Cardiology – Set 5

What this deck covers

Cardiology – Set 5 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Blue newborn with a left-sided ECG
2. Fever, fast pulse and the 12 leads
3. Pulse too fast to count at 6 weeks
4. Which lesion the echo should seek
5. Steady fast pulse years after surgery
6. Can he play in the cup final?
7. Febrile, dry infant with a fast pulse
8. How the circuit runs in a baby
9. Football, then a pounding heartbeat
10. Lead I up, aVF down in a young baby
11. Shocked baby with no line in
12. Erratic heartbeat on a new tracing
13. Collapse while sprinting for the ball
14. Self-help for the next attack
15. Correcting the QT for a fast rate
16. Telling two fast rhythms apart
17. Grey and floppy with a slow pulse
18. Daily preventer to steer clear of
19. Opening move for a settled baby
20. What the pause after adenosine shows
21. Hay fever season and more attacks
22. Tall R in V1 with a harsh murmur
23. Racing heart at a birthday party
24. Joules for a hypotensive baby
25. Three more episodes despite tablets
26. Bedside test for a suspect murmur
27. Brief pause, then fast again
28. Normal resting ECG, yet a circuit
29. Preparing for an elective conversion
30. Breakthrough attacks on propranolol
31. Grey baby and a monitor strip
32. Superior axis in trisomy 21
33. Blackout mid-race in the pool
34. Technique for the first drug dose
35. Swimmer’s ECG and a reassuring sign
36. Father asks when to rethink the rhythm
37. When the first shock changes nothing
38. Guarding the brain in persistent AF
39. Parents want a cure at 6 months
40. What a 12-day tracing should show
41. Treating the rate in a dry, hot child
42. Unstable, but a line is already in
43. Sawtooth waves on a postnatal ward
44. What the catheter study found
45. Sharp pain that a fingertip finds
46. Still slow after good breaths
47. Father asks about danger untreated
48. The odd one out on a repeat tracing
49. Fainting in a hot school assembly
50. Why a baby’s fast rhythm is found late

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Great arteries arising from the wrong ventricles, Tetralogy of Fallot, Atrial flutter with 2:1 block, Left axis deviation, abnormal at her age, Unresponsiveness of under a minute, Upright P waves before every QRS complex, Massage of one carotid sinus in the neck, Mitral regurgitation, Implantable cardioverter-defibrillator, Manifest accessory pathway (pre-excitation), Sinus tachycardia, 0.1 mg/kg rapid push, then fast saline flush, 4 J/kg, unsynchronised, Axis +125°, qR pattern in V1, inverted T in V1.

Clinical pearls from this deck

• Blue baby, left-sided ECG: think of a missing right ventricle.
• Find the P wave: upright in I and aVF means the sinus node is in charge.
• If the child is stable, capture the rhythm on 12 leads before you break it.
• Ebstein anomaly: look for pre-excitation, often with several right-sided pathways.
• A regular narrow-complex rate stuck near 150/min in a teenager after atrial surgery: think flutter with 2:1 block.
• Exertional syncope with a cardiomyopathy means no strenuous sport until risk is assessed.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all cardiology case decks · pediatric reference values.