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Cardio All > Dysrhythmias > Flashcards

Dysrhythmias Flashcards

1
Q

For normal cardiac conduction

  • Normal QRS duration < ____ (ms)

In Delayed Signals in the Ventricle

  • Depolarization of ventricles will take ________
    • QRS > ____ ms
  • QRS axis may change
    • QRS vector will be shifted in a direction of the ____ part of ventricles to be ____________
A

For normal cardiac conduction

  • Normal QRS duration < 100 (ms)

In Delayed Signals in the Ventricle

  • Depolarization of ventricles will take longer
    • QRS > 100 ms
  • QRS axis may change
    • QRS vector will be shifted in a direction of the last part of ventricles to be depolarized
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2
Q

What do you see in V1 and V6 in right BBBs?

A
  • V1
    • rabbits ears
  • V6
    • Slurred S-wave
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3
Q

What type of HB is this?

A

3rd degree

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4
Q

What are the Class IV Agents?

A
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5
Q

What is the greatest risk factor for A-fib?

A

prior stroke

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6
Q

Give the PKs for Amiodarone

A
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7
Q

What is the rule of thumb for V-tach?

A

Wide QRS + any other V-tach indication = treat as V-tach

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8
Q
A
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9
Q

What can we classify an AV junctional rhythm as?

A

An escape Rhythm [the AV Node signal travels backwards]

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10
Q

What kind of HB is this?

A
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11
Q

What are Ectopic foci?

What is the mechanism that it causes Cardiac dysrhythmia?

A

Can cause *Abnormal automaticity of the heart*

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12
Q

What does Reentry Require?

A
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13
Q

What type of HB is this?

A
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14
Q

What is Ventricular Re-entry, and what kind of Disorders of Impulse is it?

A

Disorder of Impulse Conduction

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15
Q
  • Do heart blocks cause dysrhythmia?
  • Do they affect CO?
A
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16
Q

What kind of heart block is this and how would you treat it?

A
  • First-Degree
    • This in isolation of other conditions do not require treatment
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17
Q

What type of HB is this?

A

1st degree

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18
Q
  • How do you know this is an AV junctional rhythm?
    • What should the bpm be for this condition?
A
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19
Q

What artery usually supplies the AV node?

A

Right coronary artery

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20
Q

What kind of heart block is this?

A
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21
Q

What are the non-Rx causes of HB?

A
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22
Q

What are the ADRs of Procainamide?

A
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23
Q

What happens to the PR interval in a 1° AV Block? What kind of treatment is required for it?

A
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24
Q

What kind of Ventricular dysrhythmias is this?

A

Torsades De Pointes

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25
Q

What are the Class III drugs?

A
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26
Q
  • What areas of the cardiac electrical conduction pathway are affected when alterations in “Sinus Rhythm” are seen?
  • Are alterations in “Sinus Rhythm” common?
A
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27
Q

What condition is Diltiazem useful for?

A
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28
Q
A
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29
Q

What is Brugada Syndrome?

A
  • ST-segment elevation + slurring
  • Prolonged QT
  • V-fib + V-tach
  • Familial
    • Na+ Channels are dysfunctional
  • Death by 40
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30
Q

What kind of heart block is shown?

A
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31
Q

What is shown at the yellow, green, and blue portions?

A
  • Yellow
    • Normal P
  • Green
    • Ventricular Beat
  • Blue
    • Fusion Beat
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32
Q

What are the 4 main types of Atrial dysrhythmias?

What is a deadly risk of Atrial dysrhythmias?

A
  1. Premature atrial contractions
    • ​​PAC
  2. (Paroxysmal) Atrial tachycardia
    • ​​PAT
  3. Atrial flutter
  4. Atrial fibrillation

PFPF

Risk for Blood Clot Formation

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33
Q

Describe bow an ECG differs between typical and atypical atrial flutter

A
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34
Q

What type of heart block is shown?

