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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
all intervals prolonged (PR, QRS, QT) osborn waves arrhythmias bradycardia slow a-fib artifact
hypothermia (artifact is from shivering)
26
what are 2 abnormalities you might see with pericarditis with effusion
low voltage in all leads electrical alternans
27
EKG changes with PE
sinus tachycardia S1-Q3-T3 RAD RAE RBBB T wave inversion (V1-4) lateral S waves
28
tx for brugada syndrome
ICD implantable cardioverter-defibrillator
29
coved ST elevation followed by inverted T wave in leads V1-3
brugada syndrome
30
effects of digoxin on the body at toxic doses
conduction blocks tachydysrhythmias increased risk of renal dz, hypokalemia, aging
31
syncope fam hx of sudden cardiac death asian in 30s V-tach
brugada syndrome
32
downsloping ST segment elevation
MI
33
\_\_\_\_ is a normal finding with elevated, ____ ST segments
BENIGN EARLY REPOLARIZATION is a normal finding with elevated, UPSLOPING ST segments
34
brugada has ___ types with different ___ abnormalities
brugada has **3** types with different **ST elevation** abnormalities
35
QT interval less than 0.35 seconds
short QT syndrome
36
upsloping ST segment elevation
pericarditis
37
what leads should you look for brugada syndrome
V1-3
38
sine wave pattern
merging of S and T waves seen in hyperkalemia
39
what are the EKG changes with a slightly low K
T wave flattens U wave appears
40
long QT
hypocalcemia antiarrhythmics TCAs phenothiazines macrolides
41
ST segment elevation that has an abrupt ascent at the J point and then a plunge back down the the baseline
osborn waves seen in hypothermia
42
most characteristic rhythm disturbance with toxic levels of digoxin
PAT with second degree AV block (2:1)
43
S1-Q3-T3 is seen with
massive PE: large S in lead 1 deep Q in lead 3 inverted T in lead 3
44
quinidine, procainamide, disopyramide, amiodarone, and sotalol what are they and what do they do
(anti-arrhythmics) **prolong the QT interval** and put pt at risk for V Tach and torsades **wide QRS**
45
QT interval abnormalitiy associated with syncope, arrhythmias, risk of sudden cardiac death
short QT syndrome
46
dampened electrical output with low voltage in all leads +/- T wave and ST segment changes
pericarditis with EFFUSION the fluid collection dampens the electrical output
47
toxic blood levels of digoxin
\> 2.4 ng/mL
48
azithromycin, clarithromycin, erythromycin what are they and what do they do
macrolides prolong the QT interval and put pt at risk for V Tach and torsades
49
effects of digoxin on the body at therapeutic doses
slowed SA node and conduction through AV node parasymp effect
50
what is QTc
the corrected QT interval: corrects what the QT would be if the HR was 60 bpm
51
EKG changes with digoxin at toxic levels
**slow HR, fast HR, PVCs** 1st, 2nd, or 3rd degree AV block any tachydysrhythmia **PAT with second degree AV block**
52
what are the EKG changes in K of 5.5 to 6.5
tall, peaked, narrow T waves

EKG (8 decks)

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