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CP-1 > Abnormal EKGs > Flashcards

Abnormal EKGs Flashcards

1
Q

What is ventricular tachycardia?

A

a run of 3 or more PVC

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2
Q

What is atrial trigeminy?

A

premature atrial beat after end of 2 normal cycles, repeatedly

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3
Q

What foci in the heart are good at sensing low O2?

A

ventricular automaticity foci

this can be caused by poor coronary blood supply! (MI)

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4
Q

What is aberrant ventricular conduction and when do you see it?

A

slightly widened QRS wave seen after a premature atrial beat

bc one of the bundle branches is not completely repolarized; temporarily refractory to depolarization

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5
Q

What type of murmur is associated with runs of VT and PVCs, yet is considered benign?

A

mitral valve prolapse

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6
Q

What is PAT and what does it look like?

A

paroxysmal atrial tachycardia

150-250 bpm w/ P’ waves that don’t look normal w/ normal QRS waves following

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7
Q

What will you see on an EKG in a junctional escape rhythm?

A

rate of 40-60 bpm
will see series of lone QRS complexes
can see retrograde inverted P’ waves immediately before QRS, after QRS, or buried w/in each QRS

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8
Q

What is escape rhythm?

A

automaticity focus escapes overdrive suppression to pace at its inherent rate:
atrial escape rhythm
junctional escape rhythm
ventricular escape rhythm

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9
Q

What is a PVC and what does it look like?

A

irritable ventricular focus (usually caused by hypoxia/ischemia) may suddenly fire
will see very wide and tall QRSs that are opposite normal polarity
pause after PVC, but not caused by resetting

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10
Q

What can make an atrial or junctional focus irritable?

A 
adrenaline
increased sympathetic stimulation
excess digitalis, some toxins, ethanol
hyperthyroidism
stretch
to some extent low O2
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11
Q

What rate range is paroxysmal tachycardia?
flutter?
fibrillation?

A

150-250
250-350
350-450

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12
Q

What happens in sinus arrest?

A

SA node ceases pacing –> automaticity focus will escape and take over –> escape rhythm

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13
Q

What disease do you see multifocal atrial tachycardia in?

A

COPD

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14
Q

What is R on T phenomenon?

A

when a PVC hits on a T wave –> dangerous arrhythmias

occurs in hypoxia or low potassium

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15
Q

What is a junctional escape rhythm?

A

sinus arrest or block in proximal end of AV node–> auto focus in AV junction becomes active pacemaker –> junctional escape rhythm of 40-60 bpm

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16
Q

What is junctional bigeminy?

Junctional trigeminy?

A

premature junctional beat after one normal cycle, repeatedly

premature junctional beat after two normal cycles, repeatedly

17
Q

What would you see in a non-conducted premature atrial beat?

A

too-early, unusual P’ wave that has no QRS-T response

18
Q

What is sinus arrhythmia?

A

normal physiological mechanism; will see identical, normal P waves, with rate that gradually increases and gradually decreases

19
Q

What is a premature junctional beat and what does it look like?

A

irritable automaticity focus in AV junction suddenly fires prematurely
will see early p wave and a widened QRS = aberrant ventricular conduction
can see inverted P’ waves before or after QRS

20
Q

What does a premature atrial beat look like?

A

will see early P’ wave that looks different –> normal QRS

too-tall T wave

21
Q

What is mobitz type II second-degree AV block?

A

lower down that mobitz type I/wenkebach

will see that intermittent non-conducting P waves, but no lengthened PR complexes before or after (kinda random)

22
Q

What is stokes-adams syndrome?

A

total failure of SA node and all foci above ventricles –> have ventricular escape rhythm that is so slow you get syncope and have to monitor pt’s airway

23
Q

What characterizes atrial fibrillation?

A

continuous rapid-firing of multiple atrial automaticity foci –> also see irregular QRS bc only random atrial depolarizations will reach the ventricles

24
Q

Why are ventricular escape beats not so uncommon?

A

parasympathetic innervation inhibits SA node, atrial, and junctional foci –> burst of excessive PS activity can depress them all too much –> ventricular foci will make an escape beat

25
Q

What does parasystolic mean?

A

when an automaticity focus has entrance block –> insensitive to passive depolarization but has own inherent pattern that can’t be overdrive-suppressed

26
Q

What is second-degree AV Wenckebach (mobitz type I) block?

A

PR intervals become progressively longer until one QRS complex is dropped
block is higher up than mobitz type II block

27
Q

What do frequent unifocal PVCs indicate?

A

poor oxygenation of a single ventricular focus

28
Q

How many PVCs is considered pathological?

A

6 or more per minute

29
Q

What happens in sinus block?

A

SA node misses one pacing cycle –> transient pause –> escape beat by an automaticity focus

30
Q

What is atrial bigeminy?

A

premature atrial beat after end of one normal cycle, repeatedly

31
Q

What characterizes multifocal atrial tachycardia?

A

arrhythmia of COPD, see HR over 100 bpm; each individual atrial focus paces at its own inherent rate –> rapid, irregular rhythm

32
Q

What occurs to create a ventricular escape rhythm?

A

conduction block high in ventricle, but below AV node –> ventricular focus escapes to pace at 20-40 bpm

33
Q

What is an escape beat?

A

automaticity focus transiently escapes overdrive suppression to emit one beat
atrial, junctional, or ventricular

34
Q

What is Ventricular parasystole and what does it look like?

A

a ventricular auto focus has entrance block –> paces at its own inherent rate
will see a PVC coupled to a long series of normal cycles (essentially 2 rhythms, one from SA node, one from spot in ventricle)

35
Q

What is wandering pacemaker?

A

irregular rhythm produced by the pacemaker activity wandering from SA node to nearby atrial automaticity foci –> cycle length and P wave shape variation

36
Q

What are multifocal PVCs caused by and what do they look like?

A

caused by severe hypoxia in multiple ventricular foci –> see diff looking PVCs at diff rates
This is very serious!

CP-1 (32 decks)

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