hyperkalemia

A 58 year old man on haemodialysis presents with profound weakness after a weekend fishing trip.

Hyperkalaemia

The following changes may be seen in hyperkalaemia

• small or absent P waves
• atrial fibrillation
• wide QRS
• shortened or absent ST segment
• wide, tall and tented T waves
• ventricular fibrillation

paediatric ecg

Alex is a 4 weeks old baby. He was born at term, normal delivery with no complication. From 3 weeks old, he started to be irritable especially during breast feeding. Mum noticed that he was sweating during feeds, and seems to be distressed. His grandmother thinks that he has “reflux”.

Past few days the weather have been very cold. Alex was brought into Emergency Department with a low grade fever, rhinorrhea and poor feeding. On examination, he was found to be tachypnic and tachycardic. There was a soft systolic murmur. Few crepitation was heard over the lung field. Liver is palpable 3cm below the costal margin. An ECG was done as part of the work up for the murmur.

What is the most likely diagnosis.

A) Bronchiolitis

B) Tetralogy of Fallot

C) Anomalous origin of the left coronary artery arising from the pulmonary artery

D) Coarctation of the aorta

E) Ventricular Septal Defect

atrial septal defect

A 5 years old boy with Atrial Septal Defect attended for pre-operative medical examination. He had a irregular pulse. Attached is the ECG of this child.

1. What is the diagnosis?

A) Sinus arrhythmia

B) Wandering Atrial Pacemaker

C) Atrial Fibrilation

D) Complete Heart Block

E) Second Degree Heart Block

2. What is the significance of this finding?

A) no clinical significance

B) This child is at risk of sudden death from cardiac arrhythmias

C) This child is in cardiac failure

D) This child needs a permanent cardiac pacemaker implantation

E) This child needs anticoagulation