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year 3 clasp > sudden death > Flashcards

sudden death Flashcards

1
Q

what are the reversible causes of cardiac death

A

4 H’s
4 T’s

hypoxia, hypovolaemia, hypo/hyperkalaemia(metabolic), hypothermia

Tamponade, thrombosis, toxins, tension pneumothorax

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2
Q

what are the types of shock

A

hypovolaemia, cardiogenic, septic, anaphylactic and neurogenic

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3
Q

what is hypovolaemic shock

A

Loss of circulating volume leading to reduced preload and reduced output

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4
Q

cause of hypovolaemic shock

A

bleeding, third space volume loss, severe dehydration

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5
Q

compensatory mechanism for hypovolaemic shock

A

baroreceptor reflex

sympathetic mediated neurohormonal response

renal and hypothalmopituitary

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6
Q

how to fix hypovolaemia

A

fluid and blood replacement

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7
Q

what is cardiogenic shock

A

Myocardial dysfunction causing reduction in systolic function and cardiac output

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8
Q

causes of cardiogenic shock

A

MI, myocarditis, acute valve lesion

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9
Q

treatment for cardiogenic shock

A

Enhancing inotropy = increasing sympathetic nervous system via dobutamine, adrenaline, dopamine, dopexamine

vassopressors

careful fluid management

treat underlying cause

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10
Q

what is obstructive sock

A

Physical obstruction to filling of the heart causing a reduced preload and cardiac output

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11
Q

obstructive shock causes

A

Causes = tamponade, PE, tension pneumothorax

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12
Q

treatment for obstructive shock

A

treat underlying cause

PE = anticoagulation +/- thrombolysis
Cardiac tamponade = pericardial drainage
Tension pneumothorax = decompression

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12
Q

treatment for anaphylaxis

A

Adrenaline, antihistamines, steroids and fluids

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12
Q

treatment for neurogenic shock

A

vasopressors

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12
Q

what is neurogenic shock

A

spinal cord trauma leading to loss of sympathetic tone

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12
Q

what is anaphylactic shock

A

uncontrolled activation of mast cell causing vasodilation

13
Q

main differentiation between each shock type

A

hypovolaemic- maintained bp at start then reduced in later stage + cool and pale skin

Cardiogenic- skin swollen and oedematous

Septic- pyrexia- could also be too cold

anaphylaxis- rash

neurogenic- bradycardia and unregulated temp

14
Q

what is long qt syndrome

A

Mutation in ion channel results in reduced/ dysfunctional ionic current which prolongs repolarization

most common is the potassium channel

15
Q

long qt symptoms

A

Syncope and palpitations are a result of torsades de pointes by adrenergic stimulation. This may degenerate to VF = SCD

16
Q

which disease can long qt progress to

A

torsades de points

17
Q

management of long qt

A

acute management = treat cause, magnesium infusion, defibrillation

Long term management = BB, avoid QT prolonging drugs (antipsychotics), pacemakers

18
Q

what is brugada

A

AD – 12 associated genes with sodium and calcium channels

19
Q

what can brugada lead to

A

ECG – risk of polymorphic VT, VF, AF is common, ST elevation and RBBB in V1-3 along with T wave invesions after qrs complex

20
Q

diagnostic test for brugada

A

ecg by provoking Na channels

21
Q

Treatment for brugada

A

Mx = avoid triggers, avoid certain drugs and triggers

can have ICD incase

22
Q

what is WPW

A

Patients have accessory pathway known as bundle of Kent which allows signal to return to atria from ventricles (re-entrant route)

Short PR interval, ventricular pre-excitation

23
Q

what can be seen on ecg for wpw

A

ECG – delta wave- slurred upstroke with wide qrs complex, AVRT, AF

24
Q

treatment for WPW

A

definitive is radiofrequency ablation

25
Q

what are cardiomyopathies

A

arrythmias related to scar/electric barrier formation and subsequent re-entry

26
Q

examples of cardiomyopathy

A

HOCM
Arrhythmogenic right ventricular cardiomyopathy
Dilated cardiomyopathy

27
Q

what is HOCM

A

an autosomal dominant disorder of muscle tissue caused by defects in the genes encoding contractile proteins.

most common cause of sudden death in young people

28
Q

symptoms of HOCM

A

dyspnoea, AF, syncope, palpitations and angina

28
Q

ecg findings in HOCM

A

T wave inversion

29
Q

treatment for HOCM

A

Amiodarone
Beta-blockers or verapamil for symptoms
Cardioverter defibrillator
Dual chamber pacemaker
Endocarditis prophylaxis*

30
Q

what is still birth

A

Baby dies after 24 weeks of pregnancy and before or during birth

31
Q

risk factors for still birth

A

way to many- basically anything that puts the baby under excess stress

placental causes, IGR, congenital, maternal infections, extremes of ages, medical complications, multiple pregnancies, prolonged pregnancy, obesity, smoking, previous stillbirth, antepartum hemorrhage

32
Q

how to reduce still birth

A

SLEEP ON SIDE IN 3RD TRIMESTER
Stop smoking
Avoid alcohol and drugs
Attend check ups

33
Q

After still birth what must be conducted

A

Post mortem
Skin biopsy
Placental histopathology
Blood results
Microbiology results
SUPPORT

34
Q
A

year 3 clasp (3 decks)

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