Online Clinical Case Study (January 2012)

Clinical Cardiology Series
臨床心臟科個案研究

The content of the Office Cardiology Series is provided by:
Dr. CHENG Yan Wah, Vinson MBChB (CUHK), DCH (Ireland), MRCP (UK), DCH (HK) (HKCPaed),
DCH (International) (RCPCH), MRCPCH, FHKCPaed, FHKAM (Paediatrics), Dip Med (CUHK), Specialist in Paediatrics
Dr. LI Siu Lung, Steven FHKAM (Med), FRCP (Glasg), FRCP (Edin), FRCP (Lond), Specialist in Cardiology
Dr. WONG Shou Pang, Alexander FRCP, FHKAM (Med.), FHKCP, Specialist in Cardiology
臨床心臟科個案研究之內容誠蒙鄭恩華醫生、李少隆醫生及王壽鵬醫生提供。

A 9-year-old child presenting with palpitation for 3 hours

A 9-year-old child presented to clinic for palpitation for 3 hours. She did not have chest pain or syncope. The blood pressure was normal and an ECG was done in the clinic.

Answer Sheet

Clinical Cardiology Series臨床心臟科個案研究

1. What are the possible diagnoses?
(1) Supraventricular tachycardia
(2) Ventricular tachycardia
(3) Sinus tachycardia
(4) Malingering
(5) Tachycardia due to pheochromocytoma
a. (1) and (2)
b. (1), (2) and (3)
c. (1), (2), (3) and (4)
d. None of the above
e. All of the above

2. What can you do to relieve the child's symptom in the clinic?
(1) Valsalva manoeuver
(2) Drinking a glass of ice-cold water
(3) Holding one’s breath for a few seconds
(4) Asking the patient to cough
(5) Intravenous adenosine
a. (1) and (2)
b. (1), (2) and (3)
c. (1), (2), (3) and (4)
d. None of the above
e. All of the above

3. After trying some of the above methods, the child still has
a heart rate of 190 bpm. What will you recommend to do next?
(1) Call cardiologist and fax the ECG for a second opinion
(2) Ask her to go to emergency department by ambulance
(3) Send her home and give some propranolol
(4) Reassurance
(5) Ask her to come back tomorrow to have another ECG
a. (1) and (2)
b. (1), (2) and (3)
c. (1), (2), (3) and (4)
d. None of the above
e. All of the above

Dermatology Series 皮膚科病例研究

A 32-year-old gentleman presented with a bald patch

A 32-year-old banker with good past health complained of an asymptomatic patch of hair loss over his scalp for a few months. The bald area was increasing in size. Physical examination showed a patch of alopecia over the occipital scalp. There were no other similar lesions found over the body.

Answer Sheet

Dermatology Series 皮膚科病例研究

1. What is the clinical diagnosis?

2. What are the differential diagnoses?

3. What is the cause of this skin condition?

4. How is this skin condition diagnosed?

5. What is the management?