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Cardiology > 5) AV & Blocks > Flashcards

5) AV & Blocks Flashcards

1
Q

Junctional Arrhythmias:

A

(PJC) Premature Junctional Contractions
Junctional Escape Complexes and Rhythm
Junctional Bradycardia
Accelerated Junctional Rhythm
Junctional Tachycardia

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2
Q

Ventricles have more muscles so P wave

A

“eat P wave” if AV fires same as ventricles

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3
Q

Digoxin) Typically for:
Dynamics
works bc

A

= CHF
= allows more Ca for better contraction
= confuses K/Na pumps

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4
Q

“AV node P waves” morphology:

A

= inverted before QRS, hidden w/in QRS, after QRS

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5
Q

w/ (PJC) Premature Junctional Contraction) 1Rules:

2CANNOT HAVE B/C:
3Compensatory pause
4Non-compensatory pause

A

1= rate by rhythm, usually slightly irregular, P waves are either inverted before, +after, or hidden w/in QRS
2=have upright P wave (up P= PAC)
3= keeps cadence
4= doesn’t keep cadence

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6
Q

AV pacing site defined by:

A

= P wave: 1 inverted before QRS, 2 hidden w/in QRS, 3 +/- after S

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7
Q

(AV pace impulses relation w/ P waves)Atriums fire 1st then ventricles:
Atriums & Ventricles fire at same time:
Ventricles fire 1st then atriums fire 2nd:

A

= inverted P wave before QRS
= P wave hidden w/in QRD
= P wave after QRS (before T wave)

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8
Q
  1. (Junctional rhythms) aka know by:
  2. Definer:
A

1= junctional escape: “pick up workload b/c something failed”
2= AV P waves & AV node rate 40-60BPM, Regular rhythm

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9
Q
  1. (Junctional rhythms) aka know by:
  2. Definer:
  3. S/S:
  4. Rules:
  5. Treatment:
A

1= junctional escape “pick up workload b/c something failed”
2= AV P waves & AV node rate 40-60BPM, Regular rhythm
3= Slow heart rate can decrease CO; angina
4= AV: Pace site, rate, & P-waves> regular rhythm, can have >PRI
5= O2 as needed, 15 Lead ECG, underlying cause (MI commonly), If signs poor perfusion, prepare for transcutaneous pacing (TCP)

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10
Q

(Junctional Bradycardia) 1. Remember:
2. Rules:
3. Etiology:
4. S/S
5. Treatment of Symptom Stable:
6. Treat of Symptom Unstable:

A

1= AV inherit firing rate 40-60 so <40BPM AV Brady
2= <40BPM, REG/ rhythm, AV P waves, QRS WNL but can be wide
3= +Vagal nerve tone, Patho/ slowing of SA node rate
4= Decreased HR: decreased CO, hypotension, angina, CNS S/S
5= “table” treat w/ Med admin/ of pos/ underlying cause (SBP >90)
6= (SBP<90 or AMS) “go straight 8 Cables!” PPM 60-80, Pace ASAP to increase pacing’s efficiency

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11
Q

(Atropine & Dopamine) 1. Med/ Admin/ for:
2. Atropine dosing:
3. Dopamine dosing:
(Symptomatic unstable) 4. S/S: go Cables! EX unconscious, RR<4,
5. Treatment:
Mili Amps MA (need to touch PT to feel pulse)
Pace ASAP to increase chance of pacing

A

1 = SBP greater than 90mmHg, “Stable to the table”
2= 1mg 3-5mins as needed (0.04mg/Kg (total 3mg)
3= “Real”2-5mcg, BC>5-10mcg/kg/min, Vaso-press> 10-20 mcg/kg/min
4= inadequate perfusion: hypoBP, AMS, etc)
5= “Straight 8 Cables!” PPM 60-80, (TCP)Transcutaneous Pacing ASAP

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12
Q

(Heart Blocks Raps) If the R is far from the P, then you have a:
Longer, longer, longer, drop, then you have a:
If some Ps don’t get through, then you have a:
If Ps and Qs don’t agree, then you have a:

A

= FIRST DEGREE!
= WENCKEBACH!
= MOBITZ II!
= THIRD DEGREE!

