Quiz #30: EKG - Arrhythmia

13-year old girl was transferred to Pediatric ICU for atrial flutter. She is obtunded and has muscle tremors. Suspected to have developed encephalopathy as part of a systemic vasculitis. Figure 1 is an strip from floor with EKG and pulse oximeter trace. Figure 2 is an apical 4-chamber view with Doppler trace of mitral/aortic valve flows.

Questions:
1) What is the diagnosis?
2) How will you manage?

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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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Quiz #22: ICU monitor interpretation

5 month old baby. Postoperative day 1 after closure of membranous VSD. Panel 1 and Panel 2 were recorded few minutes apart.

Questions:

1)      What is the arrhythmia in Panel 1?

2)      What type of pacing is done in Panel 2?

3)      Describe the important difference between the CVP waveform in Panel 1 and Panel 2. What is the reason for the difference?

4)      Comment about AV conduction in Panel 2.

5)   Why does arterial line trace have a “flat top”? How will you rectify this issue?

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