Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FA17 Cardio 2 > Arrythmia > Flashcards

Arrythmia Flashcards

1
Q

ectopic beats

A

potentials reached by myocardial cells outside normal conduction system

spontaneously depolarize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

escape rhythm

A

SA node fails and latent pacemakers take over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PAC

A

increased sympathetic activity depolarizes atria outside SA node

typically asymptomatic, may have palpitations

early beat on an otherwise normal rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

causes of PAC symptoms

A

EtOH
caffeine
emotional stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

bradycardia arrhythmia causes

A

issue is with the SA node

  1. sinus bradycardia
  2. sick sinus syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

sinus bradycardia

A

heart rate slowed bc of decreases SA node firing

intrinsic issue or extrinsic

often benign, only treat if symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

intrinsic causes of sinus bradycardia

A

aging

ischemic heart disease

cardiomyopathy

athletes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

extrinsic suppression of SA node causes

A

pharm (beta blockers)

metabolic causes (thyroid, DM)

vasovagal PNS stimulation (fear, pain)

secondary to shock (hemorrhagic or neurogenic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

symptoms of bradycardia

A 
fatigue
light headedness
syncope
change in mental staus 
chest pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

tx of bradycardia

A

atropine 0.5 mg IV (temp. speeds up HR)

transcutaneous or transvenous pacing (central line)

definitive tx is implantation of pacemaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Paces of SA node, AV node, ventricular escapes

A

SA: 60-100

AV: 40-60

ventricular escape: 20-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

junctional escape rhythm

A

arises from AV node or His

narrow QRS no P wave

HR 40-60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

ventricular escape rhythm

A

HR 20-40

wide QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

tx of escape rhythms

A

same as bradycardia

  1. atropine
  2. transcutaneous or transvenous pacemaker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

first degree AV block

A

prolonged PR

P wave for each complex

transient or fixed

no need for tx, but can progress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

transient first degree AV block causes

A

vagal tone increase

transient local ischemia

drugs that depress conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

fixed first degree AV block causes

A

MI and or degeneration due to age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

second degree AV block

A

intermittent failure of AV node conduction

two types (Wekenbach/Mobitz I and Mobitz II)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mobitz I

A

AV delay gradually increases until impulse is blocked

PR segment increases between each beat until blockage and then is reset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

population with Mobitz I

A

type I 2nd degree AV block

children, athletes, increased vagal tone, during sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

2nd degree AV block Type I treatment

A

almost never needed

can be benign but also could be due to MI

if symptomatic treat like bradycardia (atropine, transcutaneous pacer/transvenous pacer, permanent pacemaker)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Mobitz II

A

PR interval is unchanged prior to a P wave with no QRS

predictable cadence

treatment regardless of symptoms is pacemaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

3rd degree AV block

A

complete heart block

no association between atrial contraction and ventricular contraction

SA node passes to AV node but doesnt get to ventricle - escape beat controls ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

