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RC Test 1 > B4.016 Treatment of Cardiac Arrest > Flashcards

B4.016 Treatment of Cardiac Arrest Flashcards

1
Q

treatable causes of non-shockable arrest

A 
Hypoxia
Hypovolemia
Hydrogen ions (acidosis)
Hyper/Hypo-kalemia
Hypothermia
Tension pneumothorax
Tamponade
Toxins
Thrombosis- cardio
Thrombosis- pulm
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2
Q

shockable rhythms

A

v-fib

pulseless v-tach

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3
Q

most common treatable condition associated w cardiac arrest in a community setting

A

MI

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4
Q

most common treatable condition associated w cardiac arrest in a hospital setting

A

PE

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5
Q

major keys for primary prevention of SCA

A 
smoking cessation counseling
dietary counseling and modification
exercise
BP control
glycemic control in diabetes
lipid lowering therapy
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6
Q

epinephrine indications

A

VF/pulseless VT
pulseless electrical activity (PEA)/asystole
2nd or 3rd line for symptomatic bradycardia

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7
Q

algorithm for treatment of severe symptomatic bradycardia

A 
treat underlying cause
remove offending agents
replace electrolytes
meds to improve AV conduction: atropine, dopamine, epi
temporary pacing
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8
Q

effects of atropine on bradycardia

A

enhancement of SA and AV nodes via vagolytic effects
SA node: increase discharge
AV conduction: improved conduction
HIs/Purkinje: no effect

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9
Q

mechanism of dopamine

A

agonism of b1 and b2 receptors
inotropic, chronotropic, and vasoconstrictive effects
effects largely via NE release, which can be depleted in heart failure

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10
Q

WPW pattern

A

accessory pathway that connect atria to ventricle
faster than conduction through AV nodes
shows as shorter PR segment

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11
Q

what is PVC

A

premature ventricular complex
ventricular premature depolarization
QRS wider, non-perfusing

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12
Q

why might VT occur in a younger person?

A

a structurally abnormality

likely due to previous inflammation

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13
Q

what is VT

A

a rapid collection of PVCs

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14
Q

when is adenosine used?

A

hemodynamically unstable SVT (while preparing for cardioversion)
hemodynamically stable SVT
indeterminate hemodynamically stable wide complex tachycardia

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15
Q

mechanism of action of adenosine

A

very transient depression of SA and AV conduction

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16
Q

lifetime risk of developing symptomatic CAD after age 40

A

49% men

32% women

17
Q

what is PCI

A

percutaneous coronary intervention
non-surgical procedure that uses a catheter (a thin flexible tube) to place a small structure called a stent to open up blood vessels in the heart that have been narrowed by plaque buildup, a condition known as atherosclerosis

18
Q

treatment options for STEMI

A

primary PCI

fibrinolysis if no PCI immediately available

19
Q

treatment options for UA/NSTEMI

A

early conservative: medical management

early invasive: angiography followed by PCI and medical management

20
Q

characterize the use of fibrolytics in MIs

A

indicated in acute STEMI
convert plasminogen to plasmin to disrupt fibrin cascade and restore blood flow
1% risk of intracranial bleeding
20-40% failure rate

21
Q

when is there overwhelming evidence of benefit w use of b-blockers

A

early use in patients with STEMI in absence of contraindications

22
Q

contraindications for b blockers

A

asthma
severe COPD
bradycardia
advanced heart block

23
Q

should you prophylactically treat arrhythmias after an MI?

A

no
associated with increased mortality actually
instead look for cause and try to prevent that: electrolyte disturbance, active ischemia, mechanical disruption etc

24
Q

causes of cardiomyopathy and heart failure

A 
CAD/ ischemic heart disease
hypertension
valve dysfunction
idiopathic/infiltrative cardiomyopathy
infections
toxins
prolonged dysrhythmias
25
Q

indications for pacemakers

A

bradydysrhythmias (AV blocks)

may be indicated after initial treatment/stabilization of SCA due to bradydysrhythmias

26
Q

what are ICDs

A

implantable cardiac defibrillators
used to treat potentially lethal ventricular dysrhythmias and prevent SCD
primary and secondary indications (for prevention of SCA or after resuscitation of SCA)

27
Q

most common indications for ICD

A

primary prevention: HF and perisitently low EF (<35%) despite medical therapy OR hypertrophic cardiomyopathy with high risk for SCA
secondary prevention: resuscitated SCA not associated with acute MI OR hemodynamically significant sustained ventricular tachycardia or v-fib

28
Q

discuss the results of the MADIT II study

A

31% reduction in mortality at 20 months in patients given an ICD @ <35% EF with CAD

29
Q

when should you be mindful of Mg deficiency?

A

pts with diuretic use, K+ depletion, or alcohol abuse

can induce TdP

30
Q

characteristics of hypokalemia on EKG

A

increased amplitude of U waves (after T wave)

31
Q

characteristics of hypothermia on EKG

A

J waves present after S waves

RC Test 1 (19 decks)

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