arrhythmias

Question 1

Sinus tachycardia: sympathetic activation

Answer 1

1. Exercise
2. Emotion
3. Hypotension
4. Response to acute lung or abdominal pathology
5. Thyrotoxicosis

Question 2

Sinus tachycardia is

Answer 2

1. regular, fast HR (>100)

2. P waves precede each QRS

Question 3

Sinus tachycardia treatment

Answer 3

1. usually none

2. beta blockers in thyrotoxicosis

Question 4

sinus bardycardia is

Answer 4

1. regular, slow HR (<60)
2. P waves precede each QRS
3. seen in athletes
4. vagotonic states

Question 5

sinus bardycardia: vagotonic states:

Answer 5

1. faint
2. sick sinus syndrome
3. inferior infarct

Question 6

sinus bardycardia: treatment

Answer 6

1. none
2. atropine
3. pacemaker if symptoms

Question 7

First degree AV block results in

Answer 7

1. PR interval prolonged

2. increased junctional delay

Question 8

First degree AV block cause

Answer 8

1. Drug-induced
   (beta blockers, some calcium blockers, digitalis)
2. Conduction system disease
3. usually benign

Question 9

3rd degree heart block causes

Answer 9

1. severe conduction system disease

2. rarely drugs

Question 10

3rd degree heart block treatment

Answer 10

pacing if ventricular rate or BP are too low

Question 11

premature atrial contraction

Answer 11

1. Premature (early) beat
2. Often preceded by an abnormal P wave
3. Narrow QRS resembling normally conducted beats usually

Question 12

premature ventricular contractions (PVC)

Answer 12

1. wide QRS

2. No P wave

Question 13

PVC is caused by

Answer 13

1. common in normal subjects
2. acute myocardial infarct
3. HF

Question 14

PVC treatment

Answer 14

1. usually non required

2. beta blockers

Question 15

atrial flutter is

Answer 15

1. P waves (flutter waves) 
at rate of 240-320 beats/min
2. Pulse may be regular or irregular
3. Ventricular rates vary widely -
typically rapid if untreated

Question 16

atrial flutter treatment

Answer 16

1. Anticoagulation
2. rate control with drugs
3. cardioversion
4. ablation

Question 17

atrial tachycardia is

Answer 17

1. Rapid Heart Rate ≥ 150/min
2. Narrow QRS complexes
3. P waves - Present, but abnormal

Question 18

atrial tachycardia treatment

Answer 18

1. adenosine
2. vagal maneuver
3. beta blocker
4. verapamil
5. diltiazem

Question 19

atrial fibrillation characterized by

Answer 19

1. No P waves
2. chaotic atrial depolarizations at 350 b/min or
3. more often creating an undulating baseline
4. Irregularly
5. irregular ventricular rhythm

Question 20

Atrial fibrillation causes

Answer 20

1. Nl subjects (‘Lone A fib’)
2. Aging
3. Post-Operative
4. Heart Disease
5. Hyperthyroidism

Question 21

atrial fibrillation problems

Answer 21

1. rapid heart rate
(by ischemia or HF)
2. loss of atrial kick
(by HF)
3. Atrial thrombi
(by embolic stroke)

Question 22

Atrial fibrillation treatment

Answer 22

1. anticoagulation
2. rate control with drugs
3. cardioversion
4. ablation

Question 23

junctional rhythm

Answer 23

1. regular
2. narrow QRS usually
3. no antecedent P waves
4. treatment usually unnecessary

Question 24

ventricular tachycardia

Answer 24

1. usually regular
2. wide complexes (100-200b/min)
3. In most cases no P waves visible
4. Termed “sustained” if >30 secs duration
5. often life threatening

Question 25

ventricular tachycardia Rx:

Answer 25

1. amiodarone
2. lidocaine
3. cardioversion

Question 26

Are occasional early QRS complexes present?

Answer 26

1. atrial premature beats

2. ventricular premature beats

Question 27

Atrial premature beats

Answer 27

QRS is usually narrow and often preceded by an abnormal P wave

Question 28

Ventricular premature beats

Answer 28

QRS is wide without a preceding P wave

Question 29

Are very fast, abnormal P waves present?

Answer 29

1. atrial flutter

2. atrial tachycardia