Quiz #28: EKG

Quiz #28: EKG

3 year old, post-op day 1.

1)      What is the ventricular rate? (Note: Paper speed).

2)      What is the atrial rate?

3)      What is the diagnosis?

4)      In the past 4 hrs patient has become hypotensive with lower urine output and needed multiple fluid boluses and increase in Dopamine dose. What is the first line treatment?

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(Click on the image to enlarge)

Quiz #27: EKGs on the day of surgery

6 yr old boy, s/p Repair of subaortic membrane. Two EKGs with time of recording are given - both were recorded on the day of surgery. Second EKG was performed because bedside nurse noted a change in EKG trace on the monitor. Patient is sleeping without any complaints.

Questions:

1) Describe the most significant change between the two EKGs.

2) What are the possible reasons for change?
3) How would you proceed further?

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EKG 1: Recorded at 12:44 Hrs

EKG 2: Recorded at 22:44 Hrs. 

Quiz #25: Echo - Identify the vessel (again)!

Going with the same theme as Quiz #24.

Subcostal sagittal (bicaval) view in a newborn with severe cyanosis.

(Some labels are given. Clue: A vertical vessel flowing downwards, behind the IVC).

Question 1:

1)      Name the vessel shown by arrow.

2)      Provide a possible diagnosis. (I won’t be upset if you gave a second possible diagnosis as well!)

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