PLAB 2 (Professional And Linguistic Assessments Board Part 2) [plab-2-gmc]

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A 65-year-old man presents to A&E with central crushing chest pain for 30 minutes, diaphoresis, and nausea. ECG shows 3 mm ST elevation in leads II, III, and aVF. What is the immediate management?

Observe and repeat ECG in 6 hours Give MONA (Morphine, Oxygen if SpO2 <94%, Nitrate, Aspirin 300 mg) and arrange emergency primary percutaneous coronary intervention (PCI) or thrombolysis if PCI not available within 120 minutes Prescribe GTN spray and discharge with GP follow-up Start oral beta-blocker and admit to a general ward

Correct Answer:

Give MONA (Morphine, Oxygen if SpO2 <94%, Nitrate, Aspirin 300 mg) and arrange emergency primary percutaneous coronary intervention (PCI) or thrombolysis if PCI not available within 120 minutes

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