Blocks

Question 1

song for first degree AV block

Answer 1

if the R is far from the P, then you have a first degree

Question 2

song for wenckebach

Answer 2

longer, longer, longer drop, then you have a wenckebach

Question 3

song for mobitz II

Answer 3

if some P’s just don’t get through, then you have a Mobitz II

Question 4

song for third degree AV block

Answer 4

If P’s and Q’s just don’t agree, than you have a third degree

Question 5

what are the S&S of a first degree AV block?

Answer 5

none

Question 6

what is the treatment for a first degree AV block?

Answer 6

none needed

Question 7

what are 3 symptoms of a wenckebach?

Answer 7

bradycardia
angina
syncope

Question 8

what is the treatment for wenckebach?

Answer 8

treat bradycardia - stop AV block meds

Question 9

where is the block in a wenckebach?

Answer 9

within AV node

Question 10

where is the block in a mobitz type II?

Answer 10

below the AV node in the His Bundle

Question 11

what symptom, if any, would be present in a mobitz type II?

Answer 11

bradycardia

Question 12

what is the treatment for a mobitz type II AV block?

Answer 12

pacemaker
treat bradycardia

Question 13

a mobitz type II AV block usually occurs in the presence of what?

Answer 13

bundle branch block

Question 14

what can mobitz type II AV block lead to?

Answer 14

stokes-adams attacks

Question 15

how are third degree AV blocks characterized?

Answer 15

independent atrial and ventricular complexes

Question 16

what must be present to diagnose a third degree AV block?

Answer 16

ventricular rate that is slower than the atrial rate

Question 17

what are S&S of a third degree AV block? (5)

Answer 17

bradycardia
palpitations
angina
dyspnea
stokes-adams attacks

Question 18

what is the treatment for a third degree AV block?

Answer 18

treat bradycardia
pacemaker

Question 19

what does a left bundle branch block always indicate?

Answer 19

cardiac disease

Question 20

what are the two tests for a BBB?

Answer 20

ECG, then holter monitor

Question 21

what is the recommended treatment for patients with bifascicular block?

Answer 21

pacemaker

Question 22

what medication can be used to treat a LBBB?

Answer 22

beta blockers

Question 23

what treatment is recommended for a patient with BBB with depressed systolic function, heart failure, and QRS > 0.12 sec?

Answer 23

cardiac resynchronization therapy (surgical)

Question 24

what would be seen on ECG for a RBBB? (2)

Answer 24

wide QRS complex
rabbit ears in V1 or V2

Question 25

what would be seen on ECG for a LBBB? (2)

Answer 25

wide QRS complex notched wave in lead V5 or V6

Question 26

an ECG containing a LBBB cannot be evaluate for what? (3)

Answer 26

ischemia infarction ventricular hypertrophy

Question 27

where would reciprocal changes be seen in RBBB?

Answer 27

I, aVL, V5, and V6

Question 28

in which 2 blocks could right axis deviation occur?

Answer 28

RBBB Left posterior fascicular block

Question 29

in which 2 blocks could left axis deviation occur?

Answer 29

LBBB Left anterior fascicular block

Question 30

what is it called when half of LBBB is blocked after it splits into left anterior and left posterior fascicles?

Answer 30

hemiblock

Question 31

what is the criteria for left anterior fascicular block?

Answer 31

LAD -30 to -90 degrees

Question 32

what is the criteria for left posterior fascicular block? (1)

Answer 32

RAD 90 - 180 degrees

Question 33

LAFD + LPFB =

Answer 33

LBBB

Question 34

RBBB + LAFB + LPFB =

Answer 34

third degree AV block

Question 35

what is a RBBB + LPFB ?

Answer 35

bifascicular block

Question 36

a 16 year old patient mother state's he has been feeling lightheaded. There are associated palpitations and like "my heart is leaping out of my chest". Vitals are normal. On ECG, you see decreased PR intervals and delta waves. what is this suspicious for?

Answer 36

wolff-parkinson white

Question 37

what is the bypass pathway for WPW?

Answer 37

bundle of kent

Question 38

what can WPW lead to? (3)

Answer 38

atrioventricular reentrant tachycardia atrial fibrillation v fib

Question 39

what is the main cause of WPW?

Answer 39

congenital

Question 40

accessory pathways that represent the remnants of failed fusion of AV junctional tissue

Answer 40

bundle of kent

Question 41

what are 2 diagnostics used for WPW?

Answer 41

radiofrequency catheter ablation event monitor

Question 42

what causes the delta wave?

Answer 42

Kent bundle, depolarizing the ventricular muscle earlier

Question 43

AVRT pathway that is antegrade (down to ventricles) through AV node and retrograde (up to the atria) via the AV accessory pathway

Answer 43

Orthodromic AVRT

Question 44

what would orthodromic AVRT look like on ECG? (2)

Answer 44

narrow QRS inverted P waves 150-250 b/min

Question 45

AVRT pathway that goes through kent bundle and into AV node

Answer 45

antidromic AVRT

Question 46

what would an antidromic AVRT look like on ECG? (2)

Answer 46

wide QRS inverted P waves

Question 47

what is the first line acute treatment for orthodromic AVRT?

Answer 47

vagal maneuvers

Question 48

what is the first line acute treatment for antidromic AVRT?

Answer 48

IV procainamide

Question 49

what is the first line treatment for pre-excited atrial fibrillation?

Answer 49

IV ibutilide or IV procainamide

Question 50

what is the chronic prevention for orthodromic AVRT, antidromic AVRT, and pre-excited atrial fibrillation?

Answer 50

catheter ablation of accessory pathway

Question 51

what should all unstable patients get as treatment, especially pre-excited atrial fibrillation?

Answer 51

synchronized cardioversion