Arrhythmias

Question 1

Multifocal atrial tachycardia

Answer 1

Type 1a (Procainamide or Quinidine) or 1c (Flecainide) in older kids
Type 3 agents (Amiodarone, Sotalol) in infants

Question 2

Jervelle Lange Nielson Syndrome

Answer 2

Long QT syndrome (K+ channel mutation) and sensorineural hearing loss

Question 3

Long QT 1

Answer 3

KCNQ1, Prolonged potassium efflux, delayed replorisation
Males, childhood
Triggered by exercise

Question 4

LQT2

Answer 4

KCNH2 mutation (prolonged potassium efflux)
Girls, arousal triggered. Normal ECG

Question 5

LQT3

Answer 5

SCN5a mutation (gain of function), Prolonged Na influx
Happens at rest
Supranormal T waves on ECG

Question 6

What is Schwartz Score

Answer 6

Tool to predict likelihood of LQT syndrome

Question 7

Brugada Syndrome

Answer 7

SCN5A (loss of function in Na channel)
ST elevation, descending ST segment, negative T waves
Asian males

Question 8

What is Shanghai score

Answer 8

Predictive tool for dx of Brugada

Question 9

Management of Brugada

Answer 9

Quinidinr, ICD

Question 10

Management of LQT

Answer 10

Non selective beta blockers (Atenolol, Nadolol), Flecainide could be a good adjunct

Question 11

Atrial flutter treatment

Answer 11

DC Cardioversion first
Amiodarone/Sotalol if incessant
Flecainide if needing to slow rate

Question 12

Two types of AVRT

Answer 12

Orthodromic (anticlockwise), narrow QRS
Antidromic (clockwise), broad QRS, can look like VT

Question 13

Three sequalae of Wolf Parkinson White

Answer 13

Antidromic and Orthodromic AVRT
Atrial fibrillation