ECG Quiz – Cardiology MCQ
Rhythm strip for diagnosis:
a) Atrial fibrillation
b) Sinus arrhythmia
c) Multifocal atrial tachycardia
d) None of the above
Correct answer: c) Multifocal atrial tachycardia
Multifocal atrial tachycardia is defined as three or more different types of P waves occurring at a rate more than 100 per minute.
The nearest differential diagnosis of a multifocal atrial tachycardia is atrial fibrillation (paroxysmal atrial fibrillation in this case). Multifocal atrial tachycardia (MAT) can occur in those with chronic obstructive lung disease [1].
Multifocal atrial tachycardia is sometimes called as chaotic atrial rhythm because of...
Source: Cardiophile MD - May 12, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Source Type: blogs
A Hayekian Defense of Evidence-Based Medicine
BY ANDREW FOY, MD
It’s a lousy Saturday morning in Southeastern Pennsylvania. The 100-mile bike ride I had scheduled, the first century of the year, was cancelled at 5 AM due to inclement weather. I’ve been scanning my Twitter feed ever since.
I only joined Twitter yesterday, so I’m a bit obsessed at this point. The synapses in my prefrontal cortex are getting fresh hits of dopamine every time I land on another exciting science/political story, journal article, or blog that’s been tweeted about. Yes, I’m a nerd.
Through Twitter, I was introduced to Michel Accad less than 24 hours ago. He’s a cardiologist, phil...
Source: The Health Care Blog - May 11, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Digoxin toxicity – Cardiology MCQ
Factor/s enhancing the risk of digoxin toxicity:
a) Co-administration of verapamil
b) Hypokalemia
c) Hypomagnesemia
d) All of the above
Correct answer: d) All of the above
Hypokalemia which often occurs due to the diuretic therapy which is given along with digoxin for the treatment of heart failure, potentiates the problem of digitoxicity. Correction of hypokalemia is very important in the management of digoxin toxicity.
Severe hypomagnesemia can precipitate digoxin induced cardiac arrhythmia with normal serum digoxin and potassium levels and respond to correction of hypomagnesemia.
Important drugs which can increase the ...
Source: Cardiophile MD - May 11, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes
Conclusions: In the select group of hypokalemic patients studied, potassium infusions of 20 to 40 mmol delivered over 1 hr were safe to administer and effectively increased serum potassium levels in a dosedependent and predictable fashion. Furthermore, these results were independent of the patient's underlying renal function or associated diuretic administration. (Crit Care Med 1991; 19:694)Concentrated Potassium Chloride Infusions in Critically Ill Patients with HypokalemiaThe Journal of Clinical Pharmacology. Volume 34, Issue 11, pages 1077–1082, November 1994Although concentrated infusions of pota...
Source: Dr. Smith's ECG Blog - April 7, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
A Better Pathway to Acute Care
By KAREN SIBERT, MD
When patients need acute interventional care, coordinating the transitions away from and back to primary care is a challenge. The common pathway for these patients, no matter what their diagnosis, is an encounter with anesthesiology. But it often happens too late in the process. If we’re involved earlier, physician anesthesiologists can help reduce procedure risk, control costs, and improve the long-term health of this high-risk, high-spend population.
The numbers haven’t changed significantly in several years—only five percent of the U.S. population consumes a full ...
Source: The Health Care Blog - February 21, 2016 Category: Consumer Health News Authors: Simon Nath Tags: Featured THCB Karen Sibert Source Type: blogs
Alkalotics Anonymous
A 50-year-old man with a past medical history of alcoholism presented to the ED with altered mental status, nausea, and vomiting. He is arousable but a poor historian. His girlfriend said he drinks a half-gallon of rum daily, and had his last drink two days earlier. She reported that he started to feel nauseous, vomit, and go through alcohol withdrawal. She said he also has been taking a lot of calcium carbonate for an upset stomach, but she was unable to say exactly how much. His blood pressure was 146/70 mm Hg, heart rate was 110 bpm, respiratory rate was 14 bpm, PO2 was 96% on room air, and blood glucos...
Source: The Tox Cave - February 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 9
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Source: Cardiophile MD - January 27, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 8
This study found that though it is often associated with coronary artery disease (CAD), it can also occur in those without significant CAD. It was not specifically associated with disease of right coronary artery disease.
