Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1. CLASP Sudden Death > Cardiac Arrythmias > Flashcards

Cardiac Arrythmias Flashcards

1
Q

Who’s consent do you require to do a hospital autopsy?

A

next of kin or family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the circumstances that a procurator fiscal would instruct an autopsy?

A 
sudden and unexplained death
suspected suicide or homocide
death of a child
death at work 
death due to medical or dental care
death in custody
death due to an industrial or notifiable disease
death due to an accident
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two broad catagories of inherited cardiac arrythmias?

A

cardiomyopaties

channelopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes channelopathies?

A

ion imbalance and development of early and late depolarisations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give some examples of a channelopathy?

A 
long QT syndrome
brugada syndrome
catecholaminergic polymorphic ventricular tachycardia (CPVT)
short QT syndrome
familial AF
WPW
progressive familial conduction disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes cardiomyopathies?

A

scar or electrical barrier formation causing re entry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are examples of cardiomyopathies?

A

hypertrophic cardiomyopathy
arrythmogenic right ventricular cardiomyopathy (ARVC)
dilated cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an after depolarisation?

A

abnormal depolarisation of cardiac myocytes that interrups phase 2,3 or 4 of the cardiac AP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are early after depolarisations?

A

abnormal depolarisation in phase 2 or 3

caused by increased frequency of abortive action potentials before normal repolarisation is completed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can early after depolarisations result in?

A

torsades de pointes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can make early after depolarisations worse?

A

hypokalaemia

drugs that prolong the QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are delayed after depolarisations?

A

begin during phase 4 - after repolarisation is complete but before another action potential would normally occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes delayed after depolarisations?

A

elevated Ca
seen in digoxin toxicity
overload of the SR can cause spontaneous Ca release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the classical feature of delayed after depolarisations?

A

bidirectional ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In what condition do delayed after depolarisations occur?

A

CPVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the incidence of congenital long QT syndrome?

A

1 in 2000 are carriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is long QT syndrome?

A

polymorphic VT (i.e. torsades de pointes) due to adrenergic stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the autosomal dominant varieties of long QT?

A

isolated: Romano Ward Syndrome

extra cardiac features: Anderson-Twail syndrome, Timothy syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the autosomal recessive varieties of long QT?

A

associated with deafness: Jervell + Lange-Nielsen Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes long QT syndrome?

A

genetic mutations that cause reduced or dysfunctional ionic current - causing prolonged cardiac repolarisation
more depolarising current - Na and Ca
less repolarising current - K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is LQTS diagnosed?

A

QTc>/= 480ms

22
Q

What factors contribute to sudden death in LQTS?

A

age dependant
gender - pre adolescent males and adult females
increasing QT duration
prior syncope and response to beta blockers

23
Q

How is LQTS managed?

A

lifestyle - avoid stress, strenuous exercise, loud noise if recessive, strenuous swimming if dominant
beta blockers
ICD
avoid QT prolonging drugs

24
Q

What drugs are QT prolonging?

A 
antipsychotics - haloperidol
antibiotics - macrolides (erythromycin)
anti arrythmics - class 1a and 3
anti emetics - ondesantron
anti depressants - tricyclics
25
Q

What causes congenital short QT syndrome?

A

mutation in the K channels

26
Q

How is congenital short QT syndrome diagnosed?

A

QT <300ms at a HR of <80bpm

27
Q

How does congenital short QT present?

A

often in young children

associated with AF

28
Q

What is Brugada syndrome?

A

VT and VF due to triggers for eg - sleep, fever, alcohol, large meals

29
Q

What causes Brugada syndrome?

A

genetic mutations for eg SCN5A and CAN1AC

30
Q

How is Brugada syndrome inherited?

A

autosomal dominant

31
Q

Who is at higher risk of Brugada syndrome?

A

females x 8

32
Q

How does Brugada syndrome look on ECG?

A

ST elevation >2cm in V1 +/- V2

RBBB in V1-V3

33
Q

How can you elict Brugada syndrome?

A

flecainide

34
Q

How does flecainide stimulate Brugada syndrome?

A

blocks the cardiac Na channel

35
Q

How do you treat/manage Brugada syndrome?

A

avoid drugs that induce ST elevation
avoid excessive alcohol or large meals
ICD for those with previous cardiac arrest or type 1 ECG pattern or history of syncope

36
Q

What drugs induce ST elevation?

A

anti arrythmics
psychotropics
analgesics
anaesthetics

37
Q

What is Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)?

A

adrenergic induced bidirectional and polymorphic VT, SVT triggered by emotional stress and activity

38
Q

How does CPVT appear on ECG and ECHO?

A

normal

39
Q

How is CPVT inherited?

A

autosomal dominant or recessive

40
Q

How can CPVT be managed?

A

lifestyle - avoid emotional and physical stress
beta blockers
ICD - if contraindicated give flecanide

41
Q

How does Wolff-Parkinson-White syndrome present?

A

AVRT and AF

small risk of sudden death

42
Q

How does Wolff-Parkinson-White look on ECG?

A

delta wave and short PR interval due to ventricular pre excitation due to the accessory pathway

43
Q

How is hypertrophic cardiomyopathy inherited?

A

autosomal dominant

44
Q

What gene is mutated in hypertrophic cardiomyopathy?

A

sarcomere gene

45
Q

How does hypertrophic cardiomyopathy present?

A

AF
heart failure
sudden death

46
Q

How is hypertrophic cardiomyopathy treated?

A

lifestyle - avoid emotional and physical stress

ICD if prior cardiac arrest/sustained VT or if LV wall thickness >/= 30mm

47
Q

What genes are affected in dilated cardiomyopathy?

A

lamnin A/C and desmin

dystrophin if X linked

48
Q

Who is more affected by dilated cardiomyopathy - males or females?

A

males

49
Q

What is Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)?

A

fibrofatty replacements of cardiomyocytes

LV involvement in >50% of cases

50
Q

How is ARVC passed on?

A

autosomal dominant - genes for desmosomal proteins

autosomal recessive - genes for non desmosomal proteins

51
Q

What does ARVC cause?

A

a reentry VT

52
Q

How is ARVC managed?

A

avoid competitive sport
beta blockers
ICD

1. CLASP Sudden Death (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions