Brainscape's Knowledge GenomeTM

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


See full index

ALS > chapter 8, > Flashcards

chapter 8, Flashcards

1
Q

patients with persistent arrythmia need what ?

A

establish ECG monitoring
as soon as possible record a good quality 12 lead ECG

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

what kind of syncope do not need continuous monitoring ?

A

situational syncope - during cougar micturition
or orthostatic hypotension

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

in which syncope is continuous ECG monitoring required ?

A

unexplained syncope
esp during exercise
syncope with evidence of structural heart disease
syncope with abnormal ecg - esp prolonged qt

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

where to place the electrodes of 12 lead ecg ?

A

dry , shaven area of skin
over bone not muscle

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

in which ecg lead do we most of the time begin monitoring ?

A

lead 2 - best p , qrs waves
try to minimise muscle movement = relaxed

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

in an emergency what is used to detect rhythm?

A

assess cardiac rhythm by applying defib pads

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

in an emergency what is used to detect rhythm?

A

assess cardiac rhythm by applying defib pads

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

WHEN TO PLACE PADS IN AP position

A

ICD or perm pacemaker jin right side , or chest wall trauma

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

When should ECG monitor changes be documented

A

When patient known to have tacy arrythmia being treated (eg carotid sinus massage and adenosine) - effects of such intervention on a CONTINIOUS ECG SHOULD BE MONITORED

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

What should be documented on continuous ECG monitoring ?

A

When intervention is in place and changes in ECG seen - such as carotid sinus massage , adenosine etc

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

What is the potential difference in the myocardium ?

A

90mV - sudden shift of ions causes depolarisation

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

What is sinus rhyth

A

P WAVE FOLLOWED BY QRS wave

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

what des the t wave represent ?

A

the cells going back to their resting potential

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

duration of normal qrs ?

A

less than 0.12

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

a completely straight line indicates ?

A

lead has been disconnected

during ASYSTOLE THERE IS SLIGHT UNDULATION OF THE BASELINE - may sure interference due to resp movement or chest compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the normal heart rate ?

A

60-100

bradycardia <60

tachycardia >100

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

what does one large square represent in ecg strip ?

A

0.25sec

5 large sqaures =1sec

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

best way to calculate HR ?

A

count the number of r waves in 6 seconds =
30 large squares

and multiply by 10

=====
shower ecg strip
divide all by 2 )

(or find one r wave to r wave count how many big boxes and divide it by 300)

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

if the RR intervals are totally irregular and qrs complex has constant morphology what is it likely to be ?

A

afib

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

how can you know where ectopic beats come from - whether ventricle or atria ?

A

ventricle is less <0.12 - it is narrow

broad ectopic beats - maybe ventricle or supra ventricular with bundle branch block

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

what is escape rhythm ?

A

a beat that happens after a long pause - coming from av node or ventricular myocardium

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

ectopic beats can occur as ?

A

single
couplets
triplets

22
Q

how many amount of ectopic bets are needed for it to be classified as tacyarrythmia ?

A

more than 3 in rapid succession

23
Q

what is called an arrythmia that occurs intermittently , interspersed , with periods of normal sinus rhythm ?

A

paroxysmal

24
Q

what is called when ectopic beats or arrythmia occurs alternately with sinus beats for a sustained amount of time ?

A

bigeminy

25
Q

if qrs duration more than 0.12 where is it coming from ?

A

origin is from the ventricular myocardium or supra ventricular rhythm transmitted with bad conduction - such as bundle ranch block

26
Q

why are p wave veryhrd to fid and should not waste time with it

and in which lead can p waves be more definingly found

A

can be present as positive , negative or biphasic deflections

u waves mistaken for p waves

p wave coincide within qrs or t wave or st segments

=====

lead v1 or lead 2

27
Q

in which leads is atrial flutter best seen ?

A

inferior leads = 2,3 and avf

28
Q

how to recognise retrograde activity of p waves

A

usual p waves positive n lead 2 and aVF
negative deflection if retrograde

29
Q

if af accompanied by regular qrs complies why ?

A

due to complete av block with AF

30
Q

in atrial flutter there ca be relationship with atria and ventricles ?

A

YES
most time

som instane atrial flutter with variable AV conduction

atrial fib - irregularly irregular

31
Q

how d we know when the ecg strip is VF or artefact ?

A

if patient conscious and has pulse

32
Q

rhythm abnormality can mimic vf which are they

A

polymorphic v tach

pre-excited af - WPW (LEFT UNTREATED CAN LEAD TO VF AND VT )

33
Q

why is it safe to consider all SVT as VT unless proves otherwise

A

because in presence of bundle branch block - SVT will cause broad complex tacy

after MI out broad complex tacy cardia are ventricular in origin

34
Q

when dp torso de pointes happen ?

A

prolonged qt interval- ca be inherited
or due to drugs less common myocardial ischemia , sme anti - arrhythmic drugs = AMIODARONE (SHOULD BE AVOIDED IN TDP)

many patients with TDP - hypo kalemic, magnesia

35
Q

PEA is defines as what ?

A

no clinical cardiac output despite normal ectrical activity

36
Q

causes of pea

A

HYPOTENSION
CARDIAC TAMPONADE

4H AND T’S

37
Q

which drugs causes bradycardia ?

A

bb

38
Q

timing of normal P-R interval

A

0.12-0.2

39
Q

what is first degree block ?

A

prolonged PR interval of more than 0.2sec
= usually in trained athletes and can be physiological !
can be due to ischemia and drugs

Rarely causesanqy symptoms
Rarely requires treatmnet

40
Q

second degree av block types

A

mobits type 1
prolonging of pr - until a p wave without qrs complex
= can be physiological - in athletes with high vagal tone
= most pf the time pathological due tp myocardial infraction
= treatment dependant on effect of bradyarrythmia

mobitz type 2
constant prolonged PR
some p waves not followed by qrs waves
= high risk asystole and complete av block

41
Q

what is third degree av block ?

A

complete dissociation between atria and ventricles - site of pace maker will decide rate

42
Q

rate of each side of pacemaker ?

A

AV node and proximal bundle of his = 40-50
= naeeower qrs complex

HISS and purkinje = 3-40 or less

43
Q

what is idioventricular rhythm ?

A

rhythm arising from myocardium
= including escape rhythm
du to complete av block

accelerated idioventricular rhythm - just above normal HR
= observed after successful thrmbolysis or PCIA

44
Q

WHEN IS AGONAL RHTHM SEEN?

A

charachterised by slow irregular broad qrs complexes

doe snot have pulse

seen in later stages of unsuccful resus attempts

45
Q

common cause of af ?

A

alcohol
structural heart disease
hypertension
obesity

====
usually arising from right atrium LIKE MOST OF THE TIME FOR ATRIAL FLUTTER
disease like : copd
major pulmonary embolism
congenital heart disease
congestiv heart failure

46
Q

what inreases risk of vtach going to vfib

A

ischemia
hypokalmeia and hypomagneisa

prolonged QT !!!

47
Q

QT interval shortens as ?

A

hr increases

48
Q

what is the corrected qt interval in men and women

A

men = 0.43
women = 0.45

49
Q

a QTc of more than 0.5 is a high risk for what ?

A

cardiac arrest

50
Q

causes for short qt interval ?

A

digoxin
hypercalcemia

51
Q

causes for qt prolong

A

ischemia
amiodarone
hypo kal/ mag/ cal/ thermia

GENETICS

class 1 and 3 anti arrhythmic

52
Q

what is qt period physiological ?

A

reploraisation

ALS (19 decks)

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