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PEM Lectures dirigées > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What are the 4 stages of ECG changes in cardiac tamponnade?

A

1 - no change apart from sinus tachycardia
2 – depressed voltages
3 – electrical alternans
4 – diffuse ST elevation

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2
Q

For what arrhythmias is amiodarone used?

A

VTach- with or without pulse
SVT with pulse
Pulseless vfib

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3
Q

Causes of benign cardiac murmurs

A

Flow murmur
Peripheral pulmonary stenosis (0-6mo)
Stills murmur (2-6y)
Venous hum (3-8y)
Pulmonary flow murmur
Supraclavicular or brachiocephalic systolic murmur - older
Aortic systolic murmur - older
Mammary artery - older

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4
Q

Features concerning for a pathologic murmur

A

History concerning for cardiac disease
Systolic murmur that intensifies with standing
Holosystolic murmur
Diastolic murmur
Grade 3+
Abnormal S2 or audible click

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5
Q
A
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6
Q

Signs on X-ray of thoracic aortic injury

A

Widened mediastinum
Irregular aortic notch
Apical cap
L sided pleural effusion
L main stem bronchus depressed
R main stem bronchus elevated
Deviation of NG or ETT

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7
Q

Leading cause of sudden cardiac death in peds

A

hypertrophic cardiomyopathy

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8
Q

Causes of sudden cardiac death

A

Congenital coronary artery anomalies - anomalous left coronary artery from the pulmonary artery (ALCAPA)
dilated cardiomyopathy
myocarditis
ARVD
aortic rupture
arrhythmia - WPW (afib - VF), Long QT syndrome. CPVT, Brugada syndrome, heart block

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9
Q

What is Bland White Garland Syndrome?

A

ALCAPA in 10 week infant - PVR drops - anomalous LCA not perfused - ischemia
- crying with feeds, cardiac wheeze, resp distress, CHF, sudden cardiac death

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10
Q

What is brugada syndrome?

A

ECG abnormality putting young ppl at high risk of sudden death

Brugada sign = coved ST segment elevation > 2mm in > 1 of V1-V3 followed by negative T wave

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11
Q

What electrolyte abnormalities cause prolonged QT?

A

Low Ca, K and Mg

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12
Q

What drugs cause prolonged QT?

A

Amiodarone
TCAs
Fluconazole
Metoclopramide
Haloperidol
Methadone
Ondansetron
SSRIs
Erythromycin

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13
Q

Antihypertensives used in hypertensive emergency

A

Labetolol (beta blocker)
Nicardipine (calcium blocker)
Nitroprusside (vasodilator)
Hydralazine (vasodilator)

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14
Q

Secondary effects/contraindications to:
Labetolol (beta blocker)
Nicardipine (calcium blocker)
Nitroprusside (vasodilator)
Hydralazine (vasodilator)

A

Labetolol (beta blocker) - contraindicated in asthma, can mask hypoglycemia
Nicardipine (calcium blocker) - reflex tachycardia, intracranial hypertenision, phlebitis at infusion site
Nitroprusside (vasodilator) - cyanide toxicity, transitory hypotension
Hydralazine (vasodilator) - headache, tachycardia, fluid retention, Increased ICP

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15
Q

Causes of secondary hypertension in infants

A

renal artery thrombosis
renal artery stenosis
congenital renal malformations
coarctation of the aorta
BPD
Renal parenchymal diseases

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16
Q

Classic ECG findings in myocarditis

A

sinus tachycardia, low-voltage QRS complexes, and inverted or low-voltage T waves

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17
Q

What is the minimum age for use of an AED?

A

1 year old

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18
Q

What ages are pediatric paddles/stickers used on AED?

