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SP: Cardiology Pearls (16%) > EKG > Flashcards

EKG Flashcards

1
Q

What arrhythmia is associated with the use of medications and sudden death?

A

Long QT syndrome

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2
Q

What do PVCs which increase in frequency with exertion represent?

A

Cardiac ischemia

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3
Q

What is the treatment for LBBB or RBBB?

A

No treatment - They are signs of an underlying condition

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4
Q

Chest pain plus a new LBBB (Left Bundle Branch Block) = ?

A

An acute heart attack until proven otherwise

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5
Q

First line treatment for ventricular fibrillation?

A

Unsynchronized cardioversion

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6
Q

First line treatment for ventricular tachycardia without a pulse?

A

Unsynchronized cardioversion

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7
Q

First line treatment for ventricular tachycardia with a pulse?

A

Synchronized cardioversion

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8
Q

For a patient with a stable SVT at 220 bpm what are the first and second line treatments?

A

Vagal maneuvers first then adenosine if vagal fails

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9
Q

Untreated ventricular tachycardia progresses into what rhythm?

A

Ventricular fibrillation

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10
Q

Three PVCs in a row =?

A

Ventricular tachycardia

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11
Q

Three PACs in a row =?

A

PSVT (AKA SVT or PAT)

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12
Q

Which of the two 2nd degree heart blocks almost always becomes 3rd degree heart block?

A

2nd degree type 2

Mobitz type II

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13
Q

What is treatment for 2nd degree type 1 heart block?

A

Observation (pacer only if symptomatic)

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14
Q

What is treatment for 3rd degree heart block?

A

Pacemaker

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15
Q

What heart block has no association of P waves and QRS complexes?

A

Third Degree

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16
Q

What heart block has a long PR interval and never drops a QRS?

A

First degree

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17
Q

What heart block gets longer and longer PR then drops a beat?

A

2nd degree type 1

Wenckebach

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18
Q

What valvular disorder when combined with atrial fibrillation has highest risk of embolization?

A

Mitral stenosis

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19
Q

What conditions does a patient with atrial fibrillation have an increase risk of?

A

Stroke - ischemic limb - ischemic bowel

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20
Q

What is the treatment for valvular heart disease + atrial fibrillation?

A

Warfarin

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21
Q

What is the treatment for a patient with atrial fibrillation and a CHADS 2 score of a 0?

A

Aspirin

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22
Q

What scoring system is used to determine anticoagulation in patients with atrial fibrillation?

A

CHA₂DS₂-VASc

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23
Q

What duration is a normal QRS?

A

Less than 0.12 seconds

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24
Q

What has a short less than 0.10 sec PR interval and delta wave?

A

WPW (Wolff-Parkinson-White Syndrome)

