Cardiology – Set 6

What this deck covers

Cardiology – Set 6 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. Broad tachycardia in a talking boy
2. Rising potassium on the monitor
3. Slow pulse with a wandering PR
4. Events on exertion and in water
5. Chaotic trace after a blow at cricket
6. Racing then fainting after Senning
7. The laboratory phones the ward
8. Narrow complexes on screen, no pulse
9. Abnormally short QT, what danger
10. Broad regular rhythm, no pulse
11. Pacing wires in use after an operation
12. Which interval to watch after tablets
13. Pads on, chaotic trace, no pulse
14. Sank after two fast lengths
15. Late risk after other surgery
16. Two nurses and a bag-mask
17. Missed dialysis, tingling hands
18. Giant neck waves now and then
19. IO placed in a non-shockable arrest
20. Faint in the 800 metres, first drug
21. Slow newborn pulse, mother’s dry eyes
22. Just after the first shock
23. Seizure, then a wide fast rhythm
24. Pause of exactly two cycles
25. Proof of where a broad rhythm starts
26. Patchy infiltrates and a QT history
27. Drowsy and mottled, pulse still felt
28. Tingling eases, level still high
29. Bursts with two waves per QRS
30. Trachea pushed left, arrest in trauma
31. Dropped limp when the alarm rang
32. Slow from birth, antibodies negative
33. Shocked back to life on the court
34. Toxic level on an unchanged dose
35. Baffle repair, trouble years later
36. Where a re-entry loop sits
37. Day five of a vasodilator drip
38. Twisting runs on the night monitor
39. Still shockable after shock three
40. Night Holter in a fit teenager
41. Late bradycardia with low sugar
42. Flat trace on the monitor
43. Relatives who have never fainted
44. Vomiting three weeks into new tablets
45. Short broad runs after gastroenteritis
46. Before sotalol in a diseased node
47. Near-blackouts, lifelong slow pulse
48. Protecting him from recurrence
49. Shock after an aunt’s tablets
50. Runs return despite alkalinisation

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: IV amiodarone 5 mg/kg over 20-60 min, Wait for a free-flowing repeat sample before acting, Adenosine 0.1 mg/kg rapid push, Synchronised shock at 4 J/kg, 15 compressions to 2 breaths, Atropine 20 micrograms/kg, repeated after 5 min, Check for a central pulse for 10 s, A delta wave on her sinus-rhythm ECG, IV furosemide as the only measure, 12-lead ECG with a corrected QT, A rise in serum magnesium, Thiocyanate build-up from poor renal clearance, PR that lengthens until a beat drops, An echocardiogram for her brother.

Clinical pearls from this deck

• Stable VT: amiodarone slowly or procainamide, never both, with the defibrillator ready.
• Peaks, then P loss, then a wide QRS, then a sine wave: each step is closer to arrest.
• Regular P waves, regular QRS complexes, no relation between them: complete heart block.
• Swimming points to LQT1, an alarm clock to LQT2, sleep to LQT3.
• Shockable: VF and pulseless VT. Non-shockable: asystole and PEA.
• Fainting as the palpitations stop, after atrial surgery, is tachy-brady sick sinus syndrome.

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.