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Apex > 6 Rhythms > Flashcards

6 Rhythms Flashcards

1
Q

Anterior, middle, and posterior intermodal tracts

A

Bachman, wenkebach, and thorel

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2
Q

Slow, intermediate, and fast conductions in cardiac pathway

A

SA+AV (slow), myocardial muscle (intermediate), HIS/BB/purkinje (fast)

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3
Q

Conduction velocity is a func of: 3

A

RMP, AP amplitude, rate of change in potential in phase 0

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4
Q

Accessory pathway connection: James fiber, atrio hisian fiber

A

Atria to AV, atria to his

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5
Q

Accessory pathway connection: Kent’s bundle, mahaim bundle

A

Atrium to ventricle, AV node to ventricle

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6
Q

Ventricle: phase 0-4 with electrical event

A

0-depolarization, 1-initial repol, 2-plateau/ST, 3-final repol, 4-resting

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7
Q

Ventricle: ion movement phase 0-4

A

0-Na in, 1- cl in and K out, 2- ca in k out, 3- k out, 4- na out

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8
Q

Event that leads to: pr depression, ST elev

A

Pericarditis. High k or endocarditis

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9
Q

Q wave abn that may make you think MI: 3

A

Amp grater than 1/3 of R wave, lasts > 0.04 sec, Depth >1 mm

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10
Q

T wave pts opposite direction of QRS if what: 2

A

Myo ischemia or BBB

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11
Q

T wave may be peaked with: 3

A

Myo ischemia, high K, IC bleed

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12
Q

U wave >1.5 mm when what

A

Low K

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13
Q

K too high can lead to what changes 7 (early to late)

A

Narrow/peaked T, short QT, wide QRS, low p amplitude, wide PR, nodal block, fusion of QRS-T—> VF/asystole

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14
Q

Low K leads to: 4

A

U wave, ST dep, flat T, long QT interval

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15
Q

High hi or low ca affects ekg

A

Hi- short QT, low- long QT

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16
Q

How hi or low mg affects ekg

A

Only if very hi —> heart block/arrest. Only if very low —> long QT

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17
Q

Vector of depolarization in heart

A

Base to apex and endo to epicardium

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18
Q

Vector of repolarization

A

Apex to base and epi to endocardium

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19
Q

Lateral leads and coronary artery

A

I, avl, V5-6. Circumflex

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20
Q

Inferior leads and artery

A

II, III, avf, RCA

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21
Q

Septal leads and artery

A

V1-2, LAD

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22
Q

Anterior leads and artery

A

V3-4, LAD

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23
Q

Right axis deviation

A

Leads reaching towards each other (I down Avf up)

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24
Q

Left axis deviation

A

Leads leaving each other (I up avf down)

25
Q

Extreme right axis deviation

A

I and avf point down

26
Q

Normal I and avf axis

A

Both point up

27
Q

Normal axis between __ and __. L axis dev more neg than __, R axis dev more pos than

A

-30 to 90. -30, 90.

28
Q

Causes of r axis dev: 5

A

COPD, acute bronchospasm, cor pulmonale, pulm htn, PE

29
Q

Causes of L axis deviation: 6

A

Chronic htn, L BBB, AS, AI, mitral regurg

30
Q

Sinus arrythmia

A

Inhalation —> dec intra p —> inc venous ret —> inc hr. Exhale —> inc intra p —> dec venous return —> dec hr

31
Q

Brugada syndrome

A

Na ion channelopathy. Can cause sudden nocturnal death d/t v tach or fib

32
Q

Second degree type I block

A

Wenkebach, longer longer drop. In AV node

33
Q

Second degree type 2 block

A

Some ps dont conduct to ventricle. His or bundle branches

34
Q

Third degree HB

A

AV dissociation. In av node rate 45-55, below av node 30-40.

35
Q

IA, IB, IC where they work/how

A

A- dep phase 0, prolong phase 3. B- weak dep phase 0, shortens phase 3. C- strong 0 dep, little phase 3 fx

36
Q

Where class II blockers work

A

Slows phase 4 depol in SA node

37
Q

Where phase III blockers work

A

K channels, prolongs phase 3 repol, inc QT, inc refractory period

38
Q

How phase IV blockers work

A

Dec velocity through AV node

39
Q

When adenosine works and doesnt work

A

Works in SVT or WPW w narrow QRS. Doesn’t work in a fib, a flutter, or v tach.

40
Q

How wpw works

A

No delay between atria and ventricle impulse, shorter refractory period

41
Q

Orthodromic anvrt: incidence, pathway

A

More common, a—>av—>ventricle—>accessory path—>atrium

42
Q

Orthodromic anvrt: QRS, tx

A

Narrow. Inc av node refractory period: vagal, amio, adenosine, bb, verapamil, cardiovert

43
Q

Antidromic anvrt: incidence, pathway

A

Less common. Atrium, accessory, ventricle, av node, atrium

44
Q

Antidromic anvrt: QRS morphology, tx

A

Wide. His purkinje bypassed. Block conduc pathway: procainamide, amio, cardiovert. DONT give agents that inc the refractory period of av node

45
Q

Drugs to avoid in antidromic anvrt: 5

A

Adenosine, dig, ccb, bb, lidocaine

46
Q

DOC in afib w wpw. Consid in radiofreq ablation

A

Procainamide. Monitor esophageal temp

47
Q

Drugs that prolong QTc

A

Methadone, droperidol, haldol, zofran, halogenated IAs, amio, quinidine

48
Q

Syndromes that prolong qtc, misc causes of inc qtc 3.

A

Romano ward and Timothy syndromes. HOCM, SAH, bradycardia

49
Q

Pacers: positions 1, 2, 3, 4, 5

A

Chamber paced, chamber sensed, response, programmability, pacer can program multiple sites

50
Q

how cautery affects pacer: which mode causes more Emi

A

Coag more than cutting

51
Q

Conditions that make myo more resistant to repolarization

A

Low/hi k, low co2 (k into cell), low temp, mi, fibrosis around leads, antiarrythmic meds

52
Q

Pacer/icd: ___ contraindicated but __ not

A

MRI. Lithotripsy

53
Q

Reflex that mediates sinus arrythmia

A

Bainbridge

54
Q

Glucagon initial dose and drip rate for bradycardia

A

50-70 mcg/kg q5 min then 2-10 mg/hr

55
Q

Bipolar lead that is always positive, one that is always negative

A

I/right arm always negative, II left leg always positive

56
Q

Part of ekg that is absolute vs relative refractory period

A

Absolute= first 1/3 t. Relative= last 2/3.

57
Q

Causes of first degree hb 5

A

Aging, posterior wall mi, pns stim, amio, dig

58
Q

Best lead to visualize the p wave

A

Lead II

59
Q

Adenosine is best tx for

A

SVT

Apex (21 decks)

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