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5th year countdown > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What are the 4 types of SVT

A

AF
AVNRT
AVRT
Flutter

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2
Q

Tachycardia what are the adverse features you should exclude?

A

shock, syncope, MI, heart failure

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3
Q

Describe features AF & causes

A

Absent p wave, ireffulary irregular
CV causes - IHD, valvular disease
Non CV causes - electrolytes, thyroid, caffeine

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4
Q

Mgmt AF

A

Rate control - BB, N-D CCB, digoxin (sedentary or HF)

Rhythm control - young, acute onset failed rate control
Elective DCCV + sedation - rule out something at 48 hours.
Flecaininde if severe paroxysmal symptoms - not for structural heart disease

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5
Q

Whether to anticoagulant - what 2 scores

A

CHADSVASC

HASBLED - falls, alcohol

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6
Q

Irregular pulse + abdo pain

A

Ischaemic mastery

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7
Q

Irregular pulse + focal neurology

A

TIA

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8
Q

Irregular pulse + SOB

A

decompensated HF (not usually PE)

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9
Q

Irregular pulse + painful limb

A

thrombotic event + ischaemia

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10
Q

Who should you not give BB to?

A

Asthmatics

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11
Q

What does digoxin toxicity present like?

A

N + V, blurred/yellow vision, diarrhoea, confusion, hyperkalaemia.

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12
Q

What electrolyte abnormality can digoxin cause?

A

Hypercalcaemia (risk of digitalis toxicity); hypokalaemia (risk of digitalis toxicity); hypomagnesaemia (risk of digitalis toxicity)

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13
Q

What does digoxin toxicity present like on ECG

A

Reverse tick (ST section)

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14
Q

Palpitations, normally resolve, clicking sensation, anxiety Hx, narrow complex tachycardia, “pseudo r waves”

A

AVNRT

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15
Q

What is the mechanism of AVNRT

A

Ectopic beat reaches AV node as the fast pathway its refractory period - electrical current → retrograde conduction to atria and anterograde into ventricle- p wave after QRS most clear in V1 or V2.

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16
Q

Mgmt of SVT

A

Vagal manoever - stimulate vagus nerve ↑ parasympathetic drive.
Adenosine - blocks AV node - asystole

17
Q

Contraindications to adenosine, what to give instead

A

CI in asthma - give verapamil

18
Q

Contraindication to carotid sinus massage

A

Previous stroke

Carotid plague

19
Q

Wolf parkinson white

A

Slurred upstroke, shortened PR

20
Q

Patho of WPW

A

Accessory pathway, can get retrograde conduction as well as anterograde - can present similar to AVNRT

21
Q

Atrial flutter - describe

A

300bpm - saw tooth pathway - reentry circuit in atrium, block in AV node which can be 2:1, 3:1, 4:1, VR rate will either be 150, 100, 75

22
Q

Mgmt of atrial flutter

A

Same as AF

23
Q

How does complete heart block appear on ECG, which type of MI can cause this.

A

P waves not associated to QRS, common in inferior MI

24
Q

Causes of AV conduction

A

IHD, valve disease, medications, aging, fibrosis

25
Q

Mobits Type 1

A

Longer and longer distance then drops one suddenly.

26
Q

Mgmt heart block

A

1st + asymptotic - no Tx
2nd + asymptomatic - nox Tx, + symptomtic pacemaker
Complete: pacemaker

27
Q

Bundle branch block, which types is always pathological

A

Prolonged QRS, ventricles not contracting synchronised fashion
LBBB (WiLLiM, V6), RBBB can be normal (MarroW, V1)

  • look this slide up
28
Q

Bifasicular Block

A

L axis deviation, RBBB

29
Q

New AF, no asthma

A

BB, consider anticoagulation

30
Q

Basal consolidation, on epixban

A

Just normal AntiBx according to CURB - do not need to worry about clotting

31
Q

Do you need INR if on Epixban

A

No - does not affect INR

32
Q

Abdo pain, pain RIF fossa, rebounded tenderness, signs of septic shock, AF, air underdiaphragm

A

500ml fluids, IV antibiotics, acute surgery - AF is due to shock so mange the acute condition

33
Q

3/7 palpitations - pre recurrent unprovoked DVTs

A

Rate control and inpatient cardio version

34
Q

If AF but BB contraindicated

A

verapamil 40mg PO

35
Q

QT elongation can develop into what? How do you manage this?

A

Tosades, give magnesium

5th year countdown (17 decks)

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