Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular Medicine-Unit 2 > Cardiac Rhythm Disturbances (Johsnton) > Flashcards

Cardiac Rhythm Disturbances (Johsnton) Flashcards

1
Q

What drugs/electrolytes are associated with bradycardia?

A

Digitalis, quinidine, hyperK
Drugs used for HTN to inhibit sympathetic tone –> clonidine, methyldopa, reserpine
B blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

HR __ with inspiration

HR __ with expiration

A

Increases

Decreases

Can cause sinus arrhythmia and waxes/wanes with phases of respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the following components of bradycardia:

  • P wave:
  • Rate:
  • PR interval
A

P wave of sinus origin (normal axis)
Rate < 60/min
Constant and normal PR interval (.12-.20 sec)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sinus bradycardia is commonly seen in ___, especially in the 1st few hrs. This is related to sinus node ischemia or to a vagal reflex initiated in ischemic area

A

Acute inferior MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

To tx bradycardia with hemodynamic compromise/unstable acute situations, use:

A

Atropine- .3–> .5 , 1 mg–> 2 mg IV, repeate 10 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

___ is a property of a cardiac cell to depolarize spontaneously during phase 4 of action potential/leads to generation of an impulse

A

Automaticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

___ are seen in absence of significant heart disease, is associated with stress, alcohol, tobacco, coffee, COPD, and CAD

A

Atrial arrhythmias, PAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the QRS with a PAC with aberrant ventricular conduction

A

Wide QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the QRS in a non-conducted PAC

A

No QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can you tx PACs if symptomatic?

A

Reverse causes
Beta blocker
Metoprolol 25-50 mg BID-TID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

___ is a sudden HR greater than 100, usually rate of 150-250/min

A

Paroxysmal Atrial Tachycardia

Identify the “irritable focus”; P’ wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In PAT with AV block, you will have ___ P’ wave/QRS complex and should suspect ___ toxicity

A

2 P’ waves for each QRS (2:1 ratio of P’:QRS) –> rapid rate, spiked P’ waves

Digitalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe the following components of Multifocal Atrial Tachycardia:

  • Amount of P waves
  • PR interval
  • Ventricular rhythm
  • Atrial rate
A

3 or more different P waves
PR interval varies
Irregular ventricular rhythm
Atrial rate > 100

Should see at least 3 consecutive P waves with varying morphologies present with a rate over 100/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Multifocal Atrial Tachycardia is associated with:

A 
COPD/pneumonia/Ventilator theophylline
Beta agonists
Electrolyte abnormalities (decreased K and Mg)
Digitalis toxicity
Sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can you tx MAT?

A

CCB –> Non-DHP such as Diltiazem IV and Verapamil IV (avoid if EF <40%)
MgSO4 IV

Caution with B blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some etiologies of sinus tachycardia?

A

Emotion, anxiety, fear, drugs, hyperthyroid, fever, pregnancy, anemia, CHF, hypolvolemia

Physiologic/pathologic process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the following components of A Fib:

  • Atrial rate
  • Baseline
  • P waves
  • ventricular rhythm
A

Atrial rate > 350-600/min
Undulating baseline
No discernible P waves
“Irregularly irregular” ventricular rhythm –> irregular RR interval (QRS complex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does A flutter look like on EKG? Which leads are they often best seen? Whats the rate>

A

“Saw tooth appearance”

Leads II, III, aVF, V, often best leads

250-350/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A junctional automaticity focus may cause retrograde atrial depolarization. What does each P’ wave look like in leads with an upright QRS?

A

Inverted P’ waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the following components in Paroxysmal Junctional Tachycardia:

  • Rate
  • P waves
A

Rate 150-250/min

P wave may be lost (buried), inverted before or after each QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the P waves in AV Nodal Re-entrant Tachycardia

A

No P waves

22
Q

Describe the following components of Premature Ventricular Contraction’s:

  • QRS complex
  • P wave
A

Premature, bizarre, Wide QRS
No preceding P wave; may produced a retrograde P wave in ST segment

The ST-T wave moves in opposite direction of QRS
Usually full compensatory pause

23
Q

What are some drugs/sources that can cause ventricular rhythm disturbances?

A 
Nicotine
Caffeine
Thyroid
Aminophylline
Digitalis intoxication
24
Q

What usually happens after a premature ventricular contraction?

A

Compensatory pause

25
Q

How do you tx PVCs if the pt is stable?

