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MEDS > ARITMIA > Flashcards

ARITMIA Flashcards

1
Q

Etiologi umum aritmia

A

Vaskular
Infeksi
Trauma
Autoimun (SLE, RA, thyroid)
Metabolik (DM, Elektrolit)
Idiopatik
Neoplasma

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2
Q

mekanisme aritmia

A

peningkatan otomatisitas sel pembentuk impuls maupun sel bukan pembentuk impuls

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3
Q

klasifikasi

A
  1. Takiaritmi / bradiaritmi
    - Takiaritmi : qrs sempit atau lebar
    - Bradiaritmi : gangguan pembentukan impuls atau konduksi impuls
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4
Q

contoh takiaritmi qrs sempit

A

regular : sinus aritmia, svt, aFlut
irregular : aFib, aFlut

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5
Q

contoh takiaritmi qrs lebar

A

VES, VT, VF

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6
Q

contoh bradiaritmi gangguan pembentukan impuls

A

Sinus arrest, sinus bradikardi

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7
Q

contoh bradiartimi gangguan konduksi impuls

A

AV block, sinus exit block

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8
Q

frekuensi aFib

A

300-600x/min

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9
Q

FR aFib

A

pemicu :
- VHD
- CHF
- CAD
- COR PULMONALE
- DM, OBESE, HT, DEGENERATION

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10
Q

klasifikasi EHRA AF

A

EHRA
1. none
2. mild
a. normal daily activity not affected
b. normal daily activity not affected but patient troubled by symptoms
3. severe (normal daily activity affected)
4. disabling (normal daily activity discontinuing)
symptoms : fatigue, shortness of breath, palpitations, chest pain (FSPC)

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11
Q

klasifikasi af berdasarkan
1. waktu
2. etiologi
3. penyakit katup
4. respon ventrikel

A
  1. pertama kali, paroksismal <48 jam <7 hari, persisten >7 hari, persisten lama >1 tahun, permanen
  2. lone AF, sekunder
  3. valvular non valvular
  4. RVR, NVR, SVR
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12
Q

kapan cardioversi dipakai pada AF?

A

jika < 48 jam dan belum mendapat antikoagulan, maka beri
jika >48 jam cek echo untuk melihat ada thrombus

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13
Q

PP untuk aFib

A
  1. hem rutin
  2. ECG
  3. Echo
  4. elektrolit
  5. fungsi ginjal
  6. D-dimer
  7. cardiac marker
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14
Q

pertimbangan pemberian antikoagulan pada AF

A
  1. adanya kelainan katup
    - ya, antagonis vit K : warfarin
    - tidak, cek skor HASBLED, CHAD2 VASC2
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15
Q

HAS-BLED

A

HYPERTENSION >160 - 1
ABNORMAL LIVER/KIDNEY FUNCTION bilirubin>2x PT>3x - 1/2
STROKE - 1
BLEEDING - 1
LABILE INR - 1
ELDERLY >65 - 1
DRUGS/ALCOHOL 1/2
0-1 low, 2 intermediate, 3-9 high

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16
Q

Terapi jangka panjang AF

A
  1. Kontrol laju : beta blocker
    bisoprolol 2x2,5-10, diltiazem 1x60-360mg, verapamil 1x40-360mg, digoxin 1x0,125-0,25
  2. kontrol irama : amiodarone 3x200mg
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17
Q

Aflut mekanisme

A

macroreentry pada jalur panjang dan lambat

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18
Q

tanda ecg aflut

A

flutter wave - saw tooth appearance

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19
Q

jenis SVT

A

AVNRT - disekitar av node
AVRT - diantara atrial dan ventrikel

20
Q

gambaran ecg AVNRT

A

tidak ada P atau P retrograde di II, III, AVF

21
Q

gambaran ecg AVRT

A

delta wave

22
Q

tatalaksana akut SVT

A

vagal maneuver pada mata atau karotis
adenosine IV
CCB

23
Q

VES yang berbahaya

A

R on T
Torsades de Point
Couplet
Multifokal

24
Q

penyebab VES

A

b agonis, kafein, hipokalemia, toksisitas digoxin, MI

25
Q

gambaran ecg VES

A

QRS lebar
prematur
T berlawanan

26
Q

Lokasi kelainan VT

A

bifurcatio serabut his, otot ventrikel, atau keduanya

27
Q

mekanisme VT

A

peningkatan otomatisasi dan reentry

28
Q

diagnosis VT

A

3 gel VES berurutan

29
Q

sustained dan non sustained VT

A

sustained >30 detik

30
Q

Gambaran ECG VF

A

QRS lebar
P tidak teridentifikasi
amplitude iregular

31
Q

dosis amiodaron

A

150mg IV dalam 10 menit lanjut maintenance 1mg/menit selama 6 jam max 2,2 gram

32
Q

dosis digoksin

A

4-6 microgram dalam 5 menit

33
Q

dosis verapamil

A

2-2,5mg dalam 15 menit lanjut 5-10 mg total 20mg

34
Q

dosis diltiazem

A

15-20mg dalam 15 menit lanjut 20-25mg maintenance 5-15mg/jam

35
Q

dosis lidokain

A

1-1,5mg/kg maintenance 30-50microgram/kg/menit

36
Q

dosis adenosin

A

6mg IV flush NS
dosis 2 : 12 mg
dosis 3 : 12 mg

37
Q

obat utama bradiaritmi

A

atropin

38
Q

dosis atropin

A

0,5mg max diulang 6 kali tiap 5 menit

39
Q

dosis epinefrin

A

2-10mcg/kg/menit

40
Q

dosis dopamin

A

2-20mcg/kg/menit

41
Q

kapan pakaipacemaker sub kutan

A

kalau ada av blok 2-2 atau total

42
Q

tatalaksana ROSC awal

A

Airway : pasang ETT
Breathing : pertahankan FiO2 92-98%, RR 10xmenit, PaCO2 35-45mmHg
Circulation : Sistolik >90mmHg, MAP >65mmHg

43
Q

tatalaksana ROSC setelah ABC

A

ECG 12 LEAD

44
Q

tatalaksana ROSC setelah ecg 12 lead

A

cek STEMI, cardiogenic shock, atau butuh intervensi jantung mekanis

45
Q

tatalaksana ROSC setelah cek STEMI dll

A

cek pasien sadar atau tidak
apabila pasien sadar cari etiologi lainnya
apabila pasien tidak sadar
- TTM 32-36 C
- cek suhu rutin rektal, esophageal, kemih
- pertahankan euglikemi, normoxia, normokapnia
- patenkan jalan nafas

MEDS (7 decks)

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