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13
Q

(Heart Blocks Raps) If the R is far from the P, then you have a:

A

FIRST DEGREE!

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14
Q

(Heart Blocks Raps) Longer, longer, longer, drop, then you have a

A

= WENCKEBACH!

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15
Q

(Heart Blocks Raps) If some Ps don’t get through, then you have a:

A

= MOBITZ II!

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16
Q

(Heart Blocks Raps) If Ps and Qs don’t agree, then you have a:

A

= THIRD DEGREE!

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17
Q

Systematic approach

A
  1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
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18
Q

Re-entry loops

A

= stuck in nascar loop in a chambers pathway causing SVT / no P waves

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19
Q

WPW) Orthodromic loop;
Antidromic loop:
Treatmeats:

A

= Clockwise reentry w/ narrow complex
= Counterclockwise reentry w/ wide QRS
= procainamide 1a Na blocker, (if no procain) sedate & cardiovert) cardioversion

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20
Q
  1. (Accelerated Junctional) Know by:
  2. Definer:
  3. Symptomology:
  4. Treatment:
A

1= “Baby Tachy” faster than 60 not faster than 100
2= 61-100BPM, (from SNS & AV firing), Regular rhythm, AV P waves
3= usually does not cause a PT to have symptoms
4= Be a investigator ,History/Physical ,O2 as needed , 15 Lead ECG

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21
Q
  1. (Accelerated Junctional) Know by:
  2. Definer:
A

1= “Baby Tachy” faster than 60 not faster than 100
2= 61-100BPM, (from SNS & AV firing), Regular rhythm, AV P waves

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22
Q
  1. (Junctional Tachycardia) Know by:
  2. Definer:
  3. Etiology:
  4. Rules:
  5. Symptomatology:
  6. Treatment:
A

1= “Tachy is Tachy”
2= >100BPM, AV P waves
3= +SNS response w/ AV site & Result of AV ischemia (rarely>150)
4= >100, AV P waves & Pacing, N. QRS, ~reg/rhythm, if PRI ~<.12secs
5= usually PT doesn’t has symptoms
6= invest/, Hx, O2 PRN, 15 Lead, monitor for other arrhythmias

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23
Q
  1. (Junctional Tachycardia) Know by:
  2. Definer:
A

1= “Tachy is Tachy”
2= >100BPM, AV P waves

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24
Q

Atrioventricular (AV) block:

A

Electrical impulse is slowed or blocked as it passes through AV node

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25
Q

AV block possible causes:

A

MI, (inferior RCA) AV ischemia and/or necrosis, Degenerative disease of conductive system, Drug toxicity (particularly digitalis)

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26
Q

Heart Blocks 4 Different Types) A.
B.
C.
D.

A

1st-Degree AV Block> add to rhythm “w/”
2nd-Degree Type I AV block (Mobitz I, or Wenckebach) rhythm
2nd-Degree Type 2 AV block (Mobitz 2 or intranodal)”2:1 block” rhythm
3rd-Degree AV Block aka “complete heart block” rhythm

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27
Q

2nd-Degree Type I AV block) names

A

Mobitz 1 or Wenckebach

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28
Q

Wenckebach) Sir name

A

2nd-Degree Type I AV block

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29
Q

2nd-Degree Type 2 AV block) names:

A

Mobitz 2 or intranodal AKA “2:1 block” rhythm

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30
Q

Intranodal/Mobitz 2) Sir name

A

2nd-Degree Type 2 AV block

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31
Q
  1. (1st Degree AV Block) know:
  2. Definer:
  3. Rap:
  4. Rules:
  5. Etiology:
  6. Cause:
  7. Symptoms:
  8. Treat:
A

1= “add to any rhythm” “gandolf slowly opening door(PRI)”
2= PRI: >than 0.20 seconds for every PRI & P-P cadence
3= “If the R is far from the P, then you have a FIRST DEGREE!”
4= BPM & rhythm is underlying rhythm, P Waves: Norm/ shape, PRI >0.20secs Pace-Site: SA or atria, QRS: Usually normal
5= Delay in AV node rather than actual block (increases PRI), Not a rhythm but a condition w/in another rhythm
6= Ischemia @ AV junction, MI/@AV, getting old, arteriosclerosis
7= PT usually don’t have symptoms
8= investigate, History/Physical, O2 as needed, 15 Lead ECG

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32
Q
  1. (1st Degree AV Block) know:
  2. Definer:
A

1= “add to any rhythm” “gandolf slowly opening door(PRI)”
2= PRI: >than 0.20 seconds for every PRI & P-P cadence

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33
Q
  1. (2nd Degree Type I) AKA & Know:
  2. Definer:
  3. Rap:
  4. Rules:
  5. Symptomology:
  6. Treatment:
A

1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down”
2= progressive longing PRI till drops beat then resets/starts over
3= “Longer, longer, longer, drop, then you have a WENCKEBACH!”
4= Rate: Variable, QRS rate will be slower than atrial rate Rhythm: Irregular P Waves: Normal but some P waves don’t have a QRS PRI: longing ‘til a QRS dropped Pace-Site: SA node or atria QRS: ~normal
5= Can compromise cardiac output, Syncope, angina, Commonly MI
6= O2 as needed, 15 Lead ECG, If signs of poor perfusion, prep for transcutaneous pacing only if brady.

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34
Q
  1. (2nd Degree Type I) AKA & Know:
  2. Definer:
A

1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down”
2= progressive longing PRI till drops beat then resets/starts over

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35
Q
  1. (2nd Degree Type II) AKA & know:
  2. Definer:
  3. Rap:
  4. Rules:
  5. Etiology:
  6. Symptomology:
  7. Treatment:
A

1= “Mobitz 2/Intranodal” & “random extra Ps”
2= some P’s w/o QRS & same PRI/No longing before drop beat
3= “If some Ps don’t get through, then you have a MOBITZ II!”
4= Rate P’s unaffected; QRS rate usually brady Ir/Reg/ Rhythm, P’s WNL but some w/o QRS, PRI Constant for conducted beats, Pace-Site SA node or atria, QRS WNL or wide
5= Intermittent block, Ps not conducted to ventricles via AV (Associate w/ acute MI & septal necrosis)“2-1 block” = 2 P’s before QRS
6= May comp/ CO, syncope, angina; May dev/ into complete AV-block
7= PT condition based: If signs of poor perfusion prep for trans/pacing

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36
Q
  1. (2nd Degree Type II) AKA & know:
  2. Definer:
A

1= “Mobitz 2/Intranodal” & “random extra Ps”
2= some P’s w/o QRS & same PRI/No longing before drop beat

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37
Q
  1. (3rd Degree AV Block) AKA & know
  2. Definer:
  3. Rap:
  4. Rules:
  5. Etiology:
  6. Symptomology:
  7. Treatment:
A

1= “Complete AV-Block/dissociation” (always TCPP on) “gandalf died”
2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)
3= “If Ps and Qs don’t agree, then you have a THIRD DEGREE!”
4= P’s unaffected; QRS rate usually brady Rhythm: Ps & QRSs WNL but don’t coincide w/ other Ps: Norm w/ no relation w/ QRS Pace-Site: SA node or atria for P’s; AV node or Ventricle for QRS, QRS WNL or wide
5= NO conduction w/in atria & ventricles, Complete electrical block @/ below AV node Acute MI, Digoxin toxicity, Degen/ of conductive system
6=May severely compromise CO
7= If signs of poor perfusion, prep for immediate TCP

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38
Q
  1. (3rd Degree AV Block) AKA & know
  2. Definer:
A

1= “Complete AV-Block/dissociation” (always TCPP on) “gandalf died”
2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)

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39
Q

only condition A-Fib has cadence:

A

Afib w/ 3rd degree In rhythm “Gandalf dead so Atriums & Ventricles doing own thing

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40
Q

(Adenosine) class:

Dynamics:

A

= Misc antiarrhythmic binds to adenosine A1 receptors causes efflux of K & inhibits Ca influx (in autoarhythmic cells)
= Causes hyperpolarization of autorhythmic cells (SA/AV node)
Slows AV conduction w/ very short half-life

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41
Q

(Adenosine) indications:

contraindications

A

= 1st for stable narrow complex SVT, Regular & monomorphic wide-complex Tcardia thought from a reentry SVT (SVT w/ BBB)
= Torsades de pointes, Poison/drug-Tcardia, 2nd or 3rd AVB, WPW,DOESNT CONVERT A-FIB/FLUTTER

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42
Q

(Adenosine) Effects:
Dose:

admin notes:

A

= periods of sinus Bcardia/asystole & ventricular ectopy after admin
= 1st dose 6mg rapid IV/IO push followed w/ rapid flush &2nd dose 12mg also rapid push & flush
= rapid push followed by rapid flush 20mL fluid best accomplished w/ 3-way stopcock & 1/2 initial dose in PTs receiving dipyridamole or carbamazepine, heart transplant, or if given by central venous access

43
Q

(Aspirin) Class:
Dynamics:

A

= NSAID & COX inhibiter
= Blocks cyclooxygenase (enzyme that’s basically alarm bell for body)
COX acts upon Arachidonic Acid which in turn gen/s Thromboxane A2, a compound that reg/s the activation of platelets to form a clot

44
Q

(Aspirin) indications:
Contraindications:

A

= Cardiac S/S w/ ischemia etiology
= common allergy, Bronchospasm, Angiodema

45
Q

(Aspirin) effects:
Avoid:
dose:

A

=Can cause bromchoconstriction in ~10% asthmatic PTs, N/V, upset GI
= enteric-coated Aspirin when admin/ing to PT w/ cardiac S/S
= 160-325mg PO of non-entric coated ASA

46
Q

(Atropine) class:
Dynamics:

A

= parasympatholytic
= selectively blocks muscarinic receptors inhibiting the parasympathetic NS “Vagus N. Blocker”- letting sympathetic take over

47
Q

(Atropine) indications:

Contraindications:
Avoid:

A

= 1st med/ for symptomatic sinus Bcardia, Maybe beneficial AV block, Organophosphate poisoning (large dose r/q) hypothermic Bcardia
= Allergic to drug, Use w/ extreme caution w/ myocardial ischemia
= causes increased myocardial O2 demand so caution w/ Hblock & Doses <0.5mg may result in paradoxical slowing of the heart
May not be effective for infranodal blocks- be prepared to pace

48
Q

(Atropine) Adverse effects:
Bradycardia (w/ or w/o ACS) Dosage:
severe clinical conditions dosage:
organophosphate poisoning dosage:

A

= Blurred vision, Dry mouth, Dilated pupils, Confusion
=1 mg IV push every 3-5mins as needed (0.04mg/Kg (total 3mg)
=1 mg IVP every 3 mins
= 2-4mg (or higher) IVP

49
Q

(Calcium Chloride) indications:

Contraindications:

A

= Hyper/o/kalemia, Treatment of affects by Ca Chanel blocker OD, HypoBP 2ndary to admin/ of Diltiazem
= cardiac arrest (Unless hyperkalemia suspected)PTs taking Digoxin w/ suspected calcium Chanel blocker OD

50
Q

(Calcium Chloride) effects:

Dose:
Hypotension following admin/ Diltiazem:

A

= Bcardia w/ rapid injection, May produce severe coronary spasm & asystole, Burning sensation @ site of admin/, PERCIPITATE w/ Na-Bicarb
= 0.5-1gram slow IV over 3-5mins
= 250-500mg

50
Q

(Calcium Chloride) indications:

Contraindications:

A

= Hyper/o/kalemia, Treatment of affects by Ca Chanel blocker OD, HypoBP 2ndary to admin/ of Diltiazem
= cardiac arrest (Unless hyperkalemia suspected)PTs taking Digoxin w/ suspected calcium Chanel blocker OD

50
Q

(Diltiazem/Cardizem)class:
pharmacodynamics:

A

= IV (4) antiarrhythmic Ca channel blocker
= slows auto arrhythmic cells AP in heart atriums by blocking Ca channels

51
Q

(Diltiazem/Cardizem)effects:
1st dose:
2nd dose:

A

= HypoBP, Pos/ CHF if used w/ beta-blockers , N/V/D, Dizziness, H/A
= 0.25mg/kg w/ max dose of 20mg
= 0.35 mg/kg w/ max dose of 25mg

51
Q

(Diltiazem/Cardizem)indi/s:

Contraindications:

A

= 1st med for AFib/Flutter w/ RVR (>150bpm), 2nd med for SVT refractory to Adenosine
= hypoBP, CHF/cardio/shock, Wide-complex Tcardia, WPW, Hypersensitivity

51
Q

(Labetalol) class:
pharmacodynamics:

A

= beta-blocker
= Blocks adrenergic stim/ on B-receptors, causing a slowing of HR

52
Q

(Procainamide) max dose:
Recurrent VF/VT:
Urgent situations:
Maintenance Infusion:

A

= (max total dose: 17mg/kg)
= 20mg/min (max total dose: 17mg/kg)
= up to 50mg/min may admin/ to total dose (max 17mg/kg)
= 1-4mg/min

52
Q

(Labetalol) Indications:

Contraindications:
Do not administer to PTs w/ STEMI if following present:

A

= 2nd med/ for SVT after admin/ Adenosine, A-Fib/Flutter w/ RVR Reduce myocardial ischemia in AMI PTs w/ +HRs, Antihypertensive
= Increased risk of cardiogenic shock Hypotension Bradycardia
= signs of heart failure Low cardiac output

53
Q

(Labetalol) Adverse Effects:

Max dose:
Adult Dose:

A

= admin/ after IV Ca-channel blockers can cause severe hypotension, Bcardia, heart blocks & CHF
= 150mg
= 10 mg IV/O push 1-2 mins & May repeat every 10 mins to max dose

53
Q

(Procainamide)class:
Dynamics:

A

= 1a antiarrhythmic
= Blocks Na channels in cardiac cells which causes depolarization to slow & decrease automaticity

53
Q

(Procainamide) indications:

Contra:

A

=V-Tach w/ pulse, Pre-excitation rhythms (WPW)
=Shouldn’t admin to PTs received IV Ca channel blocker

53
Q

Procainamide)effect:

4 ending points:

A

= Drowsy, Slurred speech, Confusion, Seizures, HypoBP
= 1. Termination of rhythm, 2. HypoBP, 3. Widening QRS>50%, 4. Meet the max total dose

54
Q

Natural pacemaker of the heart is:
If SA Node failed to initiate a impulse, what is 1st back-up firing site?
If both SA & AV fails what is last firing site:

A

= SA node
= AV node
= Purjunkie

55
Q

Ejection Fraction (EF):

<45% usually indicates:
<30%:

A

= Ratio of blood pumped from the ventricle to the amount remaining @ the end of diastole/ %of blood pumped out from ventricle (60-70%)
=<45% usually indicates in or going to CHF
=<30% in CHF & chronic cardiac crip on oxy

56
Q

!!Poiseuille’s law:

Example:

A

= vessel w/ relative radius of 1 would transport 1mL per min at BP difference of 100mmHg. Keep pressure constant
= Less blood = vaso-press

57
Q

Which coronary artery feeds the inferior wall of the heart?

A

Right Coronary Artery (RCA)

58
Q

Which coronary artery feeds the left lateral wall of the heart?

A

Left Circumflex (LCX)

59
Q

A blockage of which of the following would result in the entire left ventricle not receiving blood supply?

