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EKG > Dysrhythmias (Exam #1) > Flashcards

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
Q

What rate range is seen with a Junctional Escape Rhythm? Accelerated Junctional Rhythm? Junctional Tachycardia?

A
  • Junctional Escape Rhythm: 40-60 bpm
  • Accelerated Junctional Rhythm: 60-100 bpm
  • Junctional Tachycardia: 100-180 bpm
26
Q

What type of dysrhythmia occurs when the atria, AV junction, or both cannot create impulse?

A

Ventricular dysrhythmias

27
Q

What are the three key characteristics seen with ventricular dysrhythmias?

A
  • Absent P waves
  • Wide/bizarre QRS complex
  • T wave in opposite direction as R wave
28
Q

Which dysrhythmia involves an early ectopic beat that originate from ventricular system/muscle?

A

Premature Ventricular Complexes (PVCs)

29
Q

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

A

Premature Ventricular Complexes (PVCs)

- For R-R wave, tip of right caliper does line up with next R wave

30
Q

What type of PVC occurs on/near previous T wave, and what can these precipitate (2)?

A

R-on-T PVCs

- Can precipitate VTach or VFib

31
Q

What type of PVCs involve two in a row?

A

Couplet PVCs

32
Q

What type of PVCs fall between two regular complexes and do not disrupt the normal cardiac cycle?

A

Interpolated PVCs

33
Q

What rate range is seen with an Idioventricular Rhythm? Accelerated Idioventricular Rhythm? Ventricular Tachycardia?

A
  • Idioventricular Rhythm: 20-40 bpm
  • Accelerated Idioventricular Rhythm: 40-100 bpm
  • Ventricular Tachycardia: 100-125 bpm
34
Q

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?

A

Prolonged QT interval

Tx with…

  • NOT in cardiac arrest = magnesium sulfate
  • In cardiac arrest = defibrillation
35
Q

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?

A

Prolonged QT interval

Tx with…

  • NOT in cardiac arrest = magnesium sulfate
  • In cardiac arrest = defibrillation
36
Q

Which ventricular dysrhythmias is ALWAYS clinically significant?

A

Ventricular Tachycardia

- Often unstable

37
Q

Which dysrhythmia involves 3+ PVCs in a row, and what are the two subtypes?

A

Ventricular Tachycardia

  • NON-sustained = lasts <30 seconds
  • Sustained = lasts 30+ seconds (persistent)
38
Q

Which dysrhythmia involves rate of 300-500 bpm; wavy/chaotic line without logic?

A

Ventricular Fibrillation (VF)

39
Q

If a patient is in Ventricular Fibrillation (VF), how will the patient present (3)?

A
  • Full cardiac arrest
  • Unresponsive
  • Pulseless
40
Q

Which dysrhythmia is TERMINAL (flat line); absence of any cardiac activity and no CO?

A

Asystole

41
Q

Which dysrhythmia involves organized electrical rhythm but patient is pulseless and apneic?

A

Pulseless Electrical Activity (PEA)

42
Q

Which type of block involves prolonged PR interval only?

A

1st Degree AV block

43
Q

Which type of block involves regular rhythm and fixed PR interval?

A

1st Degree AV block

44
Q

Which type of block involves progressive PR interval prolongation and dropped QRS?

A

2nd Degree AV block, TYPE I

45
Q

Which type of block involves irregular rhythm and variable PR interval?

A

2nd Degree AV block, TYPE I

46
Q

Which type of block involves fixed PR interval (often prolonged) and dropped QRS?

A

2nd Degree AV block, TYPE II

47
Q

Which type of block involves irregular rhythm and fixed PR interval?

A

2nd Degree AV block, TYPE II

48
Q

Which type of block involves QRS associated with every other P wave?

A

2:1 AV Block (Type I or Type II)

49
Q

Which type of block involves regular rhythm and fixed PR interval?

A

2:1 AV Block (Type I or Type II)

50
Q

Which type of block involves dissociate of P wave and QRS complex?

A

3rd Degree AV block

51
Q

Which type of block involves regular rhythm and variable PR interval?

A

3rd Degree AV block

52
Q

What is another name for a 2nd Degree AV block, TYPE I (2)?

A

Wenckebach or Mobitz I

53
Q

What is another name for a 2nd Degree AV block, TYPE II?

A

Mobitz II

54
Q

What is another name for a 3rd Degree AV block?

A

Complete Heart Block

55
Q

Which type of block is a serious dysrhythmia (“malignant”); often progresses to a 3rd degree AV block?

A

2nd Degree AV block, TYPE II

56
Q

Which type of block is an intermittent block at AV node? Which is an intermittent block at Bundle of His or bundle branches?

A
  • 2nd Degree AV block, TYPE I = AV node

- 2nd Degree AV block, TYPE II = Bundle of His

EKG (8 decks)

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