Cardiology – Exam Review Set 4

What this deck covers

Cardiology – Exam Review Set 4 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. Wide tachycardia, no pulse
2. Sweaty feeds, high PA pressure
3. The drug is drawn up
4. Three hundred, and comfortable
5. The drug that makes it worse
6. The slur before the complex
7. The first attempt did nothing
8. What happens between the shocks
9. Sync on or sync off
10. Nothing measurable on the strip
11. A pulse with no pattern
12. Broad, regular, and fast
13. What the pauses need
14. Years after the operation
15. What to tell her next time
16. Which one is not the block
17. Complexes on the screen, no pulse
18. Five kilograms at nine months
19. If they wait another year
20. Why they will not wait
21. Why one and not the other
22. Works in one, not the other
23. What the infusion is for
24. Why the small duct matters
25. Needing more support than yesterday
26. What that sound rules out
27. Dark lungs on the film
28. Before any drug at all
29. The one that does not happen
30. What made the blood sticky
31. The scan every one of them gets
32. Where the sound is really made
33. The shape of the sound
34. Where else to listen
35. Thick, not stretched
36. What the new murmur is made of
37. How long the line stays in
38. Where cover still applies
39. The part everyone forgets
40. What the drugs cannot touch
41. The late one that stands alone
42. How the lesion is closed
43. The pulse that comes and goes
44. Warm and wide, cold and narrow
45. The sign you can follow
46. Three jobs, three drugs
47. The ladder on the monitor
48. Well, then grey on day six
49. Put a cuff on the leg
50. The circulation is already full

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Synchronised cardioversion at 0.5 to 1 J/kg, Carotid sinus massage, Repeat the shock at the same energy, Complete heart block with an escape rhythm, An oral stimulant, A slow ventricular rate that stays regular, The defect closes spontaneously in most cases, It only works if given with a diuretic alongside it, Bounding pulses with a wide pulse pressure, Knees to the chest, with oxygen and calm handling, Nothing today, To the left axilla, Ten days of oral penicillin once she is afebrile, The arthritis of the large joints.

Clinical pearls from this deck

• No pulse means no synchronisation. Pulseless VT and VF both take an unsynchronised shock at 2 J/kg; a pulse present means you sync at 0.5 to 1 J/kg.
• Ask whether the resistance still falls on oxygen. That single number is the difference between an operation that cures and one that cannot be undone.
• A drug that lasts ten seconds has to be delivered like one. Most reported failures of adenosine are failures of the push and the flush, not of the drug.
• The cheapest intervention in the room works often enough to try first, and it costs nothing but the time it takes to fill a bag with ice.
• Pre-excitation plus digoxin is the combination the question is always testing.
• The tracing AFTER the tachycardia often names the cause. Look at the upstroke.

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.