Thursday, July 19, 2012

Which of the following will be the most appropriate initial therapy?

Quiz


Click one of the options to choose your answer 


A 50 year old gentleman is admitted to the CCU with an acute Inferior wall infarction. Three hours after the admission his B.P is 90/50 mmHg. The heart rate is 38 beats per minute with sinus rhythm. Which of the following will be the most appropriate initial therapy?

Immediate insertion of temporary pacemaker
Intravenous administration of of Isoproterenol 5 micrograms/min
Intravenous administration of Dobutamine 0.35 mg/min
Administration of Intravenous Normal saline, 300 ml over 15 mins
Intravenous administration of atropine sulfate , 0.6 mg



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5 comments:

  1. Atropine is clearly the best answer - though if I were making the question - I would have provided stronger indication that this patient is truly symptomatic (he might not be with a rate of 38/min and a BP of 90/minute - such that a brief period of cautious observation is not necessarily wrong for the case as presented given that atropine is not always benign). That said - low-dose atropine in the early hours of acute inferior MI has an excellent chance to be all that is needed ...

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    Replies
    1. You are right , The patient should be depicted more symptomatic.....

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