A

If stable, no Rx; if symptomatic or in setting of ACS-Metoprolol (B blocker) 2.5-10 mg IV

26
Q

How do you tx a PVC in an unstable pt?

A

If unstable-Amiodarone, Lidocaine (1-1.5 mg/kg up to 3 mg/kg), Procainamide

27
Q

Describe the following components of V Tac:

  • Number and characteristics of QRS complexes
  • Ventircular rate
  • size of QRS
  • P wave
  • How long they last
A

3 or more consecutive bizarre QRS complexes
Ventricular rate 120-200 (100-250)
Usually regular, Wide QRS (>.12 sec)
P wave often lost; if seen no relationship to QRS (AV dissociation)
Lasts longer than 30 seconds (sustained)

Can have fusion beats (Dressler) and capture beats

28
Q

A 63 y/o man has been in the ED for 90 mins with a hx of chest pain. The EKG reveals an acute anterior wall infarction and V Tac. He becomes suddenly cool, clammy, and confused with a systolic BP of 70. What do you do?

A

Cardioversion d/t sudden change in clinical status

29
Q

What are the clinical settings of V Fib?

A

AMI, HF, IHD, K disturbance (low or high)

Disorganized depolarization, not effective pumping

30
Q

What do you need to do if a pt goes into V Fib?

A

CPR, Defibrillation

31
Q

Ventricular flutter is characterized by a rate of ___ per minute, ___ waves, and can lead to this EKG pathology ___

A

250-350

Sine

V Fib

32
Q

How do you tx Torsades de Pointes?

A

MgSO4, 1-2 g IV bolus
Overdrive pacing
Isoproternol

33
Q

What are some etiologies of HypoK?

A 
Diuretics
Metabolic alkalosis
High aldosterone (Conns, Cushings)
B agonist overdose
Diarrhea
Renal loss
34
Q

What are EKG characteristics of HypoK?

A

U waves

Flat or Inverted T wave

35
Q

What are some etiologies of HyperK?

A 
Renal failure (insufficiency)
Metabolic acidosis
DKA
Cell breakdown --> Hemolysis, Rhabdomyolysis
36
Q

What are EKG characteristics of HyperK?

A

Peaked T wave
Wide QRS
Loss of P wave

37
Q

How can you tx HyperK?

A 
Dialysis
Insulin and glucose
NaHCO3
Albuterol
Resin-binding agents
38
Q

What are some etiologies of HypoCalcemia?

A 
Chronic renal failure
Vit D deficiency
Hypoparathyroidism
Acute pancreatitis
Hypomagnesium
39
Q

What are EKG characteristics of HypoCalcemia?

A

Prolongation of QT interval

40
Q

What are some etiologies of HyperCalcemia?

A

Hyperparathyroidism
Malignancy
Granulomatous disorders (TB, Sarcoidosis)
Endocrine disorders (adrenal insufficiency, hyperthyroid)

41
Q

What are some EKG characteristics of HyperCalcemia?

A

Short QT interval

Short ST segment

42
Q

What are some etiologies of HypoMagnesemia?

A 
Poor nutrition
Alcoholism
Decreased absorption
Renal Mg loss
Diuretics
43
Q

What are EKG characteristics of HypoMagnesemia?

A

Prolonged PR
Wide QRS
Prolonged QT
Decreased T wave

44
Q

What are some etiologies of HyperMagnesemia?

A

Renal failure

Magnesium containing drugs

45
Q

What type of EKG characteristic is associated with Hypothermia?

A

J wave (osborne wave)

46
Q

What are EKG findings of a PE?

A

T wave inversion V1-V4

Transient RBBB

47
Q

Whenever you see widespread flattening or mild inversion of T waves without associated ST segment displacement, always think of ___

A

Hypothyroidism

48
Q

In addition to a widespread flattening or mild inversion of T waves without ST segment displacement seen in Hypothyroidism, what other constant EKG finding is seen in this condition?

A

Low voltage of the QRS complex

49
Q

Brugada syndrome is characterized by a RBBB with ST elevation is leads ___ . What are these folks susceptible to?

A

V1, V2, V3

Deadly arrhythmias

50
Q

Describe the following in Wolff-Parkinson-White syndrome (WPW):

  • PR interval
  • QRS complex
  • Miscellaneous finding
A 
Short PR interval
Slurred upstroke (DELTA WAVE) of QRS complex 
Accessory AV conduction pathway (bundle of kent)
51
Q

How do you tx Wolf-Parkinson-White syndrome?

A

Event recorder/monitor

Cardiovascular Medicine-Unit 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions