Palpitations

Question 1

1st degree heartblock ECG

Answer 1

PR interval constantly > 200ms (5 small squares)- no lost heart beats.

Question 2

1st degree heartblock treatment

Answer 2

None

Question 3

2nd degree heart block type 1 ECG

Answer 3

Progressive lengthening of PR w/ 1 actual loss of a QRS

Question 4

2nd degree heart block type 1 treatment

Answer 4

None

Question 5

2nd degree heart block type 2 ECG

Answer 5

Constant prolonged PR but there’s a randomly dropped QRS- can follow a fixed ratio block of 2:1 or 3:1

Question 6

2nd degree heart block type 2 treatment

Answer 6

may need pacing either temporarily or permanently

Question 7

3rd degree heart block ECG

Answer 7

no association bwt the p waves and QRS complexes

Question 8

3rd degree heart block treatment

Answer 8

needs pacing

Question 9

Right bundle branch block ECG

Answer 9

M in V1 and W in V6
RSR’ in V1, qRS in V6

Question 10

Left bundle branch block ECG

Answer 10

W in V1 and M in V6
rS in V, R in V6

Question 11

Bradycardia management

Answer 11

Atropine 500 mcg IV first line,
if unsatisfactory response- atropine up to maximum of 3mg, transcutaneous pacing, isoprenaline/adrenaline infusion titrated to response

Question 12

Atrial tachycardia ECG

Answer 12

abnormal/inverted p waves

Question 13

Atrial flutter ECG

Answer 13

Saw tooth pattern

Question 14

Atrial flutter treatment

Answer 14

control rate w/ a beta blocker

Question 15

Atrioventricualr nodal reentrant tachycardia ECG

Answer 15

Rapid, narrow QRS. Most common SVT

Question 16

Atrioventricular reentrant tachycardia ECG

Answer 16

Can get WPW syndrome- slurred upstroke in the QRS complex

Question 17

WPW management

Answer 17

radiofrequency ablation of the accessory pathway
Sotalol, amiodarone, flecainide

Question 18

Ventricular tachycardia causes

Answer 18

Congenital
Drugs eg Amiodarone, Sotalol, Chloroquine, Eryhtromycin
Hypocalcaemia, Hypokalaemia

Question 19

Ventricular tachycardia management

Answer 19

if adverse signs, immediate synchronised DC cardioversion. Drug therapy- Amiodarone ideally thru a central line

Question 20

Torsades de pointes management

Answer 20

IV magnesium sulphate

Question 21

Ventricular fibrilation ECG

Answer 21

Uncoordinated chaotic baseline, no identifiable features

Question 22

ventricular fibrillation management

Answer 22

unsynchronised DC cardioversion

Question 23

Supraventricualr tachycardia management

Answer 23

if haemodynamically unstable- always synchronised DC cardiovert
Vagal manouevres: Valsalva manouevre, carotid sinus massage.
IV adenoside rapid IV bolus of 6mg