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GK PANCE > Cardiac Arrhythmias > Flashcards

Cardiac Arrhythmias Flashcards

1
Q

Irregularly Irregular Rhythym

Narrow QRS waves

No P wave

A

A-fib

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2
Q

4 Types of A-fib

A

Paroxysmal: self-terminating within 7 days

Persistent: lasts > 7 days

Permanent: AF > 1 yr

Lone: Any of the above w/o evidence of heart disease

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3
Q

Rate Control for A-Fib

A

BB: Metoprolol

CCB: Diltiazem

Digoxin: old people w/ hypotension or CHF

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4
Q

What kind of A-fib patient population do you want to use Digoxin for?

A

old people w/ hypotenstion or CHF

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5
Q

Tx for Unstable A-fib

A

Synchronized cardioversion

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6
Q

No P waves

regular rate

unstable atria

A

atrial flutter

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7
Q

Tx for stable atrial flutter

A

1st = vagal manuevers

BB, CCB

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8
Q

Tx for unstable A-flutter

A

synchronized cardioversion

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9
Q

Definitive tx for a-flutter

A

radiofrequency ablation

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10
Q

Anticoagulation risk stratification in nonvalvular a-fib

A

CHA2DS2-VASc Criteria

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11
Q

CHA2DS2 Vasc

A

Congestive Heart Failure

Hypertension

Age ≥ 75y

Diabetes Mellitus

Stroke, TIA, Thrombus

Vascular disease (Prior MI, aortic plaque, peripheral arterial disease)

Age 65- 74

Sex (female)

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12
Q

CHA2DS2 VASC Score ≥ 2 recommended therapy

A

Mod-high risk: chronic oral anticoagulation

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13
Q

CHA2DS2 VASC Score = 1 recommended therapy

A

Low risk: anticoag may be recommended, depends on patient

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14
Q

CHA2DS2 VASC Score = 0 recommended therapy

A

No anticoag needed

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15
Q

1st line tx for A-fib

A

Dabigatran (NOAC) (no need to check INR, lower risk of bleeding than warfarin)

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16
Q

Def tx for Long QT syndrome

A

AICD

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17
Q

2 pathways both within AV node

A

AV Nodal Reentry Tachy (AVNRT)

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18
Q

1 pathway within the AV node & a 2nd accessory pathway OUTSIDE AV node

A

AV reciprocating Tachycardia (AVRT)

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19
Q

Orthodromic conduction pattern

A

1st: impulse goes down normal AV node
2nd: Returns via accessory pathway in circles

NARROW COMPLEX TACHY

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20
Q

Antidromic Conduction Pattern

A

1st: impulse goes down accessory pathway
2nd: returns via normal pathway

WIDE COMPLEX TACHY

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21
Q

Tx for Stable Narrow Complex Tach

A

1. Vagal Manuevers

1st line tx = Adenosine, CCB

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22
Q

Tx for unstable Narrow Complex Tachy

A

synch cardioversion

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23
Q

Tx for Wide complex Tachy

A

Amiodarone

Procainamide if WPW**

24
Q

Tx for unstable WIDE complex tachy

A

synch cardioversion

25
Q

Def tx for SVT

A

radiofrequency ablation: electrically destroys abnormal pathways)

26
Q

WPW tx during pregnancy

A

sotalol

flecainide

27
Q

multiple ectopic atrial foci generate impulses that are conducted to the ventricles

HR < 100 + ≥ 3 P wave morphologies

A

Wandering Atrial Pacemaker (WAP)

28
Q

same was WAP except HR is > 100

A

Multifocal Atrial Tachycardia (MAT)

29
Q

What condition is MAT associated with?

A

COPD

30
Q

Tx for MAT

A

Verapamil or BB

31
Q

What does ECG of WPW show?

A

Delta wave (slurred QRS upstroke)

wide QRS

Short PR Interval

32
Q

What meds do you want to avoid in WPW?

A

ABCD:

Adenosine, BB, CCB, Digoxin

33
Q

wide, bizzare QRS complexes

A

Ventricular Dysrhythmias

34
Q

Premature Ventricular Complexes

A

premature beat originating from ventricles

wide, bizarre QRS occuring earlier than expected

T wave opposite direction of QRS

35
Q

V Tach

A

≥ 3 consecutive PVCs at a rate > 100bpm

36
Q

What is a common predisposing condition to V tach?

A

Prolonged QT interval

37
Q

Stable, sustained VT Tx

A

Amiodarone

38
Q

Unstable VT w/ pulse Tx

A

Synchronized cardio

39
Q

VT w/ no pulse

A

Defibrillation + CPR (tx as V fib)

40
Q

V fib Tx

A

defib + CPR

41
Q

organized rhythm seen on monitor but pt has no palpable pulse

A

pulseless electrical activity

42
Q

Tx for pulseless electrical activity

A

CPR + epi + check for shockable rhythm q 2 min

43
Q

RBBB Pattern

ST elevation V1-V3

A

Brugada Syndrome

44
Q

Inheritance pattern of Brugada Syndrome

A

aut Dominant

45
Q

Young boy w/ syncope

dad died of sudden cardiac death

NOT Hypertrophic Cardiomyopathy

A

Brugada Syndrome

46
Q

Tx for Brugada Syndrome

A

AICD

47
Q

Alcohol is associated with what cardiac arrhythmia?

A

a-fib

48
Q

most likely underlying tachydysrhythmia associated with this Sick Sinus Syndrome

A

A-fib

49
Q

Sick Sinus Syndrome

A
  • Caused by SA node dysfunction
  • Pt will have palpitations and syncope
50
Q

ECG for Sick Sinus Syndrome will show

A

Tachy-Brady Syndrome

51
Q

Definitive Tx for Sick Sinus Syndrome

A

PPM + rate control

52
Q

Patients with repeated ECGs showing a QTc interval > 480 ms with a syncopal episode

OR

> 500 ms in the absence of symptoms, are diagnosed with

A

Long QT syndrome

53
Q

Prolonged QT interval is associated with

A

polymorphic ventricular tachycardia (Torsades de pointes)

54
Q

MC complication of Brugada Syndrome

A

V-fib

55
Q

caused by a reentrant conduction pathway

A

PSVT

56
Q

PSVT Tx

A
  1. Vagal Maneuvers
  2. Adenosine (narrow QRS complex)
57
Q
A

GK PANCE (26 decks)

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