common causes of 3rd degree AV block

A

MI
drug toxicity
chronic degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
third degree AV block symptoms
``` lightheadedness syncope chest pain hypotension AMS ``` Completely unstable
26
sick sinus syndrome
intrinsic SA node dysfunction brief periods of episodic bradycardia decreased CO = sx of bradycardia
27
sick sinus syndrome symptoms + treatment
dizziness, confusion, syncope, altered mental status treatment: transcutaneous pacemaker + permanent pacemaker
28
tachycardia mechanisms
HR >100 1. enhanced cellular automaticity 2. triggered activity 3. unidirectional block and re-entry
29
factors to consider with tachycardia
is it above ventricle (narrow QRS) ? P wave association with QRS complex P wave morphology
30
sinus tachycardia
100-160 bpm p wave for every QRS (can be difficult) secondary to increased sympathetic tone and decreased vagal stimulation
31
probably causes of sinus tachycardia
exercise fever dehydration hypoxemia
32
atrial flutter
fast atrial rate (250-350) with different ventricular rate "saw tooth pattern"
33
causes of atrial flutter
re-entry impulse saw tooth P waves (atria depolarized thru out cycle) pre existing heart condition can be transient, persistent, permanent
34
symptoms of atrial flutter
palpitations SOB generalized weakenss vague (feel ill, nausea)
35
atrial flutter tx unstable
synchronized cardioversion
36
atrial flutter tx asymptomatic but stable
pharmacological Non-DHP CCB anti-arrythmics consider synchronized cardio version
37
atrial fibrillation
very common atrial quiver or anarchy in atria atrial rate 350-600 very erratic baseline w.o. recognizable p waves
38
atrial fibrillation symptoms
palpitations SOB weaknesss chest pain
39
atrial fibrillation common in its with
``` HTN CAD EtOH intoxication thyrotoxicosis pulmonary disease ```
40
atrial fibrillation is dangerous bc
1. decreased CO | 2. blood stasis, causing increased clot risk
41
unstable AFib with RVR tx
systolic BP less than 90 chest pain altered mental status synchronized cardio version
42
tx of stable AFib with RVR
control ventricle rate to restore sinus rhythm CCB (BB if needed)
43
stable asymptomatic persistent AFIB tx
CCB Beta blocker Start on anticoagulant
44
MAT
stimuli does not come from one foci from several foci isoelectric baseline which is more discernible between P waves (can see the P wave)
45
MAT commonly associated
Pulmonary disease Hypoxemia
46
MAT tx
non-DHP
47
two types of re-entrant tachycardias
AV nodal reentrant Tachycardia AVRT
48
Paroxyxsmal SVT
sudden onset and termination atrial rates b/t 160-180 narrow QRS
49
PSVT symtoms and epidemiology
mc effects young adults, if elderly will have syncope palpitations, light headedness, SOB, can be asymptomatic
50
PSVT treatment non pharm
vagal maneuvers - carotid massage - Ice pack to the face valsalva maneuvers -classical and REVERT techniques
51
PSVT tx pharm
adenosine (adenocard) 6mg IB fish theophylline may inhibit adenosine
52
mc form of AV nodal re-entrant tachycardia
PSVT
53
AVRT Ventricular pre-excitation syndrome
only one bypass tract (typically bundle of kent) impulses travel to ventricles thru accessory pathway AND AV node AKA WPW
54
distinct EKG of wolfe parkinson white syndrome
shortened PR delta wave widened QRS
55
WPW orthodromic conduction tx
narrow QRS, more common vagal maneuvers, adenosine and procanamide if stable synchronized cardio version if stable
56
WPW Antidromic conduction
wide complex QRS less common tx with procainamide DONT GIVE CCB, BB, adenosine
57
PVCs origination and EKG shows
ectopic ventricular foci widened QRS complex (No P wave)
58
PVCs are issue
not dangerous in those W/O heart disease increased risk of VTach or VFib in those WITH heart disease commonly follows MI increased risk if >10/min or couplet/triplet
59
Bigeminal PVCs
when every alternate beat is a PVC
60
trigeminy PVCs
two normal beats precede a PVC | PVC every third beat
61
PVC tx
reassurance, BB if >10/min
62
V Tach
> 3 + consecutive beats HR > 100-250
63
Non-sustained V Tach
3 or more PVCs, last less than 30 seconds, self-limiting dont usually treat (anti-arrythmics can cause VFib) consider beta blocker for tx
64
sustained V Tach
lasts > 30 seconds and requires termination can be stable or unstable
65
stable V Tach vitals + tx
Pt has: Pulse, normal BP, no chest pain, normal mental status ``` tx with: 1. IV access 2. EKG 3. Cardio consult consider anti-arrhythmic (Procainamide) ```
66
unstable VTach vitals + tx
1 of: pulseless, chest pain, hypotension, LOC WITH Pulse: tx is synchronized cardio version + ICD NO pulse: defibrillation
67
defibrillation steps in unstable V Tach
PULSELESS 1. CPR + defibrillate 2. CPR 2 min, IV/IO access 3. defibrillate again 4. Epinephrine + CPR 2 min 5. Defib (3rd time) 6. Amiodarone + CPR 7. Defibrillation
68
monomorphic V Tach
rate is regular and QRS complexes are the same single origin of arrhythmia in ventricle
69
polymorphic V Tach
rate is irregular and QRS complexes are variable in shape cyclic alteration of impulse from ventricle gives appearance of twisted QRS - TORSADES
70
Torsades des Pointes
long QT syndrome is a cause (can be congenital) can be caused by underlying metabolic abnormalities (hypo-K, Mg) or medications
71
initial tx of Torsades des Pointes
CPR non synchronized cardio version amiodarone and Epi Mg 2gm IV drip over 5-15 min while treating long term: BB + ICD
72
definitive pharm tx of Torsades
Mg IV drip
73
how is V Tach differentiated from SVT
wide QRS in v tach
74
most life threatening form of arrhythmia
V Fib severe drop in cardiac output that leads to death
75
treatment of VFib
electrical defibrillation CPR + Defib between Epi and Amiodarone
76
pulseless electrical activity
presence of rhythm without a pulse or electrical activity without perfusion
77
PEA treatment
CPR + Epi + H&Ts success depends on patient's baseline and speed when started
78
what do we do for patients who have ROSC following V Tach, V Fib, or PEA
RAVEL fluid management airway management vasopressors evaluate H & T
79
H & Ts
H: hypovolemia, Hypoxia, Hyponatremia, Hyperkalemia, Hypothermia T: thrombosis, tension pneumothorax, tamponade, toxins
80
RAVEL
``` Responsive Airway Vitals Ekg Labs ``` done after return of SR in Vtach/VFib
81
Asystole management
1. CPR 2. 1 Epi ever 3-5 min 3. H & Ts
82
physiological monitoring during CPR
PeTCO2 (end tidal CO2 device connected to endotracheal tube, measures CO2 exhalation) Arterial one (radial artery, monitors BP and ABG)
83
when an IV site is not available in cardiac arrest...
IO can give drugs, fluids, all ages, quick found in PROXIMAL TIBIA, distal femur, proximal humors, distal tibia)

FA17 Cardio 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions