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Step 1 > EKG/ Arrhythmias > Flashcards

EKG/ Arrhythmias Flashcards

0
Q

QRS complex

A

ventricular depolarization

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1
Q

What does P wave represent

A

Atrial depolarization

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2
Q

PR interval; how many boxes is normal length

A

conduction delay through AV node

*less than 5 little boxes (under 200 msec; one little box is 0.04 s)

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3
Q

QT interval

A

mechanical contraction of ventricles

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4
Q

T wave

A

ventricular repolarization

*T wave inversion may indicate recent MI

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5
Q

Chaotic and irregularly irregular baseline with NO p-waves

A

Atrial fibrillation

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6
Q

Sawtooth pattern due to identical, back to back atrial depolarization waves

A

Atrial flutter

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7
Q

PR interval over 200 ms long; what two drug classes can cause?

A

1st degree heart block

*can be caused by Beta blockers and CCBs

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8
Q

Progressive lengthening of PR interval until a beat is dropped (p wave not followed by a QRS complex)

A

Mobitz type 1 2nd degree block (Wenkebach)

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9
Q

Dropped beat not preceded by a change in length of PR interval

A

Mobitz type II 2nd degree block

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11
Q

atria and ventricles beat independently of each other (p wave and QRS complexes have no resemblance to each other)

A

3rd degree (complete) heart block

*atrial rate is faster than ventricular

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12
Q

Delta waves (representing early ventricular depolarization)

A

Wolff-Parkinson-White syndrome (accessory signal that bypasses the AV node; also called ventricular pre-excitation syndrome)–> delta wave is caused by early ventricular depolarization, is where PR interval should be

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13
Q

Wide QRS after long pause; usually there is associated bradycardia; no p-wave

A

Ventricular Escape rhythm (failure of SA or AV node to originate a signal, eventually kind of just beat on their own due to intrinsic pacemaker activity)

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13
Q

Undulating amplitude of QRS may decompensate into v-fib

A

Torsades de pointe

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14
Q

wide QRS with tachycardia

A

Ventricular Tachycardia

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15
Q

Anything that prolongs the QT interval may predispose to what?

A

Torsades de pointe

16
Q

What are 3 antibacterials that may prolong the QT interval?

A

Macrolides (esp erythromycin)
Chloroquine
Mefloquine

17
Q

What two antipsychotics may prolong QT interval?

A

haloperidol and risperidone (other as well)

18
Q

Which HIV drug class may prolong QT interval?

A

Protease inhibitors (-navir)

19
Q

What two anti-arrythmic classes may cause QT prolongation?

A

1A –> quinidine

III –> sotolol, amiodarone

20
Q

All together, what drugs prolong QT interval?

A

Macrolides (erythromycin), chloroquine and mefloquine
Haloperidol, risperidone
Protease inhibitors
Quinidine, amiodarone, sotalol

21
Q

How does Ventricular fibrillation look on EKG?

A

Completely erratic rhythm with NO IDENTIFIABLE WAVES

*fatal without immediate CPR and defibrillation

23
Q

Tx for acute Atrial fibrillation?

A

cardioversion

24
Q

Tx for chronic A-fib?

A 
Anticoagulation
Rate control (digoxin, BB, CCBs)
Rhythm control (sotalol, amiodarone)

*DONT CARDIOVERT TO NORMAL RHYTHM IF PRESENT OVER 48 HRS!! if clot has formed, normal rhythm may shake loose a clot that has formed–> stroke or PE will ensue

25
Q

what does a narrow QRS indicate in general

A

that the signal is originating above the ventricles (SA or AV node)

26
Q

AV node is pacemaker (narrow QRS), but slow rate

A

Junctional Escape Rhythm

27
Q

early wide QRS with bizarre morphology, no p-waves

A

Premature Ventricular contractions (QRS is over 4 little boxes when normal is 1)

28
Q

what causes PVCs?

A

microentry at the level of Purkinje fibers–> wide QRS tell you the signal is originating somewhere below the AV node

29
Q

what can WPW lead to if not treated

A

Supraventricular tachycardia

30
Q

ventricular bigeminy

A

PVC follows each sinus beat

31
Q

ventricular trigeminy

A

2 sinus beats followed by a PVC

32
Q

What does the height of the p-wave correlate with?

A

the K+ level–> too tall means hyperkalemia; flat p-wave can mean hypokalemia

33
Q

what does the delay in the AV node allow for

A

ventricular filling

34
Q

ST segment

A

represents the period in which the ventricles are depolarized; is isoelectric normally–> how long ventricles are deploarized

35
Q

where is speed of conduction fastes?

A

purkinje fibers > atria > ventricles > AV node

36
Q

tx for torsades

A

Mg sulfate

37
Q

congenital long QT syndromes + severe congenital deafness

A

Jervell and Lange-Nielson syndrome–> due to defective cardiac Na or K channels

Step 1 (63 decks)

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