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MBChB Year 3 > Sudden Death Week > Flashcards

Sudden Death Week Flashcards

1
Q

Define Shock

A

condition of inadequate perfusion to sustain normal organ function with resulting organ dysfunction and eventual death

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2
Q

5 causes of shock

A

Hypovolaemic, cardiogenic, obstructive, distributive and cytotoxic

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3
Q

Hypovolaemic shock can be caused by…

A

blood loss, electrolyte rich fluid loss (third space) or severe dehydration

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4
Q

Cardiogenic shock occurs due to…

A

failure of the heart to function as an effective pump (MI, myocarditis, acute valve pathology)

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5
Q

Obstructive shock occurs due to…

A

a physical obstruction to the heart or great vessels, which impair cardiac filling (PE, cardiac tamponade)

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6
Q

Distributive encomapsses…

A

septic, anaphylactic and neurogenic shock

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7
Q

Distributive shock occurs when…

A

uncontrolled vasodilation overcomes the compensatory mechanisms of >CO

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8
Q

Cytotoxic shock is rare and follows…

A

haemoglobin or mitochondrial poisoning impairing O2 transport or utilisation (CO or cyanide poisoning)

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9
Q

Which type of shock has profoundly reduced BP?

A

Anaphylactic

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10
Q

Which type of shock has bradycardia as a symptom?

A

Neurogenic (uncontrolled vagal tone)

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11
Q

Treatment of hypovolaemic shock

A

fluid and blood replacement

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12
Q

Treatment of cardiogenic shock

A

careful fluid management, inotropes, vasopressors, treat underlying cause

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13
Q

Septic shock treatment

A

Sepsis 6 (BUFALO), fluids and early vasopressors

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14
Q

Anaphylactic shock treatment

A

Adrenaline = first lines, antihistamines and steroids

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15
Q

Neurogenic shock treatment

A

vasopressors

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16
Q

8 Reversible causes of cardiac arrest

A

Hypovolaemia, hypoxia, hypothermia, metabolic (hyperkalaemia), thrombus, tension pneumothorax, tamponade, toxins

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17
Q

4Ts

A

thrombus, tension pneumothorax, tamponade, toxins

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18
Q

4Hs

A

Hypovolaemia, hypoxia, hypothermia, metabolic (hyperkalaemia)

19
Q

how deep should chest compressions be?

A

5-6 cm

20
Q

When should you give adrenaline during CPR and how much?

A

every 3-5 mins, 1mg IV

21
Q

When should you give amiodarone during CPR and how much?

A

after 3 shocks, 300mg IV

22
Q

P-R interval legnth

A

0.12 - 0.2 s (3-5 squares)

23
Q

QRS legnth

A

0.8-0.1 s (2-3 squares)

24
Q

How do you calculate HR of an ECG

A

300/ R-R interval (number of big squares)

count the number of cardiac cycles in 6 secs and times by 10 (30 squares)

25
Q

Main drug used to treat bradycardia

A

atropine 500 mcg IV

26
Q

S
A
L
I

A

S V1, V2
A V3, V4
L V5, V6, I, aVL
I II, III, aVF

27
Q

Septal MI is a blockage in the…

A

LAD artery

28
Q

Anterior / inferior MI is a blockage in the …

A

Right Coronary Artery

29
Q

Lateral MI is a blockage in the…

A

Circumflex artery

30
Q

Coronary ostia

A

where the left and right coronary arteries leave the aorta just behind the aortic valve

31
Q

normal stroke volume

A

60 - 130 mL

32
Q

Normal cardiac output

A

4 - 8 L/min

33
Q

Cardiac Output =

A

Stroke Volume x Heart Rate

34
Q

Pre-load

A

Volume and stretch of the ventricular myocardium at the end of diastole

35
Q

After-load

A

amount of pressure against which the L ventricle must work during systole to open aortic valve, clinically measured by systolic BP

36
Q

is intervals vary by less than … the rhythm is considered regular

A

0.06s

37
Q

what can the presence of a U wave indicate?

A

Hypokalaemia

38
Q

where is the SA node located?

A

the wall of the right atrium

39
Q

Signs and symptoms of pathological bradycardia

A

syncope, dizziness, chest pain, SoB, Exercise Intolerance, Cool, clammy skin

40
Q

Causes of Bradycardia

A

hypoglycemia, hypothermia, hypothyroidism, previous cardiac history, medications, toxin exposure, MI - inferior wall (RCA)

41
Q

Sinus tachycardia narrow QRS treatment

A

vagal manouvers, adenosine, beta blocker, CCB, synchronized cardioversion

42
Q

Sinus tachycardia wide QRS treatment

A

consider anti-arrhythmic such as procainamide, amiodarone or sotalol

43
Q

4 most common atrial arrhythmias

A

atrial flutter, AF, AT, PAC’s

44
Q

Drugs used to slow the ventricular rate

A

diltiazem, verapamil, digoxin, beta blockers

MBChB Year 3 (7 decks)

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