rd june 2020 (answers below) 1. what are the clinical ... · quiz answers 3rd june 2020 1. what are...
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QUIZ3rdJune2020(answersbelow)
1. Whataretheclinicalfeaturesofhydroxychloroquinetoxicity?
2. WhataretheECGchangesinsodiumchannelblockade?
3. Whatisthemanagementofhydroxychloroquinetoxicity?
4. Whatiscinchonism?
5. DescribeandinterpretthefollowingECG.
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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
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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