An 84-year-old man is brought in from a nursing home following syncope. His ECG is shown. The monitor later alarms and a further ECG is captured after a brief episode of unresponsiveness.

Syncope

1. Interpret the first ECG. 2 marks

2. List four different medication classes which can cause these ECG findings, and for each class list an example medication. 4 marks

The monitor alarm goes off while his nurse is atending to him. He had a brief episode of being unresponsive. A further ECG is captured.

3. State the diagnosis on the second ECG. 1 mark

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He is now alert and his observations are within normal limits.

4. Outline five steps in management. 5 marks