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cardiology testing 123 > EP > Flashcards

EP Flashcards

1
Q

congenital 2:1 block

A

LQT syndrome

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2
Q

what is the u wave from

A

repol of purkinje fibers

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3
Q

mortality if 2:1 block as a fetus

A

50% at 6 months, 2/3 by 2 years

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4
Q

gene of LQT1

A

KNCQ1 (Potasium K channel)

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5
Q

gene LQT2

A

KNCQ2 (potassium K channel)

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6
Q

gene LQT3

A

SCN5A (Na channel) Sodium ChaNel

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7
Q

elecrolytes that prolong QT

A

hypoKalemia, hypo Mg, hypo Ca

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8
Q

T waves for LQT1,2,3

A

1 broad, 2 broad with notch, 3 long isoelectric (shark fin)

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9
Q

Inverted T waves in V1-V3 at > 14 years old

A

ARVC (right heart)

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10
Q

EKG for ARVC

A

inverted T wave V1-V3 if > 14 years (right heart)

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11
Q

Upright T wave in V1 or V3R between 3 days and 8 years

A

high spec for RVH

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12
Q

qR pattern in right sided precordial leads (V1, V3R, V4R)

A

severe RVH

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13
Q

pure R wave/RR’ in right sided precordial leads (V1, V3R, V4R)

A

=> RV pressure overload

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14
Q

Q waves > 3 mm and tall symmetric T waves in V5 or V6

A

LV volume overload (PDA) or septal hypertrophy

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15
Q

Which leads in ALCAPA

A

q wwaves Lateral leads, also watch for ST changes and abnormal R wave progression

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16
Q

first line fetal SVT if no hydrops, dose target?

A

digoxin, maternL > 2 (0.6 transfer rate, hydrops decreased by 50%)

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17
Q

fetal SVT drugs if hydroptic

A

sotalol or felcainide

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18
Q

risk of sudden cardiac death in LQTS

A

1) QTc>500 2) previous episode of syncope

19
Q

infantile atrial flutter, Tx and Px?

A

Tx: DC cardioversion Px: good, low risk recurrence

20
Q

strongest predictors of risk of SCD in HCM

A

1)fam Hx sudden death 2) septal thickness >30mm

secondary predictors: NSVT, syncope, BP blunting with exercise

21
Q

amiodarone drug drug interactions?

A

inc warfarin effect, digoxin + phenytoin levels, class I antiarrythmic toxicity

22
Q

borrelia burgdorferi

A

lyme disease, central clearing = erythma migrans: treat with doxy or ceftiaxone

23
Q

sports EKG with T wave inversions, which are normal abnormal, what do you do?

A

normal V1, abnormal V5,V6, get an echo

24
Q

opthalmoplegia + heart block, what is it?

A

Kearns-Sayre syndrome. (mitochondrial defect with ataxia, eye muscle stuff, vision problems, heart block), implant a pacemaker if bifascicular block. [Corn Slayer - corn is for eyebals, slayer is for slicing the conduction system]

25
Q

bad prognosis LQTS in a newborn

A

LQTS with 2:1 block -> 50% mortality

26
Q

what does lack of HR variability in a fetal indicate?

A

fetal hypoxemia -> CNS depression -> loss of fetal HR variability

27
Q

why is the T wave in V1 positive at birth?

A

early repol of the LV and late termination of depolarization from the RV

28
Q

wat causes PJRT?

A

slow accesory pathwya in the right posterior septum

slow -> P wave visable (negative in II, III, aVF, due to location), slower rate (150-200)

29
Q

what CHD is associated with CHB?

A

ccTGA, LAI, DORV, AVSD: poor prognosis 30% 1 yr survival

30
Q

1st child had autoimmune fetal CHB, what is risk for child 2?

A

11-19%

31
Q

risk of CHB if SSA> 50?

A

1-5% (second child 11-19%)

32
Q

medication contraindicated in WPW?

A

verapamil

33
Q

intracardiac tracing where most activity falls under the QRS?

A

typical AVNRT

34
Q

tachycardia that is wide and irregular

A

a fib with WPW

35
Q

when is adenosine contraindicated?

A

wide irregular tachycardia = a fib with WPW

36
Q

how does pacemaker mediated tachycardia work?

A

V pace, retrograde through AV node, atrial activation, “p” wave sensed and V is paced

37
Q

intracardiac, stim of atrium: what do you check?

A

conduction to V, then check HV interval if negative WPW

38
Q

intracardiac, stim of ventricle: what do you check?

A

conduction to A, midline or eccentric

39
Q

intracardiac, no stim, next question

A

fast or slow

40
Q

intracardiac, no stim, slow, what to look for

A

earliest A

41
Q

intracardiac, no stim, fast, 3 questions

A

narrow/wide, reg/irregular, A/V relationship

42
Q

intracardiac, no stim, fast, more As than Vs

A

A fib or A flutter

43
Q

intracardiac, no stim, fast, more Vs than As

A

junctional or VT: junctional shows a his deflection before the QRS, VT may have dissociated As and Vs

44
Q

intracardiac, no stim, fast, #As = #Vs, what to look for?

A

look for earliest A

cardiology testing 123 (10 decks)

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