Cardiac arrest: pulseless electrical activity: 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 · Cardiac arrest: pulseless electrical activity

Sample item

A patient collapses on the ward on the second day after hip surgery. She is unresponsive with no carotid pulse, and the monitor shows an organised narrow-complex rhythm at 80 per minute. Which cardiac arrest rhythm is this?

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

The answer and the reasoning

C. Pulseless electrical activity

In PEA the monitor shows organised electrical activity but there is no palpable pulse. It is a non-shockable arrest rhythm and is managed with CPR, adrenaline and a search for the reversible causes, here possibly pulmonary embolism. The other rhythms appear as chaos, rapid wide-complex tachycardia or a flat line.

Option by option

  • A. Pulseless ventricular tachycardia

    Pulseless VT is a rapid regular wide-complex tachycardia, not a normal-rate narrow-complex rhythm.

  • B. Ventricular fibrillation

    VF shows irregular chaotic activity without identifiable QRS complexes.

  • C. Pulseless electrical activity (correct)

    Correct. Organised electrical activity with no pulse is the definition of PEA.

  • D. Asystole

    Asystole shows no electrical activity, a flat line.

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 C, Pulseless electrical activity. In PEA the monitor shows organised electrical activity but there is no palpable pulse.

Why is "Pulseless ventricular tachycardia" not the answer?

Pulseless VT is a rapid regular wide-complex tachycardia, not a normal-rate narrow-complex rhythm.

Why is "Ventricular fibrillation" not the answer?

VF shows irregular chaotic activity without identifiable QRS complexes.

Why is "Asystole" not the answer?

Asystole shows no electrical activity, a flat line.

What concept does this question test?

It tests Cardiac arrest: pulseless electrical activity in Anaesthesia. It is a non-shockable arrest rhythm and is managed with CPR, adrenaline and a search for the reversible causes, here possibly pulmonary embolism. The other rhythms appear as chaos, rapid wide-complex tachycardia or a flat line.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Cardiac arrest: pulseless electrical activity?

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.