cardiac arrest

Question 1

reversible causes of cardiac arrest Hs

Answer 1

Hypoxia
Hypovolaemia
Hyperkalaemia, hypokalaemia, hypoglycaemia, hypocalcaemia, acidaemia and other metabolic disorders

Hypothermia

Question 2

reversible causes of cardiac arrest Ts

Answer 2

Thrombosis (coronary or pulmonary)
Tension pneumothorax
Tamponade – cardiac
Toxins

Question 3

when should you use a defib

Answer 3

For cardiac arrest; pulseless VT and VF.

Question 4

what shock do you use for unstable tachycardias

Answer 4

synchronised DC shock

Question 5

what do you use for unstable bradys

Answer 5

pacing

Question 6

if a tachy and QRS complexes are regular what do you do to fix

Answer 6

Most probably VT

Give IV Amiodarone 300 mg.

Question 7

if QRS complex irregular and broad treat as a narrow complex as probably a AF or SVT + bundle branch block

if narrow regular what

Answer 7

Vagal manoeuvres
IV Adenosine rapid bolus (6 mg -> 12 mg -> 18 mg)
If it works, probably an SVT. If not,

Question 8

narrow irregular QRS

Answer 8

Are the QRS complexes irregular?
Most probably AF.
Rate control with a β-blocker/diltiazem.
Anticoagulants, only after risk assessment.

Question 9

management of bradys if adverse effects ( heart blocks)

Answer 9

Give IV Atropine 500 mcg.
If no satisfactory response or risk of asystole, keep giving IV Atropine till max dose of 3 mg is reached.
OR, external transcutaneous pacing OR, IV Adrenaline OR, other drugs.
If the above doesn’t work, get help + external transcutaneous pacing.

Question 10

rate control by for arrhymias

Answer 10

beta blockers , CCB or digoxin (HF)

Question 11

ryhythm control done by

Answer 11

amidarone or beta blockers

Question 12

what score for af and stroke risk

Answer 12

CHA2DS2-VASc score;
0 -> no treatment.
1 -> Males yes, females no.
2 -> Yes.
If valve disease is present with a-fib, give anti-coagulations despite score.
If patients has had a non-haemorrhagic stroke, wait 2 weeks before starting.
Warfarin, NOACs.
Aspirin is no longer recommended.
Balance risk and benefits of starting anti-coagulation with HAS-BLED score.

Question 13

atrial flutter gives what appearance

Answer 13

saw tooth

Question 14

hypertrophic obstructive cardiomyopathy what syndrome

Answer 14

wolf Parkinson white

Question 15

hypertrophic obstructive cardiomyopathy what syndrome

Answer 15

wolf Parkinson white - A type of SVT, where there is an accessory conducting pathway between atria and ventricles.
small delta wave shown

Question 16

1st degree heart block

Answer 16

PR interval prolonged

Question 17

2nd degree heart block

morbitz 1
mobitz 2

Answer 17

PR interval is progressively prolonged until a QRS complex is dropped. The cycle repeats.
‘long, long, long, drop…’
Doesn’t require treatment if asymptomatic.

PR interval remains the same until a QRS complex is dropped. The cycle repeats.
‘same, same, same, drop…’
Requires specialist care even if asymptomatic.

Question 18

3rd degree or complete heart block

Answer 18

Complete dissociation of P waves and QRS complexes.
 Requires treatment.
 Symptoms:
 Dizziness.
 Feeling lightheaded.
 Blackouts.
 SoB.

Question 19

complete heart block what artery most likely

Answer 19

RCA

Question 20

A 25 year old athlete attends her doctor for a routine check-up.
Which of the following features on his ECG would be a cause for concern?

Answer 20

LBBB