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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
Q

Class 4 anti-arrhythmics
Action
Use
Example

A

Ca+ channel blockers
Rate limiting CCBs (depress phase 4)
SVT (not WPW)
Verapamil/Diltiazem

26
Q

How does Digoxin work, what is its use?

A 
Positive Ionotrope (more Ca+ available)
HF and AF
27
Q

What are the signs of Digoxin toxicity?

A

Nausea
Xanthopsia
Brady/tachycardia
Arrhythmias

28
Q

Treatment for Digoxin toxicity, when is it more serious?

A

Digibind

Low potassium

29
Q

What is amiodarone used for?

A

SVT, Vtach

30
Q

Signs of amiodarone toxicity

A

Slate-gray pigmentation

Thyroid

31
Q

Which drug is used to treat paroxysmal supraventricular tachycardia?

A

Adenosine

Veramapil

32
Q

Indications for anticoagulation

A 
Afib
Venous thromboembolism
Valvular heart disease
Post-surgery
Immobility
33
Q

When is Warfarin indicated?

A

AF

Mechanical valves

34
Q

What does Warfarin inhibit?

A

Vitamin K epoxide reductase (clotting factors)

35
Q

How can Warfarin activity be increased?

A

Decreased albumin binding
Inhibition of degradation
Decreased clotting factor synthesis

36
Q

How can bleeding be promoted?

A

Inhibition of clotting factors

Inhibition fo platelets

37
Q

Which drugs decrease warfarin activity?

A

Induction of metabolising enzymes

Promoting clotting factor synthesis

38
Q

Why is heparin given before warfarin?

A

Warfarin has a slow onset of action

39
Q

How is Warfarin therapy monitored?

A

INR
Normal: 1
Therapeutic: 2.5-4
Alcohol intake

40
Q

Side effects of warfarin?

A

Bleeding

Teratogenic

41
Q

Score used to assess bleeding risk on warfarin?

A 
CHADS
Congestive heart failure
Hypertension
Age>75
Diabetes Mellitus
Stroke
42
Q

Which drugs are used other than warfarin?

A

Dabigatran
Rivaroxaban
Aspirin

43
Q

When is digoxin indicated?

A

SVT Afib

HF caused by AFib

44
Q

When is digoxin contraindicated?

A

Heart block (complete, 2nd degree)
WPW
Hypertrophic cardiomyopathy

45
Q

When is adenosine indicated?

A

Immediate termination of SVT/diagnosis

46
Q

When are beta blockers indicated?

A

Angina
Tachyarrhythmias
Hypertension
Heart Failure

Systems 1 (25 decks)

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