EKG

Question 1

NSR is ____ bpm

Answer 1

60-100

Question 2

Sinus brady is HR < ____bpm

Answer 2

60

Question 3

Sinus Tachy is HR > ____ bpm

Answer 3

100

Question 4

Rx for Sinus Brady

Answer 4

Atropine

Question 5

Rx for Sinus Tachy

Answer 5

Adenosine

Question 6

Narrow QRS + Regular Rhythm

Answer 6

Sinus Tach
AVNRT
Atrial Tach
Atrial Flutter
Junctional Tachy

Question 7

Narrow QRS + Irregular Rhythm

Answer 7

Atrial fib
Atrial Flutter w/variable AV block
Multifocal Atrial Tach

Question 8

Wide QRS + Regular Rhythm

Answer 8

Ventricular Tach
SVT with bundle branch block
Antidromic AVRT
Pre-excited SVT

Question 9

Wide WRS + Irregular Rhythm

Answer 9

Polymorphic Ventricular Tach
Afib w/bundle branch block
Atrial Flutter with variable AV block and bundle branch block

Question 10

Irregularly irregular R-R intervals with loss of P waves

Answer 10

Atrial Fibrillation
Tx: Rate>Rhythm control

Question 11

Rx for Afib rate control

Answer 11

BB
CCBs Non-DHP (Diltiazem, Verapamil)

Question 12

Afib puts you at risk for a

Answer 12

Stagnant blood -> Clot -> stoke
(starts out in LT atrium)

Question 13

Short PR interval, wide QRS, delta wave (initial slurring of QRS), no flat PR segment, no pause at the AV node

Answer 13

Wolff Parkinson White (WPW) Syndrome

Question 14

Tx for unstable vs stable pt with WPW

Answer 14

Unstable -> Cardiovert
Stable -> Procainamide (Na+ Channel blocker)

Tx: NO AV NODAL BLOCKING DRUGS -> RATE WILL SKYROCKET -> VFIB -> DEAD

Question 15

Multifocal Atrial Tachy (MAT) vs Wandering Atrial Pacemaker (WAP)

Answer 15

MAT = HR >100
WAP = HR <100
Both: Irregular; >3 distinct P waves in same lead

Question 16

Never give adenosine if (narrow/wide) QRS

Answer 16

wide (issue with ventricles too slow)
(Will make it worse)

Question 17

Rx for Paroxysmal Supraventricular Tachy

Answer 17

Adenosine, Verapamil (Non DHP CBB)
BOLUS

Question 18

Every P is followed by a QRS but there are consistently long P-R intervals

Answer 18

1st degree heart block

Question 19

P-R interval gets longer, longer, longer and then drops (not every P is followed by a QRS)

Answer 19

2nd degree heart block - Mobitz type I (Wenkebach)

Question 20

P-R intervals are normal, normal, drop
QRS is intermittently dropped

Answer 20

2nd degree heart block - Mobitz type II

Question 21

There are P waves and QRS but they dont correlate with one another

Answer 21

3rd degree (complete) heart block

Question 22

Wide S in 1
Triphasic QRS in V1 (extra R in QRS)

Answer 22

RT bundle branch block

Question 23

Wide R in 1
Notched S in V1

Answer 23

LT bundle branch block

Question 24

Rx for Premature Atrial Contractions (PACs) and Premature Ventriculare Contractions ( PVCs)?

Answer 24

Rate control BB, CCBs

Question 25

3+ consecutive ventricular beats @ 120bpm+
“regular broad complex tachy (wide QRS) with uniform QRS in each lead”

Answer 25

Ventricular tachy

Question 26

Pulseless vs stable sustained trmnt for V tach

Answer 26

Pulseless -> CPR -> defib -> Epi -> Amiodarone
Stable sustained -> Amiodarone -> Cardiovert

1st line antiarrhythmic = AMIODARONE

Question 27

Polymorphic VT + long QT

Answer 27

Tosades de pointes (TdP)
Tx: Magnesium sulfate

Question 28

Wide, irregular QRS
Ultrarapid baseline undulations that are irregular in timing and morphology

Answer 28

Vfib
Tx: CPR -> Defib -> Epi -> Amiodarone

Question 29

_____ syndrome = mutated loss of Na+ channel function -> die in your sleep

Answer 29

Brugada Syndrome
ST Elev in V1-V2 (slope down)
Tx: ICD, Quinidine (Na+ Channel Blocker)

Question 30

exercise-induced syncope

Answer 30

Catecholaminergic polymorphic ventricular tachy
Tx: ICD, BB, Flecainide, genetic testing

Question 31

____ syndrome = Delysm cough syrup & Quinine can put you into cardiac arrest and mimic epilepsy ss

Answer 31

Long QT syndrome

Question 32

What things can cause Long QT syndrome

Answer 32

Delsym, Sotalol, Quinine (tonic water), SSRIs, Antipsychotics,