Arrhythmias

Question 1

Bradycardia is defined as what bpm?

Answer 1

<60

Question 2

If bradycardia is unstable or risks asystole then what do you do?

Answer 2

Give atropine 500mcg

Question 3

If atropine doesn’t work for bradycardia what do you do

Answer 3

Transcutaneous pacing Isoprenaline Adrenaline Transvenous pacing

Question 4

If bradycardia is not unstable and doesn’t risk asystole then what do you do?

Answer 4

Observe

Question 5

If a tachycardia is unstable what do you do?

Answer 5

Shock

Question 6

Treatment acute AF?

Answer 6

Digoxin if signs of failure Otherwise bisoprolol (not asthmatic)

Question 7

SVT treament?

Answer 7

Vagal manouvers Adenosine 6mg, 12mg, 12mg (not in asthmatics)

Question 8

VT with pulse treatment

Answer 8

Amiodarone 300mg over 20mins then 900mg over 24hrs

Question 9

Torsades de pointes treatment

Answer 9

Magnesium

Question 10

What does torsades de pointes look like on ECG?

Answer 10

Accordion

Question 11

What are the 4 Hs and 4 Ts of cardiac arrest?

Answer 11

Hypoxia Hypovolaemia Hypothermia Hypo/erkalaemia Tension pneumothorax Tamponade Thrombus Toxins

Question 12

What are the shockable rhythms?

Answer 12

Pulesless VT VF

Question 13

What are non-shockable rhythms?

Answer 13

PEA Asystole

Question 14

How do you tell the difference between SVT and VT?

Answer 14

SVT has normal QRS

VT has wide QRS

Question 15

Saw tooth P waves with associated heart block on ECG=?

Answer 15

atrial flutter

Question 16

Answer 16

Ventricular tachycardia

Question 17

Answer 17

VF

Question 18

Answer 18

2nd degree AV block Mobitz type II

Question 19

A wide QRS means what?

Answer 19

≥120 ms.

Due to slower spread of ventricular depolarization because of disease of the His-Purkinje network and/or reliance on slower, muscle-to-muscle spread of depolarization. This can be seen during:

propagation of a supraventricular impulse (atrial premature depolarizations [APDs] or supraventricular tachycardia [SVT]) + block (preexisting or rate-related) in one or more parts of the His-Purkinje network;

depolarizations originating in the ventricles themselves (ventricular premature beats [VPDs] or ventricular tachycardia [VT]);

slowed propagation of a supraventricular impulse because of intra-myocardial scar/fibrosis/hypertrophy; or

conduction of a supraventricular impulse from atrium to ventricle over an accessory pathway (bypass tract) – so called “pre-excited” tachycardia. e.g. WPW