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Systems 1 > Arrhythmia > Flashcards

Arrhythmia Flashcards

1
Q

Arrhythmia presentations

A

Asymptomatic
Palpitations, dyspnoea, chest pain, fatigue
Embolism

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2
Q

Investigation for arrhythmia

A

12 lead ECG - 24hrs
Blood tests - thyroid
Echo

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3
Q

Supraventricular tachycardia is caused by what?

A

AV nodal re-entry

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4
Q

WPW syndrome is caused by what?

A

overt Accessory pathway

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5
Q

WPW treated how?

A

Radiofrequency ablation

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6
Q

Management of atrial flutter

A

Control Thromboembolism risk
Rate control
Cardiovert

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7
Q

Symptoms of Vtach

A

Palpitations
Dyspnoea
Dizziness
Syncope

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8
Q

Torsades de Pointes is caused by what? Presents as what?

A 
Prolonged repolarisation (long QT)
Short-long-short RR interval
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9
Q

Indications for ICD?

A

Cardiac arrest due to VF/VT (not MI)

Sustained VT

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10
Q

How does 1st degree heart block appear on ECG?

A

Long PR interval

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11
Q

How does 2nd degree type 1 heart block appear on ECG?

A

PR interval gets longer until one is missed

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12
Q

How does 2nd degree type 2 heart block appear on ECG?

A

Consistent P-P interval, consistently missing a QRS complex every few P waves

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13
Q

How does 3rd degree heart block appear on ECG?

A

P wave regular but no relation between it and QRS complexes

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14
Q

Indications for temporary pacing

A

Intermittent/sustained bradycardia
High risk of severe bradycardia
(anterior MI, 2nd/3rd AV block)

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15
Q

Indications for permanent pacing

A

Profound AV block/associated with neuro
After AV ablation
Alternating R/LBBB
Sinus node disease with symptoms

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16
Q

3 types of arrhythmia

A

Sinus
Supraventricular
Ventricular

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17
Q

Which energy-requiring pump maintains resting membrane potential?

A

Na+/K+ ATPase

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18
Q

What classification is used for arrhythmia medications?

A 
Vaughan-Williams
1a/b/c
2
3
4
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19
Q

What are class 1 arrhythmia drugs?

A

Membrane stabilising drugs, blocking sodium channels

20
Q

Class 1a arrhythmia drugs
Action
Use
Example

A

Moderate Na+ channel blocker
Delay repolarisation/increase AP duration
Afib, premature contractions, Vtach, WPW
Disopyramide

21
Q

Class 1b arrhythmia drugs
Action
Use
Example

A

Weak Na+ channel blocker
Accelerate repolarisation/decrease AP
Use for Vtach/fib
Lidocaine

22
Q

Class 1c arrhythmia drugs
Action
Use
Example

A

Strong Na+ channel blockers
Severe ventricular dysrhythmias
Atrial flutter/fibrillation
Flecainide

23
Q

Class 2 anti-arrhythmics
Action
Use
Example

A

Beta blockers
Reduce sympathetic stimulation (depress phase 4 stimulation)
Dysrhythmias
Bisprolol in Afib

24
Q

Class 3 anti-arrhythmics
Action
Use
Example

A

K+ channel blockers
Increase AP
Difficult/severe dysrhythmias
Amiodarone

25
Class 4 anti-arrhythmics Action Use Example
Ca+ channel blockers Rate limiting CCBs (depress phase 4) SVT (not WPW) Verapamil/Diltiazem
26
How does Digoxin work, what is its use?
``` Positive Ionotrope (more Ca+ available) HF and AF ```
27
What are the signs of Digoxin toxicity?
Nausea Xanthopsia Brady/tachycardia Arrhythmias
28
Treatment for Digoxin toxicity, when is it more serious?
Digibind | Low potassium
29
What is amiodarone used for?
SVT, Vtach
30
Signs of amiodarone toxicity
Slate-gray pigmentation | Thyroid
31
Which drug is used to treat paroxysmal supraventricular tachycardia?
Adenosine | Veramapil
32
Indications for anticoagulation
``` Afib Venous thromboembolism Valvular heart disease Post-surgery Immobility ```
33
When is Warfarin indicated?
AF | Mechanical valves
34
What does Warfarin inhibit?
Vitamin K epoxide reductase (clotting factors)
35
How can Warfarin activity be increased?
Decreased albumin binding Inhibition of degradation Decreased clotting factor synthesis
36
How can bleeding be promoted?
Inhibition of clotting factors | Inhibition fo platelets
37
Which drugs decrease warfarin activity?
Induction of metabolising enzymes | Promoting clotting factor synthesis
38
Why is heparin given before warfarin?
Warfarin has a slow onset of action
39
How is Warfarin therapy monitored?
INR Normal: 1 Therapeutic: 2.5-4 Alcohol intake
40
Side effects of warfarin?
Bleeding | Teratogenic
41
Score used to assess bleeding risk on warfarin?
``` CHADS Congestive heart failure Hypertension Age>75 Diabetes Mellitus Stroke ```
42
Which drugs are used other than warfarin?
Dabigatran Rivaroxaban Aspirin
43
When is digoxin indicated?
SVT Afib | HF caused by AFib
44
When is digoxin contraindicated?
Heart block (complete, 2nd degree) WPW Hypertrophic cardiomyopathy
45
When is adenosine indicated?
Immediate termination of SVT/diagnosis
46
When are beta blockers indicated?
Angina Tachyarrhythmias Hypertension Heart Failure

Systems 1 (25 decks)

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