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Dysrhythmias (Exam #1) Flashcards

1
Q

Where do sinus dysrhythmias originate from?

A

SA node

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2
Q

Which dysrhythmia involves patterned irregularity = cyclical rhythm (HR slows → speeds up → slows)?

A

Sinus Dysrhythmia (Sinus Arrhythmia)

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3
Q

Which dysrhythmia involves rate of <60 bpm; regular rhythm?

A

Sinus Bradycardia

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4
Q

Which dysrhythmia involves rate of 100-160 bpm; regular rhythm?

A

Sinus Tachycardia

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5
Q

Which dysrhythmia involves irregular rhythm when pause occurs then resumes normal appearance after pause? What are the two subtypes, and how do you tell them apart?

A

Sinus Pause/Arrest

  • Pause = 1-2 beats dropped
  • Arrest = 3+ beats dropped
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6
Q

Which dysrhythmia involves periods of bradycardia, tachycardia, prolonged pauses or alternating bradycardia/tachycardia? What is another name for this?

A

Sinus Node Dysfunction = “Sick Sinus Syndrome”

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7
Q

Where do atrial dysrhythmias originate from (2)? What three mechanisms cause these dysrhythmias?

A

Atrial tissue or internodal pathways

  • Automaticity (initiate impulses too early)
  • Triggered activity (repetitive firing)
  • Reentry
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8
Q

What are the three key characteristics seen with atrial dysrhythmias?

A
  • Altered P waves
  • Abnormal (shortened/prolonged) PR interval
  • Narrow/normal QRS complex
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9
Q

Which dysrhythmia involves P waves that change in appearance (3 or more appearances); pacemaker shifts between SA node, atria, AV junction?

A

Wandering Atrial Pacemaker

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10
Q

Which dysrhythmia involves P waves that change in appearance (3 or more appearances)?

A

Wandering Atrial Pacemaker

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11
Q

Which dysrhythmia involves early ectopic beat that originate outside of SA node?

A

Premature Atrial Complexes (PACs)

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12
Q

Which dysrhythmia involves a NON-compensatory pause, and what does this mean?

A

Premature Atrial Complexes (PACs)

- For R-R wave, tip of right caliper does NOT line up with next R wave

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13
Q

What are the three subtypes for PACs and PVCs?

A
  • Bigeminal = every other beat
  • Trigeminal = every 3rd beat
  • Quadrigeminal = every 4th beat
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14
Q

Which dysrhythmia involves rate of 150-250 bpm with regular rhythm; rate so fast that it overrides SA node? In what two patterns might they present?

A

Atrial Tachycardia

  • Short bursts (often well-tolerated)
  • Sustained (can cause sxs)
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15
Q

Which dysrhythmia involves rate of 120-150 bpm with irregular rhythm; appears similar to Wandering Atrial Pacemaker but faster?

A

Multifocal Atrial Tachycardia (MAT)

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16
Q

Which dysrhythmia involves ABSENT P waves (buried in T waves); regular rhythm?

A

Supraventricular Tachycardia (SVT)

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17
Q

Which dysrhythmia involves “saw tooth” appearance, and what is the rate range? What specific waves are seen?

A

Atrial Flutter = 250-350 bpm

- F waves

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18
Q

Which dysrhythmia involves absent P waves, instead involves F waves? f waves?

A
  • F = Atrial Flutter

- f = Atrial Fibrillation

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19
Q

For which two atrial dysrhythmias can you NOT measure PR interval or QT interval?

A
  • Atrial Flutter

- Atrial Fibrillation

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20
Q

Which dysrhythmia involves a rate of 350+ bpm; chaotic, synchronous firing?

A

Atrial Fibrillation

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21
Q

Which dysrhythmia involves irregularly irregular rhythm?

A

Atrial Fibrillation

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22
Q

Where do junctional dysrhythmias originate from?

A

AV junction

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23
Q

What are the two key characteristics seen with junctional dysrhythmias?

A
  • Inverted/absent P waves (before, buried in or after QRS complex)
  • Short PR interval
24
Q

Which dysrhythmia involves a single early beat arising from AV junction?

