Cardio FM learner Flashcards
what are the four possibilities of a narrow QRS tachycardia?
-sinus tachycardia
-atrial fib
-atrial flutter
-AVNRT
what are some possibilities for a wide QRS complex tachycardia?
-Vfib
-Vtach
-SVT with abberancy
-metabolic/tox issues
Pathological causes of left axis deviation on ECG?
LVH, LBBB, inferior MI, WPW
Pathological causes of right axis deviation?
RVH, RV strain, lateral MI, WPW
what leads do you look at to determine the axis?
Lead I and aVF
which lead do you look at to assess p wave morphology?
lead II
what is the criteria for a pathologic Q WAVE?
Q width > 1 mm
OR 1/3 amplitute of QRS
OR any q waves in V1-V3
what is an incomplete LBBB?
When QRS is <120 but other LBBB criteria present
what are the shockable rhythms?
VF / pVT
what are the doses of amiodarone used in ACLS?
300mg first dose
150 mg second dose
what is the dose of epinephrine used in ACLS?
1 mg q3-5 min
what is the dose of atropine given for ACLS bradycardia?
1mg, repeat q5 min to max of 3 mg total
when is a blood transfusion indicated?
If hb <70 and symptomatic
what is the autoantibody to in pernicious anemia?
intrinsic factor
what type of anemia (micro, normo or macro) does thalassemia cause?
microcytic
causes of normocytic anemia
-acute blood loss
-bone marrow failure
-chronic disease
-hemolysis
what are some causes of macrocytic anemia?
-folate deficiency
-B12 deficiency
-hypothyroid
-alcoholism
-liver disease
When is magnesium IV useful during cardiac arrest?
for torsades de pointes (polymorphic VT associated with a long QT interval)
How do you manage bradycardia in ACLS?
-atropine 0.5mg IV q3-5 minutes
-consider dopamine or epinephrine or transcutaneous pacing
what medication should be avoided in the acute management of an arythmia in a patient with WPW?
beta blockers (because it blocks the normal pathway and so the conduction goes preferentially through the accessory pathway which worsens things)
what medication should you use to control a tachyarythmia in patients with WPW?
procainamide
where does the clot most commonly develop during afib?
the atrial appendage
what test can rule out a clot in someone with afib?
TRANS ESOPHAGEAL US
is there a difference in mortality for patients with afib that are treated with rate VERSUS rhythm control?
Only within the first 12 months of diagnosis, rhythm control improves CV death + CVA
when is rhythm control the preferred approach for afib?
diagnosis <12 mo, symptomatic, multiple recurrences, extreme decreased QOL, arythmia induced cardiomyopathy, difficult rate control
what are two examples of non-dihydropyridine ca channel blockers?
verapamil
diltiazem
what type of calcium channel blocker would you use for rate control in afib?
NON-dihydropyridine
what additional med should you consider in all patients on anticoagulation?
PPI
