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Opening (30 s)
"Long QT and Channelopathies — give a one-line definition and the single most important immediate risk."
Model: Long QT syndrome and the related cardiac channelopathies (Brugada, CPVT, short QT, early repolarisation) are inherited arrhythmia syndromes caused by mutations in cardiac ion-channel genes that predispose young, structurally normal hearts to syncope, torsades de pointes, ventricular fibrillation and sudden cardiac death. The single most important immediate risk is degeneration of torsades de pointes into ventricular fibrillation and sudden cardiac death. The dominant therapy is beta-blockade (nadolol or propranolol for LQTS and CPVT), avoidance of QT-prolonging drugs, lifestyle modification, and ICD implantation for secondary prevention or high-risk primary prevention.
Station 1 — Pathophysiology (2 min)
Explain the mechanism chain from cause to clinical features and one major complication.
Station 2 — Clinical diagnosis (2 min)
Classic presentation, atypical groups, named bedside signs, and what you examine for red flags.
Red flag cue: Syncope during exercise, swimming, auditory stimulation, or emotional stress in a young patient - think LQT1, LQT2 or CPVT - exercise restriction, beta-blocker, urgent cardiology referral
Station 3 — Investigations (2 min)
First-line tests, definitive tests, and any named score with exact components.
Station 4 — Emergency management (3 min)
ABC priorities, first drugs with dose and route, procedures, and when to escalate to ICU/theatre.
Station 5 — Definitive / long-term care (2 min)
Stepwise definitive therapy, monitoring, complications of treatment, follow-up.
Station 6 — Special populations (2 min)
Child / pregnancy / elderly / immunocompromised / renal impairment — what changes.
Station 7 — Evidence & pitfalls (2 min)
Landmark trial or guideline name if standard; three classic exam traps.
Station 8 — Rapid-fire pearls (1 min)
Five high-yield facts a candidate must not forget under time pressure.
Examiner pass criteria
- Speaks in mechanisms and numbers, not vague lists
- Gives at least one exact dose or threshold
- Names escalation criteria
- Avoids dangerous delays (imaging when unstable, etc.)