Arrythmias

Question 1

sinus bradycardia

Answer 1

<60 bpm

Question 2

causes of sinus bradycardia

Answer 2

physiological
- normal during sleep/ highly trained athletes

beta blockers
hypothyroidism
ischaemia
‘sick sinus’ syndrome in the elderly - degenerative fibrosis

Question 3

acute treatment of sinus bradycardia

Answer 3

atropine

Question 4

contraindications of atropine

Answer 4

myasthenia gravis
paralytic ileum
(temporary pacing instead)

Question 5

sinus tachycardia

Answer 5

> 100 bpm

Question 6

causes of sinus tachycardia

Answer 6

drugs
anxiety
anaemia
fever

Question 7

acute treatment of sinus tachycardia

Answer 7

beta blocker

Question 8

narrow complex tachycardia

Answer 8

SVT

Question 9

causes of SVT

Answer 9

AV node re-entrant tachycardia (most common)

AV reciprocating - presence of accessory pathway

Question 10

accessory pathway in Wolff Parkinson white

Answer 10

bundle of Kent

Question 11

1st line SVT in stable patient

Answer 11

vagal manœuvres

• valsalva (children + elderly)
• carotid massage (adults)

Question 12

2nd line SVT tx

Answer 12

IV adenosine

Question 13

3rd line SVT tx

Answer 13

verapamil

Question 14

broad complex tachycardia

Answer 14

ventricular tachycardia

Question 15

causes of ventricular tachycardia

Answer 15

underlying heart disease

• coronary heart disease
• previous MI
• cardiomyopathy

Question 16

Tx of ventricular tachycardia if stable

Answer 16

amiodarone

Question 17

Tx if unstable

Answer 17

DC cardioversion

Question 18

Tx of ventricular fibrillation

Answer 18

DC cardioversion

Question 19

causes of torsades de pointes

Answer 19

hypokalaemia

hypocalcaemia

Question 20

Tx of torsades de pointes

Answer 20

magnesium sulphate

Question 21

first degree heart block

Answer 21

regular lengthening of PR interval (>22s)

Question 22

mobitz type 1 second degree heart block

Answer 22

gradual lengthening of PR interval then dropped QRS

Question 23

mobitz type 2 second degree heart block

Answer 23

fixed length of PR interval and irregular QRS complexes dropped

Question 24

third degree heart block

Answer 24

complete dissociation between atrial and ventricular activity

Question 25

tx of mobitz type 1

Answer 25

pacing if symptomatic

Question 26

tx of mobitz type 2

Answer 26

permanent pacing

Question 27

tx of third degree heart block

Answer 27

ventricular pacing

Question 28

atrial fibrillation

Answer 28

irregularly irregular

no P waves

Question 29

paroxysmal AF

Answer 29

lasts less than 48 hours

Question 30

persistant AF

Answer 30

lasts >48 hours but can be treated with drugs to restore normal HR

Question 31

permanent AF

Answer 31

cannot be brought back to normal rhythm with drugs

Question 32

1st line AF rate control

Answer 32

bisoprolol/ verapamil

Question 33

1st line AF rhythm control congenital heart disease

Answer 33

amiodarone

Question 34

1st line AF rhythm control normal heart

Answer 34

flecainide

Question 35

what drug should also be given to AF patients

Answer 35

warfarin for anticoagulation

Question 36

atrial flutter

Answer 36

sawtooth baseline

Question 37

tx atrial flutter

Answer 37

adenosine

anticoagulants

Question 38

what does LBBB indicate

Answer 38

underlying cardiac pathology

• ischaemic heart disease
• left ventricle hypertrophy
• aortic valve disease

Question 39

RSR in lead 6

Answer 39

Left bundle branch block

Question 40

RSR in lead 1

Answer 40

Right bungle branch block

Question 41

causes of RBBB

Answer 41

PE
right ventricle hypertrophy
congenital heart disease
can also occur in healthy individuals