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EKG > drugs/electrolytes/ pericarditis > Flashcards

drugs/electrolytes/ pericarditis Flashcards

1
Q

EKG changes with digoxin at therapeutic levels

A

short QT interval

flattened T waves

asymmetric ST depression and T wave inversion in leads w/ tall R waves

coved ST segment (gradual downslope)

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2
Q

prolonged QTc in men

A

more than 0.44 secs

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3
Q

why do you see AV blocks with digoxin at toxic levels

A

because it slows the conduction through the AV node

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4
Q

what are the EKG changes with a very low K

A

prominent U waves

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5
Q

with ___ (drugs) you need to monitor the QT interval and DC the drug if ____

A

with anti-arrhythmics you need to monitor the QT interval and DC the drug if more than 25% prolongation develops

(or QTc more than 0.5 seconds)

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6
Q

amitryptyline, doxepin, and nortriptyline

what are they and what do they do

A

TCAs

prolong the QT interval and put pt at risk for V Tach and torsades

narrow QR and wide RS

long PR interval (hidden beneath T)

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7
Q

EKG changes with hypercalcemia

A
  • decreased automaticity
    • increased PR interval
    • increased QRS interval
    • BBB
    • AV block
  • short refractory period
    • short ST segment
    • short QT interval
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8
Q

QRS complexes with changing amplitudes

A

elecritical alternans seen in

LARGE PERICARDIAL EFFUSION

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9
Q

digoxin has a narrow therapeutic window and ___ excretion, so be careful with ___ and ___

A

digoxin has a narrow therapeutic window and renal excretion, so be careful with geris and CKD pts

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10
Q

prolonged QTc in women

A

more than 0.46 secs

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11
Q

EKG changes in hypokalemia

A

flattened T wave

U waves

ST depression

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12
Q

EKG changes in hyperkalemia

A

tall peaked T waves (tent like)

flattened P waves

1st degree AV block

wide QRS

sine wave pattern

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13
Q

you can differentiate pericarditis from MI b/c the ST elevation is ___ and ____, and _____ is also commonly seen (you’ll also not have weird Q waves)

A

you can differentiate pericarditis from MI b/c the ST elevation is DIFFUSE and UPSLOPING, and PR INTERVAL DEPRESSION is also commonly seen

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14
Q

prochlorperazine

what is it and what does it do

A

phenothiazine

prolong the QT interval and put pt at risk for V Tach and torsades

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15
Q

with acute pericarditis, the ST segment ____

A

evolves: it goes from being elevated to returning to baseline, and the T wave inverts

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16
Q

tall peaked T waves

A

hyperkalemia

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17
Q

positive inotropy (contractility)

negative chronotropy (HR and AV conduction)

A

digoxin

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18
Q

delayed repolarization following depolarization

associated with ___

A

Long QT Syndrome

associated with ventricular dysrhythmias (v-fib and torsades)

arrhythmias associated with exercise

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19
Q

most common thing to see with pulmonary embolism

A

sinus tachycardia

(esp. if PE is small)

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20
Q

therapeutic drug levels of digoxin

A

0.8 to 2.0 ng/mL

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21
Q

what are the EKG changes in K over 7.0

A

sine wave

(wide QRS and peaked T waves become indistinguishable)

22
Q

short QT

A

hypercalcemia

digoxin

23
Q

EKG changes with low electrolytes (K, Ca, Mg)

may progress to

A

prolonged QT

may progress to V-tach or torsades

24
Q

you can differentiate benign early repolarization from MI by

(6 things)

A
  • the ST segment will be upsloped (like in pericarditis)
  • doing multiple ECGs- the findings will be stable
  • no other ischemic findings
  • the ST elevation will be minimal (less than 1/4 the T wave height)
  • the T wave will be asymmetric
  • the J point will be notched
25
Q

all intervals prolonged (PR, QRS, QT)

osborn waves

arrhythmias

bradycardia

slow a-fib

artifact

A

hypothermia

(artifact is from shivering)

26
Q

what are 2 abnormalities you might see with pericarditis with effusion

A

low voltage in all leads

electrical alternans

27
Q

EKG changes with PE

A

sinus tachycardia

S1-Q3-T3

RAD

RAE

RBBB

T wave inversion (V1-4)

lateral S waves

28
Q

tx for brugada syndrome

A

ICD

implantable cardioverter-defibrillator

29
Q

coved ST elevation followed by inverted T wave in leads V1-3

A

brugada syndrome

30
Q

effects of digoxin on the body at toxic doses

A

conduction blocks

tachydysrhythmias

increased risk of renal dz, hypokalemia, aging

31
Q

syncope

fam hx of sudden cardiac death

asian

in 30s

V-tach

A

brugada syndrome

32
Q

downsloping ST segment elevation

A

MI

33
Q

____ is a normal finding with elevated, ____ ST segments

A

BENIGN EARLY REPOLARIZATION is a normal finding with elevated, UPSLOPING ST segments

34
Q

brugada has ___ types with different ___ abnormalities

A

brugada has 3 types with different ST elevation abnormalities

35
Q

QT interval less than 0.35 seconds

A

short QT syndrome

36
Q

upsloping ST segment elevation

A

pericarditis

37
Q

what leads should you look for brugada syndrome

A

V1-3

38
Q

sine wave pattern

A

merging of S and T waves

seen in hyperkalemia

39
Q

what are the EKG changes with a slightly low K

A

T wave flattens

U wave appears

40
Q

long QT

A

hypocalcemia

antiarrhythmics

TCAs

phenothiazines

macrolides

41
Q

ST segment elevation that has an abrupt ascent at the J point and then a plunge back down the the baseline

A

osborn waves

seen in hypothermia

42
Q

most characteristic rhythm disturbance with toxic levels of digoxin

A

PAT with second degree AV block (2:1)

43
Q

S1-Q3-T3 is seen with

A

massive PE:

large S in lead 1

deep Q in lead 3

inverted T in lead 3

44
Q

quinidine, procainamide, disopyramide, amiodarone, and sotalol

what are they and what do they do

A

(anti-arrhythmics)

prolong the QT interval and put pt at risk for V Tach and torsades

wide QRS

45
Q

QT interval abnormalitiy associated with syncope, arrhythmias, risk of sudden cardiac death

A

short QT syndrome

46
Q

dampened electrical output with low voltage in all leads

+/- T wave and ST segment changes

A

pericarditis with EFFUSION

the fluid collection dampens the electrical output

47
Q

toxic blood levels of digoxin

A

> 2.4 ng/mL

48
Q

azithromycin, clarithromycin, erythromycin

what are they and what do they do

A

macrolides

prolong the QT interval and put pt at risk for V Tach and torsades

49
Q

effects of digoxin on the body at therapeutic doses

A

slowed SA node and conduction through AV node

parasymp effect

50
Q

what is QTc

A

the corrected QT interval:

corrects what the QT would be if the HR was 60 bpm

51
Q

EKG changes with digoxin at toxic levels

A

slow HR, fast HR, PVCs

1st, 2nd, or 3rd degree AV block

any tachydysrhythmia

PAT with second degree AV block

52
Q

what are the EKG changes in K of 5.5 to 6.5

A

tall, peaked, narrow T waves

EKG (8 decks)

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