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Cardiology: Exam > Conduction Disorders > Flashcards

Conduction Disorders Flashcards

1
Q

What is the treatment for a patient in Sinus Bradycardia that is symptomatic or hemodynamically unstable?

A

Atropine

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2
Q

Loss of Sinus “P” Wave for less than 2 seconds.

A

Sinus Pause

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3
Q

Loss of Sinus “P” Wave for more than 2 seconds.

A

Sinus Arrest

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4
Q

What medications can cause Sinus Arrest or Pause?

A

Digoxin
Beta Blockers
Verapamil
Diltiazem

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5
Q

What is the treatment for Sinus Arrest or Pause?

A

Asymptomatic = None
Discontinue Offending Drug
Pacemaker if necessary

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6
Q

What is Sick Sinus Syndrome known as?

A

Tachy-Brady Syndrome

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7
Q

What is the treatment for Sick Sinus Syndrome?

A

Symptomatic = Permanent Pacemaker with Dual Chamber Pacing

Bradycardia + Ventricular Tach = Permanent Pacemaker with Implantable Cardioverter-Defibrillator

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8
Q

What is the most common chronic Arrhythmia?

A

A-Fib

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9
Q

What are some risk factors of A-Fib?

A

Cardiac Disease
Lung Disease
Hyperthyroidism

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10
Q

A-Fib that terminates spontaneously or with intervention in < 7 days.

A

Paroxysmal A-Fib

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11
Q

A-Fib that lasts for > 7 days.

A

Persistent A-Fib

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12
Q

A-Fib that lasts longer than 12 months.

A

Longstanding Persistent A-Fib

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13
Q

A-Fib that is jointly decided by both the patient and clinician not to treat.

A

Permanent A-Fib

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14
Q

A-Fib in the absence of rheumatic mitral stenosis, mechanical or bioprosthetic heart valve, or mitral valve repair.

A

Nonvalvular A-Fib

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15
Q

What is used to assess the risk of stroke in a patient with A-Fib?

A

CHA2DS2-VASc Risk Score

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16
Q

What are the components of the:
CHA2DS2-VASc

A

CHF or LVEF < 40% = 1
Hypertension = 1
Age > 75 = 2
Diabetes = 1
Stroke/TIA = 2
Vascular Disease = 1
Age 65 - 74. = 1
Female = 1

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17
Q

What CHA2DS2-VASc score would recommend oral anticoagulation?

A

> 2 in Men
3 in Women

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18
Q

What CHA2DS2-VASc score would you consider oral anticoagulation?

A

1 in Men
2 in Women

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19
Q

When should you admit a patient with A-Fib to the hospital?

A

Active Ischemia
Heart Failure
Hypotension
Difficult Rate Control
Confusion
Acute Renal Injury

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20
Q

What is the first-line treatment for RHYTHM Control in a patient with onset and identifiable cause of A-Fib, or if the patients remains symptomatic despite rate control?

A

Cardioversion

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21
Q

How is A-Fib treated in an unstable patient?

A

IV Heparin
IV Rate Control
- Calcium Channel Blocker or Beta Blocker
Cardioversion (120 - 200 J)

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22
Q

What medication do you NOT give for rate control in patients with A-Fib + COPD

A

Beta Blockers

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23
Q

What medication do you NOT give for rate control in patients with LV Dysfunction + Heart Failure

A

Calcium Channel Blockers

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24
Q

What medications can be given to patients without Cardiovascular Disease to control A-Fib rate?

A

Beta Blocker
Diltiazem
Verapamil

25
Q

What is the drug of choice for A-Fib rhythm control?

A

Amiodarone

26
Q

What would be some indications for Rhythm Control (Cardioversion) instead of Long-Term Rate Control in A-Fib?

A

Hemodynamic Instability
Failure of Rate Control
First Episode
Younger Patients (< 65)
CHF
Potentially Reversible Causes

27
Q

What are the Anticoagulants of choice for A-Fib stroke prophylaxis?

A

Warfarin
Apixaban or Rivaroxaban
Dabigatran

28
Q

Atrial Rhythm characterized by a rapid and regular atrial depolarizations with an atrial rate of 250 - 300.

A

A-Flutter

29
Q

A-Flutter is best seen in which leads?

A

Inferior Leads
(II, III, avF)

30
Q

What is the preferred treatment for A-Flutter?

A

Catheter Ablation

31
Q

What are the two rhythms caused by Atrioventricular Re-Entrant Tachycardia (AVRT)

A

SVT
Wolff-Parkinson-White

32
Q

Type of AVRT where the impulse travels down the normal AV node first and returns via the accessory pathway.

A

Orthodromic (95%)

33
Q

What kind of QRS complex results from Orthodromic AVRT?

A

Narrow QRS

34
Q

Type of AVRT where the impulse travels down the accessory pathway first and returns via the normal pathway.

A

Antidromic

35
Q

What kind of QRS complex results Antidromic AVRT?

A

Wide QRS

36
Q

SVT is most common among which population of patients?

A

Young Females

37
Q

How do you treat Stable SVT?

A

Vagal Maneuvers
Adenosine

38
Q

How do you treat Unstable SVT?

A

Cardioversion

39
Q

What is the treatment for Wolff-Parkinson-White Syndrome?

A

Radiofrequency Ablation

40
Q

What medications can be used to treat Wolff-Parkinson-White?

A

Procainamide
Ibutilide

41
Q

What medications should you avoid in patients with WPW?

A

Digoxin
Beta Blockers
Calcium Channel Blockers
Adenosine

42
Q

What is the difference between Multifocal Atrial Tachycardia and Wandering Atrial Pacemaker?

A

MAT > 100 bpm
WAP = 60 - 100

43
Q

Patients with Multifocal Atrial Tachycardia commonly have what?

A

Chronic Lung Disease

44
Q

What is the treatment for a First Degree AV Block?

A

No Treatment

45
Q

What is the treatment for a Second Degree Type 1 AV Block?

A

Asymptomatic = Nothing

Symptomatic = Atropine or Epi

46
Q

What AV Block often progresses to a 3rd Degree?

A

Second Degree Type 2

47
Q

How do you treat a 2nd Degree Type 2 AV Block?

A

Atropine or Pacing
Permanent Pacemaker if not resolved

48
Q

Type of AV Block where no atrial impulses reach the ventricles.

A

Third Degree AV Block
(Atrial Rate > Ventricular Rate)

49
Q

What is the treatment for a 3rd Degree AV Block?

A

Temporary Pacing
Permanent Pacemaker

50
Q

What type of QRS complex is seen with a bundle branch block?

A

Wide QRS

51
Q

What is the primary cause of V-Tach?

A

Coronary Artery Disease + Prior MI

52
Q

How long must V-Tach be to be considered sustained?

A

Longer than 30 seconds

53
Q

What rhythm can V-Tach progress to?

A

V-Fib

54
Q

What should all patients with Sustained V-Tach have?

A

Implantable Caridoverting Defibrillator

55
Q

How do you treat stable but symptomatic V-Tach?

A

Amiodarone

56
Q

How do you treat unstable V-Tach?

A

Cardioversion + Amiodarone

57
Q

What usually causes Torsades de Pointes?

A

QT Prolongation
- ↓ Mg, K, or Ca

58
Q

How do you treat Torsades de Pointes?

A

Cardioversion
Magnesium

59
Q

Fatally arrhythmia that usually begins as V-Tach and has a rate > 300

A

V-Fib

Cardiology: Exam (5 decks)

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