A

Premature Junctional Complexes (PJCs)

25
What rate range is seen with a Junctional Escape Rhythm? Accelerated Junctional Rhythm? Junctional Tachycardia?
- Junctional Escape Rhythm: 40-60 bpm - Accelerated Junctional Rhythm: 60-100 bpm - Junctional Tachycardia: 100-180 bpm
26
What type of dysrhythmia occurs when the atria, AV junction, or both cannot create impulse?
Ventricular dysrhythmias
27
What are the three key characteristics seen with ventricular dysrhythmias?
- Absent P waves - Wide/bizarre QRS complex - T wave in opposite direction as R wave
28
Which dysrhythmia involves an early ectopic beat that originate from ventricular system/muscle?
Premature Ventricular Complexes (PVCs)
29
Which dysrhythmia involves a compensatory pause, and what does this mean?
Premature Ventricular Complexes (PVCs) | - For R-R wave, tip of right caliper does line up with next R wave
30
What type of PVC occurs on/near previous T wave, and what can these precipitate (2)?
R-on-T PVCs | - Can precipitate VTach or VFib
31
What type of PVCs involve two in a row?
Couplet PVCs
32
What type of PVCs fall between two regular complexes and do not disrupt the normal cardiac cycle?
Interpolated PVCs
33
What rate range is seen with an Idioventricular Rhythm? Accelerated Idioventricular Rhythm? Ventricular Tachycardia?
- Idioventricular Rhythm: 20-40 bpm - Accelerated Idioventricular Rhythm: 40-100 bpm - Ventricular Tachycardia: 100-125 bpm
34
What is a classic finding seen with Torsades de Pointes (TdP)? How do you treat a patient with TdP NOT in cardiac arrest? IN cardiac arrest?
Prolonged QT interval Tx with... - NOT in cardiac arrest = magnesium sulfate - In cardiac arrest = defibrillation
35
What is a classic finding seen with Torsades de Pointes (TdP)? How do you treat a patient with TdP NOT in cardiac arrest? IN cardiac arrest?
Prolonged QT interval Tx with... - NOT in cardiac arrest = magnesium sulfate - In cardiac arrest = defibrillation
36
Which ventricular dysrhythmias is ALWAYS clinically significant?
Ventricular Tachycardia | - Often unstable
37
Which dysrhythmia involves 3+ PVCs in a row, and what are the two subtypes?
Ventricular Tachycardia - NON-sustained = lasts <30 seconds - Sustained = lasts 30+ seconds (persistent)
38
Which dysrhythmia involves rate of 300-500 bpm; wavy/chaotic line without logic?
Ventricular Fibrillation (VF)
39
If a patient is in Ventricular Fibrillation (VF), how will the patient present (3)?
- Full cardiac arrest - Unresponsive - Pulseless
40
Which dysrhythmia is TERMINAL (flat line); absence of any cardiac activity and no CO?
Asystole
41
Which dysrhythmia involves organized electrical rhythm but patient is pulseless and apneic?
Pulseless Electrical Activity (PEA)
42
Which type of block involves prolonged PR interval only?
1st Degree AV block
43
Which type of block involves regular rhythm and fixed PR interval?
1st Degree AV block
44
Which type of block involves progressive PR interval prolongation and dropped QRS?
2nd Degree AV block, TYPE I
45
Which type of block involves irregular rhythm and variable PR interval?
2nd Degree AV block, TYPE I
46
Which type of block involves fixed PR interval (often prolonged) and dropped QRS?
2nd Degree AV block, TYPE II
47
Which type of block involves irregular rhythm and fixed PR interval?
2nd Degree AV block, TYPE II
48
Which type of block involves QRS associated with every other P wave?
2:1 AV Block (Type I or Type II)
49
Which type of block involves regular rhythm and fixed PR interval?
2:1 AV Block (Type I or Type II)
50
Which type of block involves dissociate of P wave and QRS complex?
3rd Degree AV block
51
Which type of block involves regular rhythm and variable PR interval?
3rd Degree AV block
52
What is another name for a 2nd Degree AV block, TYPE I (2)?
Wenckebach or Mobitz I
53
What is another name for a 2nd Degree AV block, TYPE II?
Mobitz II
54
What is another name for a 3rd Degree AV block?
Complete Heart Block
55
Which type of block is a serious dysrhythmia (“malignant”); often progresses to a 3rd degree AV block?
2nd Degree AV block, TYPE II
56
Which type of block is an intermittent block at AV node? Which is an intermittent block at Bundle of His or bundle branches?
- 2nd Degree AV block, TYPE I = AV node | - 2nd Degree AV block, TYPE II = Bundle of His

EKG (8 decks)

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