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J CLASP > Sudden death > Flashcards

Sudden death Flashcards

1
Q

sudden death definition;

age
timing

A

<50yo

<6 hours of being previously well

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2
Q

inheritance pattern of most cardiac inherited conditions

A

autosomal dominant

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3
Q

what is the most common inherited cardiomyopathy

A

hypertrophic cardiomyopathy

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4
Q

aetiology of sudden death (3)

A

shock
sepsis
cardiac causes - inherited

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5
Q

most common inherited arrhythmia syndrome that causes sudden death

A

long QT syndrome

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6
Q

inherited arrhythmias that cause sudden death (5)

A 
long QT 
brugada 
short QT 
catecholinergic polymorphic VT 
wolff Parkinson white syndrome
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7
Q

inherited cardiomyopathies that cause sudden death (3)

A

hypertrophic cardiomyopathy
arrythmogenic right ventricular cardiomyopathy
dilated cardiomyopathy

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8
Q

which MSK condition is abdominal aortic aneurysms connected to

why

A

marfans

fibrillin mutation = connective tissue disorder

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9
Q

example of QT prolonging drug (3)

A

azithromycin, clarithromycin

second generation atypical antipsychotics eg olanzapine, quetiapine, risperidone

SSRIs - citalopram

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10
Q

what syndrome is caused by autosomal dominant inheritance of long QT

do any other symptoms present?

A

ramano-ward syndrome

no just QT

(THINK 1 part to syndrome name = 1 symptom)

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11
Q

what syndrome is caused by autosomal recessive inheritance of long QT

do any other symptoms present?

A

jervell + lange-nielsen syndrome

deafness + long QT

(THINK 2 parts to syndrome name = 2 symptoms)

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12
Q

ECG of long QT syndrome (2)

A 
QT >480ms (T wave finishes over half way between S and Q) 
polymorphic VT (torsades de pointes)
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13
Q

fourth rail bridge on ECG

A

torsades de pointes = long QT syndrome

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14
Q

what is the QRS like in polymorphic VT

A

broad QRS (+ ventricular problem)

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15
Q

are there p waves in polymorphic VT

A

no p waves

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16
Q

what is the equation for calculating QT length depending on heart rate

A

QT length divided by square root of R-R interval

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17
Q

treatment of long QT syndrome

A

beta blockers

18
Q

inheritance pattern of brugada syndrome

A

autosomal dominant

19
Q

ECG findings for brugada syndrome (2)

A

‘hash brown’/coved shaped ST elevation in V1-V3

RBBB

20
Q

what does RBBB look like

A

M in V1
W in V6

MaRRoW

21
Q

which group of people does short QT present in

is it rare or common

prognosis

A

children

rare

kills them!

22
Q

triggers of arrhythmias

A

intense exercise/stress (Adrenaline)

23
Q

delta wave on ECG

A

wolff Parkinson white syndrome

24
Q

acute treatment of wolff Parkinson white syndrome

A

ablation

25
Q

which protein is altered in hypertrophic cardiomyopathy

A

myosin binding protein C

26
Q

which ventricle is thickened in hypertrophic cardiomyopathy

A

left ventricle hypertrophy

27
Q

young athlete collapsed on pitch

sudden death caused by heart failure

A

hypertrophic cardiomyopathy

28
Q

ECG findings in hypertrophic cardiomyopathy

A

tall QRS (>7 boxes in V2 and V5)

29
Q

tall QRS

A

ventricular hypertrophy

30
Q

what should you do to the families of anyone with an inherited cardiomyopathy/arrhythmia

A

family screening

31
Q

if hypertrophic cardiomyopathy, what should they avoid

A

intense exercise

32
Q

autosomal dominant inheritance in most congenital cardiac conditions,

what is the chance of child being affected

A

1 in 2

33
Q

which gene causes half of arrythmogenic right ventricular cardiomyopathy

A

PKP2 gene

34
Q

what does having PKP2 gene mean in terms of penetrance and expression

A

low penetrance - not everyone with gene will have disease
highly variable expression - a range of presentations, some asymptomatic, some will die

in relation to arrythmogenic right ventricular cardiomyopathy

35
Q

ECG in arrythmogenic right ventricular cardiomyopathy

A

broad QRS (= ventricular problem)

36
Q

if you had to guess in exams, how would you treat an inherited cardiac problem

A

beta blocker

avoid exercise/competitive sports

37
Q

what do you need to do before you confirm death in a neonate

A

pat nappy

38
Q

what do you need to do after confirmation of sudden/unexpected neonatal death

A

procurator fiscal

39
Q

what can happen to the other children of people who have had neonatal bereavement

A

neglect

40
Q

methods to prevent cot death

A

clear cot
lie on back
feet at bottom - so they cant wriggle down under covers

41
Q

what do doctors do to verify death

A 
pulse - 1-2min, 2 pulses 
pupil reflexes - with torch, lens clouding 
auscultate - breathing and heart 1 min
observe movement and breathing 
reaction to voice or pain (GCS = 3) 
NOTE if there's a pacemaker
42
Q

who orders a post mortem

A

procurator fiscal

J CLASP (4 decks)

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