Resuscitation: shockable rhythms: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Resuscitation: shockable rhythms

Sample item

During a cardiac arrest, ventricular fibrillation persists after three defibrillation shocks and adrenaline. Which antiarrhythmic drug is recommended next?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Amiodarone 300 mg intravenously

In refractory ventricular fibrillation or pulseless ventricular tachycardia, amiodarone 300 mg is given after the third shock, with a further 150 mg dose after the fifth shock if needed. High-quality CPR continues with minimal interruptions, and reversible causes (the 4 Hs and 4 Ts) are sought. Lidocaine is an alternative when amiodarone is unavailable. Atropine is no longer recommended in asystole or pulseless electrical activity.

Option by option

  • A. Amiodarone 300 mg intravenously (correct)

    Correct. Amiodarone is the recommended drug for shock-refractory VF or pulseless VT.

  • B. Atropine 3 mg

    Atropine has no role in the treatment of VF.

  • C. Calcium chloride

    Calcium is given only in specific situations such as hyperkalaemia.

  • D. Adenosine 6 mg

    Adenosine treats supraventricular tachycardia, not ventricular fibrillation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Amiodarone 300 mg intravenously. In refractory ventricular fibrillation or pulseless ventricular tachycardia, amiodarone 300 mg is given after the third shock, with a further 150 mg dose after the fifth shock if needed.

Why is "Atropine 3 mg" not the answer?

Atropine has no role in the treatment of VF.

Why is "Calcium chloride" not the answer?

Calcium is given only in specific situations such as hyperkalaemia.

Why is "Adenosine 6 mg" not the answer?

Adenosine treats supraventricular tachycardia, not ventricular fibrillation.

What concept does this question test?

It tests Resuscitation: shockable rhythms in Anaesthesia. High-quality CPR continues with minimal interruptions, and reversible causes (the 4 Hs and 4 Ts) are sought. Lidocaine is an alternative when amiodarone is unavailable. Atropine is no longer recommended in asystole or pulseless electrical activity.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Resuscitation: shockable rhythms?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.