A

Left Main Coronary Artery (LMCA)

60
Q

Precordial “chest” leads:
V1 location:
V2 location:
V3 location:
V4 location:
V5 location:
V6 location:
V ”5” 8 location:
V ”6” 9 location:

A

=
= V1: 4th ICS R of sternum
= V2: 4th ICS L of sternum
= V3: ½ in between
= V4: 5th ICS mid-clavicularly
= V5: 5th ICS anter auxillary
= V6: mid auxillary
= V ”5” 8: 5th ICS mid scapular
= V ”6” 9: ½ between spine & midscapular

61
Q

Double hump P wave morphology:
Sharp P morph/:

A

= atrium ballooning & way dif
= Pulmonale from right atrium pulmonary

62
Q

(P wave) Limb leads amplitude:
Precordial “chest” leads amplitude:

A

= <2.5mm in limb leads Avl (2.5mV)
= <1.5mm in precordial (1.5mV)

63
Q

(T wave) Limb leads Amplitude:
Precordial “chest” leads amplitude:

A

= <5mm in LL
= <10mm in precordial

64
Q

1Lateral Wall high view:
2Left Lateral low view:
3Inferior wall view:
4Septal wall view:
5L-Anterior view:

A

1= Lead I & aVL= LA
2= Lead 1, aVL, V5 & V6: views LCX & LAD
3= 2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs
4= V1 & V2: Along sternal borders blockages from LAD commonly
5= V3 & V4: left anterior wall : LAD & LMCA blocks

65
Q

Class IV Antiarrhythmic of Vaughan-Williams Class is:
Class I Antiarrhythmic of Vaughan-Williams Class is:
Class III Antiarrhythmic of Vaughan-Williams Class is:
Class II Antiarrhythmic of Vaughan-Williams Class is:

A

= Calcium channel blocker
= Sodium channel blocker
= Potassium channel blocker
= Beta-Blocker

66
Q

When obtaining a 12 lead ECG, where do you place V2?
When obtaining a 12 lead ECG, where do you place V5?
When obtaining a 12 lead ECG, where do you place V6?
When obtaining a 12 lead ECG, where do you place V3?
When obtaining a 12 lead ECG, where do you place V1?
When obtaining a 12 lead ECG, where do you place V4?
When obtaining a 15 lead ECG, where do you place V4R?

A

= 4th ICS just left of Sternum
= Left 5th ICS anterior of auxiliary
= 5th ICS midaxillary
= ½ in between V2 & V4
= Right of Sternum 4th ICS
= 5th ICS left Midclavicular
= Right ICS midclavicular

67
Q

Widowmaker :

A

clot in left coronary artery wiping out L side

68
Q

Ectopic

A

Not the normal

69
Q

Leads V1 and V2 look at what part of the heart?

A

Septal

70
Q

Leads V3 and V4 look at what part of the heart?

A

Anterior

71
Q

Leads II, III and aVF look at what part of the heart?

A

Inferior

72
Q

An ECG rhythm that presents with a rate of 70 beats per minute, has an irregular cadence, a normal looking P wave but the PRI progressively gets longer until a QRS complex is dropped is classified as a:

A

Wenckebach

73
Q

Initial dose of Adenosine for SVT:
2nd dose of Adenosine for SVT:

A

= 6 mg given rapid IV push, followed with a 20 mL flush.
= 12 mg given rapid IV push, followed with a 20 mL flush.

74
Q

Premature ectopic beat presents w/ a inverted P wave & narrow QRS:
Premature ectopic beat presents w/ an upright P wave & narrow QRS:

A

= Premature Junctional Contraction (PJC)
= Premature Atrial Contraction (PAC)

74
Q

An ECG rhythm that presents with P waves and QRS complexes that don’t appear to coincide with each other is classified as a:

A

3rd Degree AV block

75
Q

The upward slurring of the isoelectric line after the P wave up into the QRS complex that is associated with Wolff Parkinson White Syndrome (WPW) is known as the:
The accessory pathway associated with Wolff Parkinson White Syndrome (WPW) is known as the:

A

= Delta wave
= Bundle of Kent

76
Q

Typically, we don’t attempt to control the rate of Atrial Fibrillation unless it is

A

above 150 per minute and the patient is presenting with signs and symptoms related to the rhythm.

