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CLASP > Sudden Death > Flashcards

Sudden Death Flashcards

1
Q

Define sudden death

A

Death within 24 hours from the onset of symptoms

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2
Q

State the four H’s of cardiac arrest

A

Hypoxia
Hypovolaemia
Hypo/hyperkalaemia
Hypothermia

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3
Q

State the four T’s of cardiac arrest

A

Thrombosis
Tamponade
Toxins
Tension pneumothorax

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4
Q

What are non-suspicious causes of hypoxia?

A

Asthma, pneumothorax, obstruction, respiratory depression, aspiration

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5
Q

What would be classed as a suspicious cause of hypoxia?

A

Obstruction, overdose, negligence, poisoning, drowning

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6
Q

State the main causes of hypovolaemia

A

GI haemorrhage, haemoperitoneum, trauma

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7
Q

How can aortic valve disease cause sudden death?

A

Congenital bicuspid valve is more prone to calcification/endocarditis and may lead to increased heart size due to increased load

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8
Q

What is a typical sign of cholesterol deposition in the eye?

A

Corneal arcus

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9
Q

How do baroreceptors compensate for hypovolaemia?

A

Stretch receptors in carotid/aortic arch sense reduced stretch and enhance sympathetic output with inhibition of parasympathetic

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10
Q

What is the sympathetic neurohormonal response?

A

Release of vasoconstrictors redirects fluid from peripheral/secondary organs

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11
Q

What is the effect of capillary absorption of interstitial fluid?

A

Reduced hydrostatic pressure

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12
Q

How does the HPA respond to hypovolaemia?

A

Intrarenal baroreceptors lead to renin release from JGA resulting in Ang II vasoconstriction and ADH secretion

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13
Q

Describe the presentation of cardiogenic shock

A

Hypotension, fatigue, syncope, raised JVP, oedema, hepatic congestion

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14
Q

Define positive inotropy

A

Increase force of contraction for any preload

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15
Q

What can cause cardiogenic shock?

A 
Acute MI 
Acute valve dysfunction 
Myocarditis
Cardiomyopathy 
Contusion
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16
Q

Name three causes of obstructive shock

A

PE
Cardiac tamponade
Tension pneumothorax

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17
Q

What is McConnells sign?

A

Hyperkinetic RV apex

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18
Q

Name the types of shock that come under distributive

A

Septic
Anaphylactic
Neurogenic

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19
Q

Name two shockable rhythms

A

VF

Pulseless VT

20
Q

Name two non-shockable rhythms

A

Pulseless electrical activity

Asystole

21
Q

What does VF look like on an ECG?

A

Bizarre irregular waveform, no QRS, uncoordinated electrical activity

22
Q

What does pulseless VT look like on ECG?

A

Monomorphic - broad complex, rapid, constant QRS

Polymorphic - torsade de pointes

23
Q

Describe drug treatment during arrest

A

Adrenaline given after 3 shocks Img IV

Amiodarone 300mg IV

24
Q

What does asystole look like on ECG?

A

Absent QRS may be atrial activity

25
Q

What is PEA?

A

Organised electrical activity in the absence of a pulse

26
Q

What does each letter of the ECG pattern indicate?

A

P - atrial depolarisation
QRS - ventricular depolarisation
T - ventricular depolarisation

27
Q

How do you calculate heart rate on ECG?

A

regular - 300/number of large squares between beats

irregular - number of QRS in 30 and multiply by 10

28
Q

Describe the stages of ECG analysis

A
  1. Verify patient details
  2. Check date and time
  3. Check calibration
  4. Determine axis
  5. Rate and rhythm
  6. Individual leads
29
Q

Which views of the heart correspond to which artery?

A

Lateral - circumflex
Inferior - RCA
Septal - LAD
Anterior - RCA

30
Q

What is first degree heart block?

A

SA node depolarisation conducted to ventricles but there is a delay - PR prolonged

31
Q

What is the problem in second degree heart block?

A

Excitation intermittently fails to pass through the AV node/bundle of His

32
Q

Describe Mobitz type 1

A

Gradually PR increases until failure of conduction and beat is missed

33
Q

Describe Mobitz type 2

A

Constant PR but occasionally no ventricular contraction

34
Q

What is third degree heart block?

A

No APs from SA to AV node

35
Q

What is a useful way to remember ECG patterns in bundle branch block?

A

William Marrow

36
Q

Describe bundle block ECG

A

RBBB - big R wave in V1 and deep S wave in V6

LBBB - M shape V6, V1 deep S wave

37
Q

What is normal heart deviation on ECG?

A

I and aVF are positive

38
Q

What does atrial flutter look like on ECG?

A

Saw tooth

39
Q

What does AF look like on ECG?

A

Irregularly irregular - p wave abnormality

40
Q

State the components of the triple risk model

A
  1. Critical development period
  2. Vulnerable infant
  3. Exogenous stress
41
Q

Name some of the risk factors for SUDI

A 
Acute illness
Premature
Congenital anomaly 
Small for gestation
Multiple births 
Male 
Depression in carer 
Alcohol/substance misuse
Maternal smoking 
Poor housing 
Co-sleeping/soft surface
42
Q

What is a genetic variant?

A

Change to DNA sequence

43
Q

What is a polymorphism?

A

Variant that is prevalent in the population

44
Q

What gene is mutated in Marfans?

A

Fibrillin

45
Q

Describe Loeys Dietz Syndrome

A

TBR1 or TBR2 mutations

46
Q

What is a diagnostic feature of familial hypercholesterolaemia?

A

Tendon xanthoma

47
Q

Name some genes associated with FH

A

LDLR
APOB
PCSK9

CLASP (3 decks)

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