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25
What is the PR interval over in first degree block?
Over 0.2 seconds (Normal is 0.12 to 0.2 seconds)
26
What is the rate for sinus tachycardia?
Over 100 bpm but less than 150
27
What is the rate for normal sinus rhythm?
60 - 100
28
What is the rate for bradycardia?
Less than 60 bpm
29
What electrolyte abnormality is associated with flattening of the T waves?
Hypokalemia
30
What electrolyte abnormality is associated with a prolonged PR interval and a widened QRS complex?
Hypermagnesemia
31
What electrolyte abnormality is associated with long QT?
Hypocalcemia
32
A 69 year old male dialysis patient is found on 12 lead ECG to have peaked T waves in all leads. What is the most likely electrolyte abnormality?
Hyperkalemia
33
How does the pharmacological management of ventricular fibrillation and ventricular tachycardia differ from that of Torsades do Pointes?
In Torsades, magnesium is used first line before amiodarone or lidocaine
34
Which antiarrhythmic medications can be used for a patient in ventricular tachycardia or ventricular fibrillation?
Amiodarone or lidocaine
35
A 54 year old in ventricular tachycardia, has a BP of 82/44 mmHg. What settings are appropriate for cardioversion of this patient?
Synchronized cardioversion
36
What medication class may be used to prevent arrhythmic events in a patient who has non-acquired long QT syndrome?
Beta blockers
37
What counseling must be given to a patient once they are diagnosed with non-acquired long QT syndrome?
The patient's family must be screened for long QT as well
38
A 76 year old who was recently started on levofloxacin, suffers a cardiac arrest. What may likely be found on further evaluation of her ECG?
Long QT
39
What is the most common accessory pathway in Wolff-Parkinson- White syndrome (WPW)?
The bundle of Kent
40
What medication is indicated for emergent treatment of tachyarrhythmia in a patient with diagnosed Wolff-Parkinson- White syndrome (WPW)?
Procainamide
41
Direct thrombin inhibitors can not be used for anticoagulation of atrial fibrillation if the patient also has which disorder?
Valvular heart disease
42
A 69 year old male with a history of mitral regurgitation has developed atrial fibrillation. Should he be placed on anticoagulation?
All patients with valvular heart disease + atrial fibrillation need to be anticoagulated
43
Should a solitary episode of atrial fibrillation in a healthy 34 year old require anticoagulation?
CHADS2 score is 0 - Patient is to be sent home on aspirin only
44
A stable 67 year old patient presents in atrial fibrillation but is unsure of any prior cardiac history. Should you cardiovert this patient?
No. 1) Medical treatment before cardioversion in stable patients 2) Unknown time of atrial fibrillation would anticoagulate prior
45
What is the dosing protocol for adenosine and what must you ensure regarding the IV access prior to administering the adenosine?
Adenosine 6 mg, if no change then 12mg, if no change then second dose of 12mg - Give through a large bore IV followed by rapid saline bolus
46
What is the first line treatment for a stable patient who is in a supraventricular tachycardia?
Vagal maneuvers (No carotid sinus massage in elderly)
47
A 48 year old patient has chest pain. Comparison of his 12 lead ECG to past tracings finds a new left bundle branch block. What is this finding consistent with?
New myocardial infarction
48
Although right bundle branch blocks are not pathological in and of themselves, what underlying pathology may they represent?
Pulmonary embolus - ASD - Heart attack
49
A nurse notes that a patient is having frequent premature atrial contractions (PACs), but is asymptomatic. What is your next step?
Check O2 saturation and electrolytes
50
Does second degree type I or type II more likely represent an significant underlying pathology?
Second degree type II
51
What is the recommended treatment for a patient in a second degree type I heart block with a blood pressure of 74/40 mmHg and chest pain?
Pacing - Rule out acute underlying ischemic pathology
52
Which of the following medications is the most likely to cause bradycardia? Furosemide Metoprolol Amlodipine
Metoprolol (beta blocker)
53
An 83 year old has a blood pressure of 90/58 mmHg and a heart rate of 132 bpm fever and a + UA. Should you use rate controlling medication?
No - The patient's tachycardia is reactive from her urosepsis and fever
54
What is the most common cause of sinus tachycardia?
Underlying non-cardiac pathology (sepsis, anemia, hyperthyroid state etc.)
55
You count 12 QRS complexes across the entire length of a 12 lead ECG. What is the approximate heart rate?
72 bpm - 10 seconds X 6 = 60 seconds/1 minute - 12 beats X 6 = 72 beats per minute
56
How many seconds are represented across the entire length of a 12 lead ECG?
10 seconds
57
While undergoing a stress test a patient's heart rate is 180 bpm and he is breathing heavily. What is the likely reason for his tachycardia?
Normal physiologic response to exercise
58
A 45 year old marathon runner presents to the office with a resting heart rate of 42 bpm. He is stable. What is your recommendation?
No treatment
59
Name leads which represent a lateral wall AMI?
V5 V6 I AvL
60
Name leads which represent an anterior AMI?
V3 V4
61
Name leads which represent a septal AMI?
V1 V2
62
Name the leads which represent an inferior AMI?
II III AvF
63
What does a finding of S1Q3T3 on a 12 lead EKG suggest?
Pulmonary embolism
64
What do diffuse ST elevations on a 12 lead EKG suggest?
Pericarditis
65
What is the first line medication for a patient with SVT from WPW?
Procainamide
66
What is the first line medication used in the treatment of Torsades?
IV magnesium

SP: Cardiology Pearls (16%) (12 decks)

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