77
Q

A junctional escape rhythm would present with a ventricular rate between
An accelerated junctional escape rhythm would present with a ventricular rate between

A

= 40 & 60 beats per minute.
= 61 & 100 beats per minute.

78
Q

Initial dose of Diltiazem for the control of Atrial-Fib w/ RVR is:
ECG rhythm that presents w/ a ventricular rate of 170-190 beats per minute, has a totally irregular cadence, has no discernible P waves, and has narrow QRS complexes is classified as:

A

= 0.25 mg/kg with a max dose of 20 mg.
= A-Fib with RVR

79
Q

ECG rhythm presents w/ rate of 30-50BPM, totally irregular cadence, has no discernible P waves, narrow QRSs is classified as:

A

A-Fib with SVR

79
Q

An ECG rhythm that presents with a ventricular rate of 80-100 beats per minute, has a totally irregular cadence, has no discernible P waves, and has narrow QRS complexes is classified as:

A

Controlled A-Fib w/ RVR

79
Q

Supraventricular tachycardia will have a heart rate of:
ECG presents w/ rate of 200BPM, reg/ cadence, no visible P waves, narrow QRSs is classified as:

A

= at least 150 beats per minute.
= Supraventricular Tachycardia

80
Q

if the R is far from the P, then you have a:

A

1st Degree

80
Q

ECG rhythm presents w/ rate 80 BPM, reg/ cadence, norm/ shaped P wave, a prolonged but constant PRI, & norm/ QRS is classified as as:

A

Sinus with 1st Degree

81
Q

If SA node for some reason stops firing, what should be 1st back-up firing system?

A

AV Node

82
Q

A junctional tachycardia rhythm would present with a ventricular rate

A

greater than 80 beats per minute.

83
Q

A junctional bradycardia rhythm would present with a ventricular rate

A

less than 40 beats per minute.

84
Q

if some Ps don’t get through, then you have a:

A

Mobitz 2

84
Q

ECG rhythm presents w/ a ventricular rate of 80 BPM, reg/ cadence, saw-tooth waves in place of P waves, & narrow QRSs is classified as:

A

Atrial Flutter

85
Q

Sinus bradycardia rhythm would present w/ a ventricular rate less than:
Sinus tachycardia rhythm would present with a ventricular rate:

A

= 60 beats per minute
= greater than 100 beats per minute

86
Q

ECG rhythm presents w/ rate 110 BPM, slightly irregular cadence, & P waves that have three or more different morphologies is classified as:

A

Multifocal Atrial Tachycardia

87
Q

ECG rhythm presents w/ a rate of 40BPM, reg/ cadence, normal looking Ps, normal PRI for the P waves that have a QRS following, but has some P waves that don’t have a QRS after it is classified as a:

A

2nd Degree Type II / Mobitz 2

88
Q

if Ps and Qs don’t agree, then you have a

A

3rd degree

89
Q

(Verapamil) class:
pharmacodynamics:

A

= IV antiarrhythmic Ca channel blocker
= Slows AP of autorhythmic cells in heart by blocking Ca channels

90
Q

(Verapamil) indications:

Contraindications:

A

= 2nd med for A-Fib/Flutter w/ RVR, May use as alterative med (after adenosine), narrow QRS complex Tcardia w/ preserved LV function
= HypoBP (SBP<90), CHF/cardio/ shock, Wide-complex Tcardia, WPW
Hypersensitivity to med

91
Q

(Verapamil)1.May cause:
2. Effects:
3. Max total dose:
4. 1st dose:
5. 2nd dose:

A

1.= more profound hypotension response than that of Diltiazem
2.= Severe CHF may result if used w/ beta-blocker, N/V/D, Dizziness, H/A
3.= 20mg
4.=2.5-5mg IV/O bolus 2-3min
5.= 5-10mg over 2-3 mins

Cardiology (20 decks)

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