Cardiovascular

Question 1

Shockable rhythms

Answer 1

Ventricular tachycardia
Ventricular fibrillation

Question 2

Non shockable rhythms

Answer 2

• pulseless electrical activity
  -asystole

Question 3

Narrow complex tacycardia

Answer 3

• QRS less than 0.12
• equal to 3 small squares on ecg

Sinus tachycardia (treatment focuses on the underlying cause)
Supraventricular tachycardia (treated with vagal manoeuvres and adenosine)
Atrial fibrillation (treated with rate control or rhythm control)
Atrial flutter (treated with rate control or rhythm control, similar to atrial fibrillation)

Question 4

Management of life-threatening features of narrow complex tachycardia

Answer 4

• synchronised DC cardio version under sedation or GA

IV amioadrome is given if shocks are unsuccessful

Question 5

Broad complex tachycardia

Answer 5

• QRS greater than 0.12 or 3 small squares
• VT
  -polymorphic ventricular tachycardia (Rosales de pointes)
  -AF with bundle branch block
  -SVT with bundle branch block

Question 6

Management of tornadoes de pointes

Answer 6

IV magnesium

Question 7

Management of AF

Answer 7

• Rate control drugs
• Anticoagulant

Question 8

Ventricular tachycardia management

Answer 8

IV amiodarone

Question 9

Atrial flutter

Answer 9

• re-enterant rhythm
• self perpetuating loop
  -300bpm regular regular
  -sawtooth appearance
  -CHA2DS2VASC score

Question 10

Prolonged QT number in men vs women

Answer 10

More than 440 milliseconds in men
More than 460 milliseconds in women

Question 11

Causes of long QT syndrome

Answer 11

• Long QT syndrome (an inherited condition)
• Drugs: such as antipsychotics, citalopram, flecainide, sotalol, amiodarone and macrolide antibiotics
• Electrolyte imbalances, hypokalaemia, hypomagnesaemia and hypocalcaemia

Question 12

Management of prolonged QT interval

Answer 12

• Stopping and avoiding medications
• Correcting electrolyte disturbances
• Beta blockers (not sotalol)
• Pacemakers or implantable cardioverter defibrillators

Question 13

Type 1 heart block

Answer 13

• slow conduction to the AV node.
• typically results in increased PR interval
• greater than 0.2 seconds
• regular HR
• can be asymptomatic

Manamgment
- monitoring
-identify underlying cause
Pacing

Question 15

Acute NSTEMI tx- Batman

Answer 15

Bisoprolol
Aspirin (300mg)
T icagreloe
M Orphine
Anti coax
Nitrates

Question 16

LCA

Answer 16

Anterolateral
I, avL
V3-6

Question 17

LAD

Answer 17

Anterior
V1-v4

Question 18

Circumflex

Answer 18

Lateral
I, AVL
V5-v6

Question 19

RCA

Answer 19

Inferior
II, III, AVF

Question 20

First degree heart block

Answer 20

AV node issue
Takes longer for signals to get to ventricles
PR elongation seen

Question 21

Type 1 Wenckebach

Answer 21

progressive lengthening of the PR interval until a beat is dropped

Question 22

Type 2 mobitz

Answer 22

occasional dropped beats occur without a progressive lengthening of the PR interval.

Question 23

3rd degree heart block

Answer 23

complete heart block, there is a complete block of electrical signals between the atria and ventricles.