This cardioinhibitory response may be a manifestation of the Bezold-Jarisch reflex. Bezold-Jarisch reflex inhibits sympathetic activity (sympathetic withdrawal) and increases parasympathetic activity, resulting in bradycardia, which may be associated with vasodilatation, nausea and hypotension. Bezold-Jarisch has been described in the setting of inferior wall infarction and coronary angiography. Origin...
Source: Cardiophile MD - January 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ Cardiology X-ray Featured Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 7
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Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test.
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Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 7.
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Source: Cardiophile MD - January 23, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
LITFL R&R – Best of 2015
This article is one more piece of the mounting evidence demonstrating a clear call to change what is the usual care in many institutions in the U.S. Stop the madness!
Chest pain is tough — it’s the second most ED common chief complaint, and it scares the heck out of us and our patients – partially because missed MI is one one of the top causes of litigation. But we also see a ton of resources spent on a terribly low yield from chest pain workups. This new study in JAMA-IM including Mike Weinstock (of Bounceback fame), Scott Weingart and David Newman looked at the bad outcomes of patients with normal ECG...
Source: Life in the Fast Lane - January 9, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Anaesthetics Cardiology Education Emergency Medicine Intensive Care Pre-hospital / Retrieval R&R in the FASTLANE Respiratory Resuscitation Trauma critical care examination research and reviews Source Type: blogs
Nocturnal pauses in Holter monitoring : How significant is it ?
Holter monitoring is the Initial test for all those with documented syncope (or Pre syncope ) with suspected cardiac arrhythmia .It is a 24 hour ambulatory ECG monitoring , expected to pick up any electrical abnormality and its correlation with the resultant symptom if any. Though the test looks attractive , the diagnostic yield is far less. (About 10%) .The reason being the episodes can be rare to be missed by 24hr sample time. We have extended Holter (48hr) , Event monitors , Loop recorders and implantable devices that can record ECG for extended periods.(18 Months ,Reveal Plus Medtronic) that improve the yie...
Source: Dr.S.Venkatesan MD - December 11, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Multifocal atrial tachycardia
MAT
Multifocal atrial tachycardia
(Click on the images for a larger view)
Multifocal atrial tachycardia is defined as three or more different types of P waves occurring at a rate more than 100 per minute. In the second rhythm strip there is a pause before the onset of sinus rhythm after the tachycardia terminates. This could be due to down regulation of the If current (funny current or pacemaker current) in the sinus node due to the tachycardia or due to a block atrial ectopic beat which is not very evident as it is superimposed on the T wave.
Multifocal atrial tachycardia and blocked atrial ectopic beat
(Click on the ...
Source: Cardiophile MD - November 15, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: ECG / Electrophysiology ECG Library chaotic atrial rhythm chronic obstructive lung disease MAT multifocal atrial rhythms Multifocal atrial tachycardia Source Type: blogs
How Many More Annas Must Die?
It’s been over a year since my older sister Anna died, so I choke up less readily while speaking about it. The raw anger is less, but the frustration of losing someone to a preventable medical mistake will always remain with me. Anna was five years older than me, my only sister, and the one I often turned to for advice. We were close despite living 600+ miles apart. She was smart and insightful; she was at ease in most social situations. I, on the other hand, was the nerdy kid sister who loved science, who became a physician in my early 40’s.
In 2012, Anna’s world turned upside down when she was diagnosed wit...
Source: Disruptive Women in Health Care - September 29, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Advocacy Policy Publc Health Quality Source Type: blogs
Finding compassion for the choice a patient made
Yesterday my friend Sophie asked me to accompany her to a Miami hospital intensive care unit to see her older brother, Guillermo. He’d been admitted the previous night with seizures and cardiac arrhythmia.
Joined by my husband, we made our way to the ICU. When she saw Guillermo lying immobile, swollen and unresponsive, with a breathing tube in his mouth and other tubes snaking into his chest from IV poles, Sophie broke down sobbing.
Seeing her reaction, I felt a little ashamed at my own calm, although I knew it was hard-earned. During my years as a family doctor working in Miami-Dade County’s community clinics,...
Source: Kevin, M.D. - Medical Weblog - September 8, 2015 Category: Journals (General) Authors: Suzanne Minor, MD Tags: Physician Intensive care Nephrology Source Type: blogs
