Arrythmias

Question 0

What is the definition of second degree heart block type I?

Answer 0

Progressive PR interval lengthening until a dropped beat occurs

Question 1

What is the definition of first degree heart block?

Answer 1

PR interval greater than 200 msec (5 little boxes)

Tx: none necessary

Question 2

What is second degree heart block associated with?

Answer 2

Increased vagal tone
Right coronary ischemia
Drugs

Question 3

What is the treatment for second degree type I?

Answer 3

Stop the offending drug

Use atropine as needed

Question 4

What is the definition of second degree heart block type II.

Answer 4

Dropped beats without preceding PR interval lengthening

Question 5

What is the pathogenesis of second degree type II?

Answer 5

Fibrotic disease of the conduction system as in after an MI

Question 6

What is the treatment of second degree type II.

Answer 6

Pacemaker

Question 7

What is third degree heart block?

Answer 7

Complete dissociation between atria and ventricles

Question 8

What is the complication of second degree type II.

Answer 8

Frequent progression to third degree

Question 9

What is sick sinus syndrome?

Answer 9

Dysregulation of SA node that leads to tachy and Brady arrythmias.

It is the most common indication for a pacemaker

Question 10

What is atrial flutter?

Answer 10

Circular movement of electrical activity around the atrium at a rate of 250-350 BPm

Question 11

What is the treatment of atrial flutter?

Answer 11

Cardioversion if unstable or new onset
If onset greater than 48 h –> TEE or anti coagulation for 3-6 weeks before cardioversion
Rate control

Question 12

What is multimodal atrial tachy associated with?

Answer 12

COPD, hypoxemia

Question 13

What are the features of MAT?

Answer 13

3 or more P wave morphologies
Rate over 100
Atrial rate at 150-250

May be caused by digoxin

Question 14

What is the treatment of MAT?

Answer 14

Treat underlying disorder

Verapamil or Bb for rate control and suppression of atrial pacemakers

Question 15

What is atrioventricular nodal reentry tachy?

Answer 15

A reentry circuit in the AV node depolarizes the atrium and ventricle simultaneously

Question 16

What is the treatment for unstable AVNRT.

Answer 16

Cardioversion if unstable

Question 17

What is the treatment for stable AVNRT?

Answer 17

Carotid massage
Valsalva
Adenosine

Question 18

What are the EKG findings of AVNRT.

Answer 18

Rate of 150-250

P wave buried in QRS or right after

Question 19

What is atrioventricular reciprocating tachy?

Answer 19

An ectopic connection between the atrium and ventricle that causes a reentry circuit. (WPW)

Question 20

What is seen on EKG of AVRT?

Answer 20

Retrograde p wave after QRS

Delta wave

Question 21

What is the treatment of AVRT?

Answer 21

Cardioversion if unstable

Stable: valsalva, carotid massage, adenosine

Question 22

What does paroxysmal atrial tachy look like?

Answer 22

P wave with weird axis before QRS

Rate over 100

Question 23

What is paroxysmal atrial tachy?

Answer 23

Ectopic Pacemaker in atria

Question 24

What are PVCs?

Answer 24

Ectopic beats from ventricular foci

Question 25

What are PVCs associated with?

Answer 25

Hypoxia, electrolyte abnormalities, hyperthyroidism

Question 26

What is the treatment of PVCs?

Answer 26

Treat underlying cause | Can use Bb or antiarrythmics if sx

Question 27

What is the definition of VT?

Answer 27

3 or more consecutive PVCs | May see AV dissociation -= diagnostic

Question 28

Treatment of VT?

Answer 28

Cardioversion | Amiodarone, lidocaine, procainamide

Question 29

What is torsades associated with?

Answer 29

``` Long QT syndrome Drugs: zofran, quinidine, sotalol Hypokalemia Congenital deafness Alcoholism ```

Question 30

What is the treatment of torsades?

Answer 30

Give magnesium and cardioversion if unstable Correct hypokalemia Stop offending drugs