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FINALS - CARDIO > arrhythmias > Flashcards

arrhythmias Flashcards

1
Q

what is the issue in AV block

A

impaired conduction between atria and ventricles

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2
Q

what is 1st degree heart block

A

PR interval >0.2 seconds

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3
Q

how is 1st degree HB managed

A

does not need treatment

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4
Q

what is 2nd degree HB (Mobitz I)

A

PR interval lengthens until a dropped beat occurs

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5
Q

what is 2nd degree HB (Mobitz II)

A

PR interval is constant but there are occasional dropped QRS’s (3:1 or 2:1)

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6
Q

what is 3rd degree heart block

A

no association between P waves + QRS

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7
Q

symptoms of heart block

A

syncope // HF // wide pulse pressure // regular bradycardia //JVP cannon waves // variable S1

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8
Q

in unstable heart block what mx is recommended

A

IV atropine x2 –> IV adrenaline –> trancut pacing eg defib

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9
Q

how is AV block mobitz type II or complete heart block managed

A

temporary cardiac pacing –> permanent pacemaker

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10
Q

how is complete heart block following a posterior MI managed differently

A

if haenodynamically stable can observe

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11
Q

what conditions does supraventricular tachycardia cover (4)

A

any tachycardia not from ventricles: normal tachycardia // AV nodeal re-entry tachy (AVNRT) // AV re-entry tachycardias (AVRT) // junctional tachycardias

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12
Q

how do SVTs present + what type of QRS

A

sudden onset and termination // narrow complex QRS

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13
Q

what 1st line non medical management can be done in SVTs

A

vagal manouvres eg vasalva // carotid sinus massage

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14
Q

what 2nd and 3rd line mx for SVTs

A

IV adenosine (6mg–>12–>18) –> direct current cardioversion

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15
Q

what can be given instead of adenosine in SVTs and what type of patients mayrequire it

A

verapamil - asthmatics

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16
Q

what can be done for longterm prevention of SVT episodes

A

BB // radio frequency ablation

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17
Q

where is the reentry point in AVNRT

A

AV node

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18
Q

where is the rentry point in AVRT

A

accessory pathways eg purkinje fibres

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19
Q

what are vaslava manouvres used for

A

terminate SVT + normalise middle ear pressure

20
Q

what commonly causes monoporphic v tach

A

MI

21
Q

what commonly causes polymorphic v tach

A

long QT –> torsades de pointes

22
Q

in an unstable patient how should V tach be treated

A

ALS guidelines (pulseless v tach or V fib)

23
Q

drug management V tach

A

amiodarone // lidocaine // procainamide

24
Q

if drug therapy fails what mx for ventricular tachycardia

A

EPS or ICD (implantable cardio-defib)

25
Q

what drug should be avoided in v tach

A

verapamil

26
Q

what can v tach progress too

A

v fib

27
Q

what is torsades de pointes

A

polymorphic V tach with long QT

28
Q

what congenital conditions can cause long QT

A

Jervell-lange + romano ward

29
Q

what meds can cause torsades de points

A

antiarrhythmics eg amiodarone // TCAs + SSRIs // antipsychotics eg haloperidol // anti-histamine eg terfenadine // sotalol

30
Q

what abx can cause torsades de poinrs

A

erythrmoycin + chloroquine

31
Q

what cocnditions can cause torsades de pointes (4)

A

hypoK/Ca/Mg // myocarditis // hypothermia // SAH

32
Q

mx torsades de ponts

A

IV mag sulphate

33
Q

what is long QT syndrome + what is the common variant

A

inherited condition which delays depolarisation of ventricles // slow K channel

34
Q

what is long QT1 assoc with

A

exercise syncope esp swimming

35
Q

what is long QT2 assoc with

A

syncope with emotional, excercise or auditory

36
Q

what is long QT3 assoc with

A

sudden events at night or rest

37
Q

what drug management for long QT

A

BB EXCEPT SOTALOL

38
Q

if drugs fail what mx for long QT

A

impantable cardio defib (ICD)

39
Q

what type of arrhythmia is WPW

A

SVT –> AVRT from accessory conducting pathway

40
Q

ECG features WPW

A

short PR // wide QRS + delta wave // left (right accessory) or right axis (left accessory) deviation

41
Q

how can you differentiate between left and rights sided WPW on ECG

A

left pathway (type A) = dominant R wave in V1 // right pathway (type B) = no dominant R wave V1

42
Q

what is WPW assoc with (5)

A

HCOM // mitral prolapse // thryoid problem // ASD // ebsteins

43
Q

mx WPW

A

radiofrequency ablation

44
Q

mx WPW

A

antiarrhymics eg BB blockers, amiodarone, flecainide

45
Q

what 1st line invx should all patients with palpitations receive

A

ECG // TFT // U+E // FBC

46
Q

DVLA after explained + treated syncope episode

A

4 weeks

FINALS - CARDIO (17 decks)

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