Arrhythmia's

Question 1

2 shockable rhythms

Answer 1

ventricular tachycardia

ventricular fibrillation

Question 2

2 non-shockable rhythms

Answer 2

pulseless electrical activity

asystole

Question 3

treating supraventricular tachycardias

Answer 3

continuous ECG
carotid sinus massage
valsava manouevres 
adenosine
DC cardioversion

Question 4

treating ventricular tachycardia

Answer 4

amiodarone

Question 5

atrial flutter

Answer 5

re-entrant rhythm in either atrium
electrical signal re-circulates in self-perpetuating loop
300bpm

Question 6

atrial flutter on ECG

Answer 6

sawtooth appearance

p wave after p wave

Question 7

atrial flutter associated conditions

Answer 7

hypertension
IHD
cardiomyopathy
thyrotoxicosis

Question 8

treating atrial flutter

Answer 8

beta blockers/cardioversion
treat underlying cause
radiofrequency ablation
anticoagulation

Question 9

what causes SVT?

Answer 9

electrical signal re-enter atria from ventricles

narrow complex tachycardia

Question 10

3 main types of SVT

Answer 10

AV node re-entrant
Atrioventricular re-entrant (Wolff-parkinson-white) accessory pathway
atrial tachycardia - atria other that SAN

Question 11

Adenosine

Answer 11

slows cardiac conduction through AVN/accessory pathway

brief asystole/bradycardia

Question 12

WPW

Answer 12

extra connection apart from AVN between atria and ventricles

bundle of kent

Question 13

definitive treatment wpw

Answer 13

radiofrequency ablation

Question 14

ECG changes wpw

Answer 14

short PR interval
wide QRS
delta wave - slurred upstroke on QRS

Question 15

What conditions is radiofrequency ablation curative for?

Answer 15

AF
Atrial flutter
SVT
WPW syndrome

Question 16

Radiofrequency ablation

Answer 16

catheter ablation
femoral veins under xray guidance
heat applied to accessory pathways and scar tissue no longer conducts

Question 17

causes of prolonged QT

Answer 17

long QT syndrome
medications eg antipsychotics, amiodarone, macrolide antibiotics
electrolyte disturbance eg hypocalcaemia/kalaemia

Question 18

managing long QT

Answer 18

beta blockers
pacemaker
(magnesium infusion)

Question 19

ventricular ectopics

Answer 19

premature ventricular beats

Question 20

symptoms ventricular ectopics

Answer 20

random, brief palpitations

Question 21

managing ventricular ectopics

Answer 21

bloods - anaemia, elctrolytes, thyroid

Question 22

ventricular ectopics - ECG

Answer 22

individual, abnormal broad QRS complexes on a normal ECG

Question 23

1st degree heart block

Answer 23

delay AVN conduction
every p wave results in QRS
PR interval >0.2

Question 24

2nd degree heart block

Answer 24

some p waves do not lead to QRS

Question 25

2nd degree heart block - Mobitz 1

Answer 25

atrial impulse gradually weaker until it does not pass through AVN
fails to stimulate ventricular contraction goes back to being strong
cycle repeats
increasing PR interval until no conduction then normal

Question 26

Mobitz type 2

Answer 26

missing QRS
3 p waves to 1 QRS
risk of asystole

Question 27

2:1 heart block

Answer 27

2 p waves for each QRS

Question 28

3rd degree heart block

Answer 28

complete
no relationship between p and QRS
significant risk of asystole

Question 29

Treating heart block

Answer 29

atropine 500mcg IV
other inotropes
transcutaneous cardiac pacing
permanent implantable pacemaker

Question 30

atropine

Answer 30

antimuscarinic
inhibits parasympathetic nervous system
pupil dilatation, urinary retention, dry eyes and constipation