rd June 2020 (answers below) 1. What are the clinical ... · QUIZ answers 3rd June 2020 1. What are...
4
QUIZ 3 rd June 2020 (answers below) 1. What are the clinical features of hydroxychloroquine toxicity? 2. What are the ECG changes in sodium channel blockade? 3. What is the management of hydroxychloroquine toxicity? 4. What is cinchonism? 5. Describe and interpret the following ECG.
Transcript of rd June 2020 (answers below) 1. What are the clinical ... · QUIZ answers 3rd June 2020 1. What are...
QUIZ3rdJune2020(answersbelow)
1. Whataretheclinicalfeaturesofhydroxychloroquinetoxicity?
2. WhataretheECGchangesinsodiumchannelblockade?
3. Whatisthemanagementofhydroxychloroquinetoxicity?
4. Whatiscinchonism?
5. DescribeandinterpretthefollowingECG.
QUIZanswers3rdJune2020
1. Whataretheclinicalfeaturesofhydroxychloroquinetoxicity?
o Decreasedlevelofconsciousness/seizures
o Cardiogenicshock/arrhythmias/wideQRSandQTprolongation
o Hypokalaemia
Ingestionofjustonetabletispotentiallylethalinachildlessthan6yearsold
2. WhataretheECGchangesinsodiumchannelblockade?
o QRS>100msinleadII
o RightaxisdeviationofterminalQRS
§ TerminalRwaves>3mminaVR
§ R/Sratio>0.7inaVR
3. Whatisthemanagementofhydroxychloroquinetoxicity?
• IntubationatfirstsignofcardiotoxicityordecreasedLOC
• HyperventilationtolownormalpCO2
• Serumalkalinisation–Sodiumbicarbonate1-2mmol/LforpH>7.5
• IVfluidsjudiciously
• Adrenalineasvasopressorofchoice
• Benzodiazepinesforseizures
• Potassiumforhypokalaemia,rememberingthattotalbodypotassiumis
normal
• Activatedcharcoalupto4hoursonceairwayprotected
• Highdosediazepaminfusionisproposedasanantidotebutunproven
Patientswhoareasymptomatic6hourspostingestioncanbedischarged
Allchildrenshouldbeadmittedforobservation
4. Whatiscinchonism?Cinchonismistheclinicalmanifestationofquininetoxicityofnausea,vomiting,
alterationsinhearing,tinnitusandvertigo.Itoccursearlyfollowingoverdoseand
resolvesatbloodquinineconcentrationfalls.
5. DescribeandinterpretthefollowingECG.
Rate 71/minRegular
Pwaves Normalmorphology,allconducted
PRinterval Short0.10sec
QRS Nodeltawave
Narrow0.10sec
Normalaxis
Morphologynormal
STsegment Isoelectric
Twaves Normal
QTinterval Normal
è ShortPRintervalwithnormalPwavesandnormalQRS
è Lown-Ganong-Levinesyndrome