A
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35
Q
  • In Prolonged Sinus Node Dysfunction from conditions like A-fib, what can occur to the AV node?
A

Increased Vagal Tone

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36
Q

What is a delta wave from in an ECG?

A

Accessory pathway

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37
Q

Give the Clinical Application of Verapamil

A

Note: More useful than digoxin for rate control in atrial fibrillation due to the Ca+2 channel blockade in AV node persisting during sympathetic stimulation.

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38
Q

Give the PKs and ADRs for Propranolol

A
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39
Q

What condition can be described as a “polymorphic ventricular tachycardia with a long QT interval” that manifsts as QT elongation followed by Ventricular Tachycardia?

A

Torsades De Pointes

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40
Q

What does a right BBB look like?

A

“Rabbit Ears”

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41
Q

What type of HB is this?

A

2nd degree type 2 WITH a R BBB

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42
Q
  • How long does a narrow QRS complex last and how long does a wide QRS complex last?
    • Where does the wide complex usually occur?
A
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43
Q

Is this associated with V-Tach or SVT + Aberrancy

A

V-Tach

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44
Q

Differentiate between Asystole, Arrhythmia, Dysrhythmia, and Ventricular fibrillation,

A
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45
Q

What actually is WPW?

A
  • Wolff Parkinson White Syndrome​
    • WPW is an electrical abnormality in the heart that may be associated with supraventricular tachycardia (fast heart rate originating above the ventricles). When you have WPW, along with your normal conduction pathway, you have an extra pathway called an accessory pathway.
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46
Q

What type of HB is this?

A

right BBB

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47
Q

Is this associated with V-Tach or SVT + Aberrancy

  • No History of MI, CHF, or ASHD
A

SVT + Aberrancy

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48
Q

What is a defining feature of Junctional Tachycardia?

A

Retrograde P waves

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49
Q

Describe what Flecainide does to cardiac conduction, and the Clinical Applications for it

A
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50
Q

What are the Clinical Applications for Digoxin?

  • What does it do to Na+/K+-ATPase?
  • What happens to ERP?
  • What happens to P-wave depolarizations?
A
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51
Q

What are the causes of Torsades De Pointes?

A
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52
Q

What do you do if you see A-fib in a PT who has a mechanical valve?

A
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53
Q

What kind of Atrial dysrhythmia is shown?

A
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54
Q

What is a Sinoatrial exit block?

A

The exit of the impulse from the sinus node is blocked, so no P-wave

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55
Q

How does Atropine increase HR?

What receptors does it act on?

A
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56
Q

Is this associated with V-Tach or SVT + Aberrancy

A

V-Tach

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57
Q

Give the general effects and Clinical Applications for Propranolol

A
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58
Q

What mechanism, besides abnormal automaticity, can cause cardiac dysrhythmia?

A
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59
Q

What is indicative of all second-degree heart blocks?

A

Dropped QRS complexes, so not a 1:1 ratio from P waves:QRS complexes

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60
Q

Describe WPW - Management

A
  1. Adenosine or any other Calcium blockers
  2. Procainamide
    • A) Procainamide or Cardioversion
    • B) Cardioversion
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61
Q

What is the target for A-fib tx via ablation?

A
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62
Q

What are two parasite-related diseases that can cause HB?

A
  1. Lyme Disease
    • Creates 1st to 3rd degree HB
    • Resolves in most PTs even if untreated for Lyme Disease
    • HB may actually be 1st sign of Lyme Disease
  2. Chagas Disease
    • From a parasite from Latin America
    • Can cause all types of Hb
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63
Q

What type of HB is this?

A

2nd degree type 1

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64
Q

What are the steps in reading an ECG?

A
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65
Q

What type of atrial dysrhythmia is shown?

A
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66
Q

Concerning Class IV Agents

  • Give the general mechanism
  • What it does to the SA Node and AV Node, and ventricular
    contractility
A
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67
Q

Give each of the following the title as

  • ST segment
  • P Wave
  • QT Interval
  • QRS Complex
  • T Wave
  • PR Interval
A
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68
Q

What kind of HB is this?

A
  • Third degree
    • P wave can be buried in a QRS complex
    • Each P to P interval is =
    • Each R to R interval is =
69
Q

Describe a third-degree HB aka Complete Heart Block

  • What is the relationship b/w the atria and ventricles?
  • Where does the QRS/ventricular depolarization originate?
  • What is the Tx?
A
70
Q
  • Describe what a first-degree block is
    • What happens to the PR interval
    • Where can it occur?
    • Compare the P-waves to the QRS complexes
A
71
Q

Concerning the Causative Mechanisms for Dysrhythmia Generation, describe Disorders of Impulse Formation.

A
72
Q

What type of HB is this?

A

4:3 ratio

73
Q

What is Sotalol used to treat and channel does it effect that is unique among other NS Beta Blockers?

A
74
Q

Concerning AV Nodal Blocks, describe the difference in 1st, 2nd and third degree. What kind of Disorders of Impulse are they?

A
75
Q

How do you manage Sinus Tachycardia?

A
76
Q

What are the normal times for the following?

  • PR interval
  • QRS Complex
  • QTc Interval
A
77
Q

What are the Class 5 drugs?

A
78
Q

What are the ADRs Quinidine?

A
79
Q

Give the PKs for Verapamil

A
80
Q

What are the ADRs for Amiodarone?

A
81
Q

What is the general mechanism of Class Ib drugs?

What happens to phase 3, APD, and QT?

What conditions are they useful in treating?

A
82
Q

Give the general causes (not mechanisms) of Dysrhythmia

A
83
Q
  • Is this normal, left BBB, or right BBB?
    • Left is from V1
    • Right is from V6
A
  • Right BBB
    • V1 Ravvit Ears
    • V6 S wave slurring
84
Q

What are the main Ventricular (alliterations at the ventricle muscle mass) Dysrhythmias?

A
85
Q

What type of atrial dysrhythmia is shown?

A
86
Q

What are the three general treatment options for Atrial Dysrhythmia?

A
87
Q

What are the three major Consequences of Dysrhythmia?

A
88
Q

Concerning Quinidine

  • What Clinical Applications does it have?
  • What does it do to the QRS and QT?
A
89
Q

What kind of Ventricular dysrhythmia is this?

A
90
Q

What type of HB is this?

A

2nd-degree type 1

91
Q

What is “Sick Sinus Syndrome”?

A
92
Q

Which type of BBB can be seen in normal healthy young people?

A

Right

93
Q
  • What is the bpm for an Idioventricular Escape Rhythm?
  • What region of the ventricle does this occur, and how do you know?
  • When does this type of beat occur?
A
94
Q

What is the general mechanism for all Class I Antidysrhythmic drugs?

A

Block voltage-sensitive Na+ channels

95
Q

What are the 4 types of Ventricular Dysrhythmias?

A
  1. Brady/Tachy
  2. PAC or PVC
  3. Narrow Complex
  4. Wide Complex
96
Q

Concerning Class III Agents

  • Give the general mechanism
  • What they do to phase 3 and QT
  • What they are generally useful for
A
97
Q

What is the Class II Agent?

A

Propranolol

98
Q

What are the parameters for an incomplete heart block and a complete heart block?

A
  • Incomplete
    • Between 100 bpm and 120 bpm
  • Complete
    • > 120 ms (3 boxes)
99
Q

What type of HB is this?

A

Left BBB

100
Q

What does the Cardiac Action Potential look like for the Atria, Purkinje fibers, and Ventricles?

What about the SA and AV nodes?

A
101
Q

Label each action potential as either

  • Atrium
  • Ventricle
  • SA node
  • AV Node
  • Purkinje Fibers
A
102
Q

Describe what happens to the P and QRS of a 3° AV Block (complete) heart block?

A
103
Q

What are the ADRs for Digoxin?

A
104
Q

Describe the PKs of Procainamide

A
105
Q

List the steps of Reentry Mechanism

A
106
Q

What are the main types of heart blocks?

A
  • 1° AV Block
  • 2° AV Block [Mobitz Type I or Wenchebach]
  • 2° AV Block [Mobitz Type II]
  • 3° AV Block (complete)
107
Q

What type of diseases are normally associated with right BBBs?

A
  • Pulmonary Diseases
  • Atrial septal defects
108
Q

What kind of Ventricular dysrhythmia is this?

A
109
Q

Describe the management for TdP

A
110
Q

What type of heart block is Lyme disease associated with?

A

3° AV Block (complete)

111
Q

What are the Class Ia Agents?

A
112
Q

Is this a Right BBB or a left BBB? How can you tell?

A

V1 has rabbits ears and a slurred S wave in V6

113
Q

What actually is a Premature atrial contraction?

A

If your heart’s electrical system triggers the early or extra beat in the atria, the result is a premature atrial contraction.

114
Q

What are the ADRs for Verapamil?

A
115
Q

What type of Atrial dysrhythmia is shown?

A
116
Q
  • What is the general mechanism for Class Ia Antidysrhythmic drugs?
  • What do they do phase 0? phase 2? phase 3? How?
  • What happens to QRS and QT?
A
117
Q

Describe the management for general V-Tach?

Why are the drugs prescribed in that way?

A

Procainamide is a membrane stabilizer, the others are nodal blockers

118
Q

What happens to the PR interval in a 2° AV Block [Mobitz Type II]? Why is this type of heart block especially risky, and how is it treated?

A
119
Q

Compare Verapamil and digoxin for use in controlling A-Fib.

A
120
Q

What kind of Disorders of Impulse are DADs or Delayed After- Depolarizations?

A
121
Q

What are the General mechanisms for Class II drugs?

A
122
Q

Fill in the blank

A
123
Q

What are the PKs of Lidocaine?

A
124
Q

Describe Secondary Pacemakers and Escape Rhythms, including bpms

A
125
Q

What is the common cause for heart blocks?

A
126
Q

What type of HB is this?

A

2nd degree type 2

127
Q
  • Is this normal, left BBB, or right BBB?
    • Left is from V1
    • Right is from V6
A

Normal

128
Q

What type of HB is this?

A
129
Q

Concerning Class Ic drugs

  • What happens to QRS, APD, QT, and PR?
  • What happens to phase 0?
  • What is special about the mechanism kinetics?
A
130
Q

What is the common symptom of Sinoatrial exit block, and how is it usually treated?

A

Syncope

Pacemaker

131
Q

What kind of Ventricular dysrhythmia is this?

A
132
Q
  • Consider all the reentry circuits. What rhythms are associated with:
    • Atrio-Ventricular reentry
    • Atrial reentry
    • AV nodal reentry
    • Ventricular reentry
A
133
Q

What are the general indications for V-tach?

A
  1. QRS > 140 msec
  2. AV Dissociation
  3. Over 50 y/o
  4. Heart Disease, recent MI, Hypertension
  5. P wave displacement, regularly
  6. HR over 150
134
Q

In a 2° AV Block [Mobitz Type I or Wenchebach], what happens to the following

  • PR interval
  • QRS complex
A
135
Q

What is a Bifascicular Block?

A
136
Q

Is this a right BBB or left BBB? How can you tell?

A

Left BBB

137
Q

Is this normal, left BBB, or right BBB?

  • Left is from V1
  • Right is from V6
A
  • Left BBB
    • Pen tip in both V1 and V6
138
Q
  • What are three main types of Ventricular dysrhythmias, and which one is most common?
  • Do they affect cardiac output?
A
  1. Ventricular premature beats aka Premature Ventricular​ Contractions
    • PVC
    • Most common and can progress to Ventricular Fibrillation
  2. Ventricular Tachycardia
  3. Ventricular Fibrillation
139
Q
  • What is the mechanism for Lidocaine?
  • What is Lidocaine used to treat?
  • What does Lidocaine do to the ERP and APD?
A
140
Q

What is Digoxin?

A

Class 5 Antidysrhythmic

Cardiac Glycoside

141
Q

What type of heart block is shown?

A
142
Q
  • How do you treat HBs with meds?
    • Compare the Tx for an AV node block vs a block at the His bundle or more distal areas
A
143
Q

What are the temporal definitions for Atrial Fibrillation?

What are the general causes of permanent A-fib?

A
144
Q

What does a left BBB look like?

A
145
Q

Describe the general mechanism of Verapamil

  • What does it do to HR, SA automaticity, PR, AV conduction, CO, and ventricular contractility?
A
146
Q

Concerning Ibutilide

  • What is different about its mechanism compared to other drugs of the same class?
  • What effect does it have on MAP, HR, QRS, and PR?
  • What is notable about its PKs?
A
147
Q

What is the treatment for an HB that is caused by MI or ischemia?

A
148
Q
  • Is a right or left BBB usually considered a marker of underlying heart disease and degeneration of the conducting system?
    • List the various diseases it is associated with
A
149
Q

What is sinus arrhythmia, and in which PT population is this condition considered “normal”?

A

RR intervals are not equal

150
Q

What is the target for Target for Atrial Flutter Ablation?

A
151
Q

Describe the different types of Pacings that are used to treat HB

A
  1. Emergent Pacing
    • Electric current through the chest wall to reach the heart
    • PAINFUL
  2. Temporary Pacing
    • Use a central line to reach the right side of the heart with wires
  3. Permanent Pacing
152
Q

What are the risks and transient symptoms of Torsades De Pointes?

A
153
Q

What is the main similarity between these?

A

Prolonged QT syndrome

154
Q

Concerning Amiodarone

  • What is the general mechanism
    • What does it do to ERP and APD
  • What the Clinical Applications
A
155
Q

What type of HB is this?

A
156
Q
  • What is a “sick sinus syndrome”?
A
  • Sick sinus syndrome is a relatively uncommon heart rhythm disorder. SSS is not a specific disease, but rather a group of signs or symptoms that indicate the sinus node, the heart’s natural pacemaker, is not functioning properly.
    • The dysfunctional impulse is probably not originating at the SA Node.
157
Q
  1. What condition does an Accelerated Idioventricular Rhythm look like?
  2. What do avoid when if you see this rhythm?
A
  1. Like a slow V-Tach
    • HR under 100
  2. Avoid any nodal blockers or HR suppressors
158
Q

What are the main Supraventricular (alliterations at or above the level of the AV NODE) Dysrhythmias?

A
159
Q

What are the Mechanisms of Atrial Arrhythmia?

A
160
Q

What is the only “normal” way that an electrical signal should travel from the atria to the ventricle?

A

AV Node

161
Q

What are the types of medications that can cause HR?

A
162
Q

What artery supplies the anterior wall of the heart?

A

Left anterior descending artery supplies anterior wall and can cause bundle branch block and second and third-degree block

163
Q

Is this a Right BBB or a left BBB? How can you tell?

A
164
Q

Describe a Second Degree Type II HB

  • What happens to the PR interval?
  • Where is this block usually located?
  • What is the Tx?
A
165
Q

Is this associated with V-Tach or SVT + Aberrancy

A

SVT + Aberrancy

166
Q

Describe a second-degree Type I Wenckebach HB

  • What happens to the PR interval?
  • What heart structure is this type of block most likely near?
  • What is the tx for this?
A
  • Probably near the AV node
167
Q

What occurs in a Bundle Branch Block?

A
168
Q

What are the Pharmacokinetics for Digoxin?

A

Cardio All (8 decks)

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