Day 4 - CV2 Arrhythmias, HF, Valvular, Pericardial

Question 1

EKG Rhythm - Narrow QRS not associated with p waves; HR 60

Answer 1

3rd degree heart block; aka Junctional rhythm

Question 2

Wide QRS not associated w/ p waves; > 40 but less than 100 HR

Answer 2

Accelerated ventricular rhythm

Question 3

Chaotic, Erratic wide QRS

Answer 3

Ventricular fibrillation

Question 4

Narrow QRS not assoc. w/ p waves; HR > 100

Answer 4

Junctional tachycardia

Question 5

Wide QRS not assoc. w/ p waves; Rate 20-40

Answer 5

Ventricular rhythm

Question 6

Wide QRS not assoc w/ p waves; Rate > 100

Answer 6

Ventricular tachycardia

Question 7

Narrow QRS not assoc w/ p waves; Rate > 60 but

Answer 7

Accelerated junctional rhythm

Question 8

Erratic QRS varies in amplitude in repeating pattern

Answer 8

Torsade de pointes

Question 9

Wandering pacemaker vs. MAT

Answer 9

(1) Wandering pacemaker aka multifocal atrial rhythm: at least 3 different p wave morphologies, 100 (also, there’s MABradycardia, which is

Question 10

PAC Tx

Answer 10

Observation; Stop caffeine if uncomfortable

Question 11

Amiodarone pre-cautions

Answer 11

LFTs, PFTs (avoid if pre-existing lung disease), TFTs

Question 12

Acute onset Afib w/ rapid ventricular rate in patient w/ WPW

Answer 12

Electrocardioversion or Procainamide

Question 13

Complete independence of p waves from QRS. Next step is:

Answer 13

Pacemaker

Question 14

PSVT Tx

Answer 14

Carotid massage (if no carotid artery disease), Valsava, IV Adenosine

Question 15

Valves blood flow thru during systole

Answer 15

Aortic and pulmonic valves

Question 16

Systolic murmurs

Answer 16

AS, PS, MR, TR, VSD,

Question 17

Valves blood flow thru during diastole

Answer 17

Tricupsid, Mitral

Question 18

Diastolic murmurs

Answer 18

TS, MS, PR, AR

Question 19

Kussmaul sign v. Pulsus paradoxus

Answer 19

Both occur w/ inspiration; JVD w/ inspiration vs. Drop in systolic bp larger than 10 w/ inspiration; KS - decreased capacity of Right ventricle, seen in constrictive pericarditis (sometimes, cardiac tamponade); PP - decreased capacity of Left ventricle, seen in cardiac tamponade (sometimes, pericarditis)