most likely represents:
Answer: A. Early repolarization, a benign pattern
Early repolarization is a common normal variant in young patients: concave elevation with a notch or slur at the J point, stable over time and unaccompanied by symptoms or reciprocal change. It is recognized so that a well young adult is not labeled with an infarction, while remembering that the pattern is read together with the story — the same tracing in a patient with crushing pain deserves an entirely different level of suspicion.
An adult regains a pulse after cardiac arrest but remains unresponsive. Which AEMT action best follows current post-cardiac arrest care?
Answer: A. Titrate oxygen to about 92-98% and ventilate without hyperventilating
After ROSC the goals are to avoid hypoxia and hyperoxia by titrating oxygen to about 92-98%, ventilate at a normal rate, avoid hypotension with fluid as needed, obtain a 12-lead and transport. Prolonged 100% oxygen risks hyperoxia injury, hyperventilation constricts cerebral vessels and lowers brain blood flow, and withholding ventilations in an unresponsive patient invites re-arrest.
A patient on a QT-prolonging medication becomes pulseless in polymorphic VT that twists around the baseline. What is the immediate electrical treatment?
Answer: A. Unsynchronized defibrillation, as for ventricular fibrillation
Pulseless torsades is managed on the VF/pulseless VT pathway: high-quality CPR and unsynchronized shocks without delay. Magnesium is the drug of choice for torsades but never replaces or delays defibrillation. Synchronized cardioversion fails because the constantly changing QRS shape prevents the monitor from reliably finding an R wave, which can delay the shock.
Nitroglycerin is withheld from a patient who has recently taken a phosphodiesterase inhibitor for erectile dysfunction because the combination:
Answer: A. Can produce profound, refractory hypotension
Both drugs work along the same nitric-oxide vasodilation pathway, so together they can drop the blood pressure far below what either would cause alone, and that hypotension is hard to reverse. It is a hemodynamic interaction, not an allergic one — which is why the question to ask is about timing of the last dose rather than about allergies.
A patient in sympathetic crashing acute pulmonary edema has a BP of 210/120. Why are nitrates, rather than a diuretic, the first-line drug?
Answer: A. Most of the fluid is redistributed, not excess volume
In sympathetic crashing acute pulmonary edema, intense vasoconstriction and afterload shift fluid into the lungs; many patients are not total-body overloaded. Nitrates rapidly reduce preload and afterload to redistribute that fluid, while a loop diuretic acts slowly and can leave a euvolemic patient dehydrated and hypotensive once the crisis resolves.
Your crew has terminated resuscitation on a patient at home with medical direction. Which action best reflects good care of the family afterward?
Answer: A. Tell them plainly that the patient has died and stay to support them
Families cope better with clear language such as died or dead, time to ask questions and a provider who stays until support arrives. Euphemisms and false hope create confusion and delay grief. Leaving abruptly or removing the family from the room abandons them at the most difficult moment; follow your agency's direction about equipment and scene preservation.
Answer all 15 questions to see how you did.
Free to start
Timed mock exams, a rationale on every answer and progress that follows you from web to phone.
