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Emergency Medicine and Surgical Care > ER cardiology > Flashcards

ER cardiology Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Osborne Waves

A

Hypothermia

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2
Q

5 Steps for ECG

A

Rate, Rhythm, Axis, Hypertrophy, Infarction

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3
Q

What to look for Rhythm

A

p before every QRS, QRS after every P, P and QRS intervals

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4
Q

Irregular rhythms

A

Sinus arrhythmia, Wandering pacemaker, multifocal atrial tachycardia, atrial fibrillation,

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5
Q

Escape Rhythms

A

atrial escape rhythm, Junctional escape rhythm, ventricular escape rhythm

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6
Q

Tachyarrhythmias

A

Atrial flutter(sawtooth pattern), atrial fibrillation, ventricular flutter, Ventricular fibrillation

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7
Q

1st degree AV block

A

prolonged PR interval >0.2 seconds

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8
Q

2nd degree AV block

A

Mobitz/Wenkebach . PR lengthens with a dropped QRS

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9
Q

2nd degree AV block Mobitz II

A

some P waves do not produce a QRS

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10
Q

3rd degree AV block

A

complete heart block. no P waves produce a QRS

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11
Q

Right BBB

A

R, R’ in V1 or V2

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12
Q

Left BBB

A

R, R’ in V5 or V6

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13
Q

What to look for in Axis

A

QRS + or - in leads 1 and aVF, is axis norma?

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14
Q

Normal Axis deviation

A

QRS upright in Lead 1 and in aVF

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15
Q

inferior MI

A

leads II, III, aVF, right coronary artery

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16
Q

anterior, anteroseptal MI

A

leads V1-V4, left anterior descending artery

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17
Q

lateral MI

A

v5-v6, 1, aVL, left circumflex artery

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18
Q

posterior MI

A

ST depression in V1, V2, left circumflex or right coronary artery

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19
Q

Anterior leads

A

V3, V4

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20
Q

Septal leads

A

V1, V2

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21
Q

inferior leads

A

II, III, aVF

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22
Q

Lateral leads

A

I, aVL, V5, V6

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23
Q

life threatening DDX

A

ACS, aortic dissection, PE, pneumonthorax, pericardial tamponade, Mediastinitis

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24
Q

Non-life threatening DDX

A

pleurisy, CHF, pneumonia, angina pectoris, pericarditis, endocarditis, PUD, GERD, panic disorder

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25
Q

Sick sinus syndrome ECG

A

alternating tachy/brady

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26
Q

SSS TX

A

pacemaker

27
Q

SVT TX

A

Unstable- cardiovert. Stable- vagal manuever or carotid massage.
Drugs- adenosine 6mg IV, diltiazem or CCB, BB

28
Q

Torsades TX

A

Magnesium sulfate

29
Q

Ventricular fibrillation TX

A

defibrillation 360J monophasic, 120-200J Biphasic

30
Q

Asystole/PEA algorithm

A

CPR 2 min, IV access/epi, continue CPR until shockable rhythm

31
Q

VF/VTach

A

CPR 2 min, IV access/epi, continue CPR, amiodarone (300mg, then 150mg) if epi doesnt work

32
Q

adult tachycardia w/ pulse algorithm

A

1) maintain airway, oxygen, cardiac monitor
2) unstable- synchronized cardioversion. consider adenosine
2) stable with wide QRS- adenosine or antiarrhythmic
3) vagal maneuvers, adenosine, BB/CCB

33
Q

Adult Bradycardia w/ Pulse

A

1) identify and treat underlying cause
maintain airway, oxygen, monitor
2) unstable- atropine (.5 mg bolus to a max of 3 mg), dopamine or epinephrine
3) stable- monitor

34
Q

Post cardiac arrest care

A

1) maintain oxygen

2) treat hypotension

35
Q

Wandering Pacemaker

A

Maintains rate but P waves change

36
Q

Multifocal Artrial Tachycardia

A

P wave changes shape and rate is >100bpm

37
Q

Atrial Fibrillation

A

chaotic atrial spikes, no discernable P waves

38
Q

Atrial Escape

A

skips a beat and then resumes sinus pacing

39
Q

Junctional escape rhythm

A

skips a beat and a P wave then resumes pacing 40-60bpm with no P waves

40
Q

Ventricular Escape rhythm

A

Skipped beat and 20-40 rate resumes with no P waves and wide QRS

41
Q

Junctional Escape beat

A

sinus pause then a beat with no P wave

42
Q

Ventricular Escape beat

A

sinus pause then a beat with no P wave and wide QRS

43
Q

Premature junctional contractions

A

premature beat with no P wave or inverted P wave

44
Q

Premature Ventricular contraction

A

premature beat with wide QRS

45
Q

Paroxysmal atrial tachycardia

A

regular rhythm that suddenly becomes much faster, P waves will be normal if they are not buried in the T wave

46
Q

Paroxysmal Junctional Tachycardia

A

often looks the same as SVT but no discernible P waves ever

47
Q

atrial flutter

A

saw tooth pattern

48
Q

atrial fibrillation

A

irregularly irregular chaotic atrial firing

49
Q

ventricular fibrillation

A

Smooth sine waves

50
Q

Ventricular fibrillation

A

totally erratic

51
Q

Heart Block poem

A

if the R is far from P then you have a first degree
Longer, longer, longer drop! Then you have a Wenkebach
If some P’s just don’t get through, then you have a mobitz II
If P and Q just don’t agree, then you have a third degree

52
Q

RBBB

A

RR’ in V1-V2

53
Q

LBBB

A

bunny ears in V5-V6

54
Q

Right axis deviation

A

QRS upright in lead aVF and inverted in Lead 1

55
Q

Left axis deviation

A

QRS upright in lead I and inverted in aVF

56
Q

Extreme RAD

A

QRS inverted in both lead I and avf

57
Q

Right atrial hypertrophy

A

large diphasic P wae with tall initial componentq

58
Q

Left atrial hypertrophy

A

Large diphasic P wave with a wide terminal component

59
Q

ST elevation

A

injury

60
Q

T wave inversion

A

Ischemia

61
Q

Atropine

A

Bradycardia

62
Q

Adenosine

A

6mg supraventricular tachycardia

63
Q

diltiazem

A

atrial flutter

64
Q

Ventricular arrhythmias

A

Amiodarone

Emergency Medicine and Surgical Care (9 decks)

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