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EKG > 3- arrhythmia > Flashcards

3- arrhythmia Flashcards

1
Q

why do you never hear normal atrial rhythms

A

tachy flutter fibrillation

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2
Q

atrial flutter is how many bpm

A

250-300

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3
Q

atrial fibrillation

A

400-600 bpm

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4
Q

multifocal tachy (MAT)

A

100-200/250

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5
Q

types of atrial rhythms

A

Atrial Flutter = 250 -350 bpm Atrial Fibrillation (afib) = 400 – 600 bpm Multifocal Atrial Tachycardia (MAT) Premature Atrial Complex (PAC) Supraventricular Tachycardia (SVT)

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6
Q

P wave positive, different shape than a NSR d/t

A

the electrical impulse follows a different path to the AV node also known as

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7
Q

wandering atrial pacemaker is seen as

A

fluctuating P waves HR<100 bpm

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8
Q

Junctional rhythm the rate is

A

40-60 bpm

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9
Q

Junctional rhythm is seen with

A

positive or negative P in lead II can be before or after QRS complex

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10
Q

Pacemaker cells located near the AV node are called

A

Pacemaker cells located near the AV node, called junctional pacemakers,

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11
Q

With junctional escape, depolarization originates near the AV node, and the usual pattern of atrial depolarization does not occur.

A

With junctional escape, depolarization originates near the AV node, and the usual pattern of atrial depolarization does not occur. as a result no P wave or neg P wave in II or positve in AVR

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12
Q

wide QRS is how long

A

>.12 second

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13
Q

if more htan 40 to 60 and you have the absence of a P wave or an inverted P wave it is

A

accelerated ventricular rhythm?

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14
Q

There are no P waves, the QRS complexes are wide, and the rate is between 50-100 beats per minute.

A

accelerated idioventricular rhythm

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15
Q

Accelerated idioventricular rhythm is benign or nah?

A

benign

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16
Q

There are no P waves, the QRS complexes are wide, and the rate is below 50

A

idioventricular rhythm

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17
Q

Single ectopic supraventricular beats can originate where?

A

Single ectopic supraventricular beats can originate in the atria or in the vicinity of the AV node. this happens in the middle of a regular rhythm

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18
Q

normal P wave occurs before the next P wave is due

A

atrial premature beats (or premature atrial contractions PAC

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19
Q

atrial premature beats junctional premature beats which one can initiate more sustained arrhythmias?

A

junctional premature beats

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20
Q

wide QRS seen with what

A

idioventricular rhythm premature ventricular contraction bundle branch block

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21
Q

no P wave is present, stimulus originates from ventricles and a wide QRS is seen with this

A

PVC

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22
Q

how can you describe PVC

A

UNIFORCAL OR BIFOCAL couplet triplet, etc bigeminy, trigeminy, qudrageminy

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23
Q

super-ventricular arrhythmia

A

Any tachy-dysrhythmia arising from above the level of the Bundle of His

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24
Q

list all the types of super-ventricular arrhythmia

A

Atrial flutter Atrial fibrillation A-fib with rapid ventricular response Supraventricular tachycardia (SVT)/Paroxysmal supraventricular tachycardia (PSVT), Multi-focal atrial tachycardia (MAT) Junctional rhythm - tachycardia

25
Q

super-ventricular arrhythmia seen with narrow complex

A

Supraventricular tachycardia (SVT)

26
Q

super-ventricular arrhythmia seen with wider QRS complez

A

bundle branch block

27
Q

Atrial flutter rate

A

= Atrial rate is 250-350 bpm “saw tooth” flutter waves

28
Q

Atrial fibrillation = Atrial rate is

A

is 400-600 bpm

29
Q

“tremulous” waves or no decirnable P

A

Atrial fibrillation

30
Q

ventricular response

A

R-R interval is normal

31
Q

saw tooth appearance is associated w/ what super-ventricular arrhythmia

A

Atrial flutter

32
Q

when the ventricular response is 100 bpm

A

3:1

33
Q

atrial flutter 150 bpm ventricular response of

A

2: 1

34
Q

atrial flutter of 100 bpm will have a ventricular response of

A

1:1

35
Q

which atrial flutter av block is the most common

A

2:1

36
Q

how do you distinguish between a fib and atrial flutter

A

ventricular response is irregular in atrial fibrilation

37
Q

irregularly irregular appearance of QRS complexes in the absence of discrete P waves

A

usually atrial fibrillation

38
Q

what is more common atrial fibrillation or atrial flutter

A

a fib

39
Q

paroxysmal svt lasts only

A

30 minutes

40
Q

rate is 150-250 rhythm is regular P waves are frequently buried in T PR interval is not possible to measure

A

SVT

41
Q

coming from different areas in the atrai and seen as at least three different forms of P and variable PR interval with normal QRS

A

Multifocal atrial tachycardia

42
Q

what does the QRS look like in MAT

A

normal

43
Q

would you have normal sinus rhythm with MAT

A

no because the atrial contraction is coming from different areas and seen as different P waves

44
Q

what underlying diagnoses would we have with MAT

A

acute MI COPD

45
Q

ventricular arrhytmias

A

ventricular tachycardia ventricular fibrillation torsade de pointes

46
Q

run of consecutive PVCs

A

ventricular tachycardia

47
Q

difference between sinus and ventricular tachycardia

A

p wave for every QRS seen in sinus tachycardia ventricular tachycardia is trickier

48
Q

Ventricles fibrillate & quiver asynchronously & ineffectively w/o coordinated fashion

A

Ventricular fibrillation No cardiac output occurs & patient becomes unconscious immediately

49
Q

Ventricular fibrillation tx

A

Requires immediate defibrillation w/ an unsynchronized DC shock Generally stat dose of IV anti-arrhythmic drug in attempt to suppress further ventricular ectopy

50
Q

Polymorphic VT

A

Polymorphic VT –> “twisting of the points” Torsade de pointes

51
Q

Occurs in the setting of delayed ventricular repolarization

A

Torsade de pointes delayed T waves

52
Q

Evidenced by prolongation of the QT intervals or presence of U waves is indicative of

A

Torsade de pointes

53
Q
  • Visible P wave but different shape and/or PR interval ~ looks like T on top of P wave
  • Narrow QRS complex
A

premature atrial contraction

54
Q
A

Premature_Atrial_Contraction_Aberrantly_Conducted.j

55
Q
  • P wave may be hidden / Premature / Abnormal
  • Wide/oblong QRS complex
A

PVC

à delay in AV node in order to get proper filling + cardiac output

56
Q
A

PVC

  • Premature Ventricular Contractions (PVC): stimulus originates from ventricles
    • P wave may be hidden / Premature / Abnormal
    • Wide/oblong QRS complex à delay in AV node in order to get proper filling + cardiac output
57
Q

normal amplitude of QRS

A

1-6 small boxes

58
Q

steps of evlauating EKG

A

determine the rhythm -regular or nah (60-100 bpm, P up in II, PR normal, P for every, QRS norma, T wave up)

determien the rate- 300 150 100 75 60 50 43

measure the PR interval 3-5

determine the QRS interval 2-3

examine the T wave

measure QT interval 11-13

check for abnormalities

59
Q

atrial flutter ratios

A

75 bpm 4:1

100 bpm 3:1

150 bpm 2:1

300 bpm 1:1

EKG (7 decks)

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