A

1-8y/o

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19
Q

ECG changes in beta blocker and calcium channel blocker toxicity

A

sinus bradycardia
AV block (all degrees)
Junctional bradycardia
Ventricular bradycardia

20
Q

ECG changes in propranolol toxicity

A

QRS widening
positive R’ wave in avR

21
Q

ECG changes in Sotalol poisoning

A

QT prolongation - torsades de pointes

21
Q

ECG findings in carbamazepine toxicity

A

QRS widening
1st degree AV block
(sodium channel blockade)

21
Q

ECG findings in Wolff-Parkinson-White syndrome

A

short PR interval
widened QRS
delta wave (slurred upstroke to QRS complex)

21
Q

ECG changes in digoxin toxicity

A

SVT (increased intracellular calcium)
slow ventricular response (increased vagal effects at AV node)
frequent PVCs* (most common)

sinus bradycardia
slow atria fibrillation
any type of AV block
ventricular tachycardia

21
Q

ECG changes in hypercalcemia

A

shortened QT interval
severe - osborn/J waves

21
Q

ECG changes in hyperkalemia

A

peaked T waves
P wave flattening/widening
PR prolongation
Bradyarrhythmias
Conduction blocks
QRS widening

22
Q

ECG changes in hypokalemia

A

T wave inversion
ST depression
Prominent U wave

22
Q

ECG findings in thyrotoxicosis

A

Sinus tachycardia
Afib
apparent LVH

23
Q

ECG changes in hypocalcemia

A

QT prolongation (prolongation of ST segment)

24
Q

ECG changes in hypomagnesemia

A

Prolonged PR
Prolonged QT with risk of TdP
Atrial and ventricular ectopy

25
Q

ECG changes in hypothermia

A

Bradyarrhythmia
Osborne waves (J waves)
Prolonged PR, QRS, QT
ventricular ectopics

26
Q

ECG changes in hypothyroidism

A

bradycardia
low QRS voltage
widespread t-wave inversions

27
Q

ECG changes in intracranial hypertension

A

Widespread giant T-wave inversions
QT prolongation
Bradycardia

28
Q

ECG changes in pericarditis

A

widespread concave ST elevation and PR depression
Reciprocal ST depression and PR elevation in aVR + V1
Sinus tachycardia

29
Q

4 stages of ECG changes in pericarditis

A

Stage 1 – widespread STE and PR depression with reciprocal changes in aVR (occurs during the first two weeks)

Stage 2 – normalisation of ST changes; generalised T wave flattening (1 to 3 weeks)

Stage 3 – flattened T waves become inverted (3 to several weeks)

Stage 4 – ECG returns to normal (several weeks onwards)

30
Q

ECG changes in pulmonary embolism

A

Sinus tachycardia *

R ventricular strain - T wave inversion in V1-4 and II, III, aVF

31
Q

ECG changes in quetiapine toxicity

A

HR > 120 (sinus)
prolonged QTc

32
Q

ECG changes in TCA overdose

A

wide QRS
terminal R wave > 3mm in aVR
sinus tachycardia

33
Q

ECG findings in WPW syndrome

A

shortened PR interval
delta wave
widened QRS

34
Q

ECG findings in Brugada syndrome

A

coved ST segment elevation > 2mm in >1 of V1-V3 followed by negative Twave

35
Q

Diagnostic criteria for Brugada Syndrome

A

ECG findings (coved ST elevation + neg T wave in 2 leads) PLUS 1 of:
Documented VF or VT
Family history of sudden cardiac death at <45 years old
Coved-type ECGs in family members.
Inducibility of VT with programmed electrical stimulation
Syncope
Nocturnal agonal respiration

36
Q
A
37
Q

What are cardiac problems associated with/caused by anorexia nervosa?

A

Hypotension
Bradycardia
Long QT
Dilated Cardiomyopathy

38
Q

What systemic conditions can cause pericarditis?

A

SLE
Periarteritis nodosa
peptic ulcer
uremia

39
Q

Medications that act on the following in CHF managment:
preload
pump
afterload

A

i. Preload – nitroprusside (reduces preload and improves cardiac output), furosemide
ii. Pump – epinephrine, norepinephrine
iii. Afterload – milrinone, ace-inhibitors, ARBS, nitrates

PEM Lectures dirigées (28 decks)

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