Exam 2

Question 1

3 general types of blocks

Answer 1

SA node block, AV block, bundle branch block

Question 2

Define SA node block

Answer 2

SA node fires but depolarization of atria doesn’t occur. Appears as pause in cardiac cycle.

Question 3

Define AV block

Answer 3

Block b/t SA and Purkinje fibers. Includes AV node and His bundle.

Question 4

Define Bundle Branch Block

Answer 4

Block on ventricle bundle branches.

Question 5

What is it called if only one bundle is blocked?

Answer 5

Fascicular block or hemiblock

Question 6

How to diagnose 1st degree AV block

Answer 6

PR interval longer than 0.2 s

Question 7

How to diagnose 2nd degree AV block?

Answer 7

P to QRS greater than 1:1 (not all atrial impulses able to pass through to ventricles)

Question 8

What does Wenkebauch block look like on EKG? How does this differ from Mobitz type 2?

Answer 8

Each successive atrial impulse encounters a longer and longer
delay in the AV node until one impulse (usually every third or fourth) fails to make it through. With Mobitz progressive lengthening does not occur, it is an all-o-none phenomenon.

Question 9

What is 3rd degree AV block AKA? Why? What happens?

Answer 9

Complete heart block because nothing from the SA node is going through to the ventricles. Idioventricular “escape” rhythm takes over at 30-45 beats/min

Question 10

Is Vtac ever slower than the heart’s normal rhythm?

Answer 10

No

Question 11

Cause of and solution to 3rd degree heart block?

Answer 11

Cause: degenerative disease or Lyme disease. Solution: pacemaker

Question 12

What is the critical rate?

Answer 12

Heart rate at which bundle branch block forms (bbb not always rate related)

Question 13

Criteria for bundle branch block

Answer 13

QRS < 0.12s

Question 14

How is MI diagnosed?

Answer 14

Usually by Troponin I levels, which are released by the dying myocardium and can be detected for several days

Question 15

Treatment for MI

Answer 15

O2 and nitroglycerin, thrombolytics, percutaneous coronary angioplasty (PCA), intra-coronary stent (ICS), coronary artery bypass graft (CABG)

Question 16

Types of thrombolytics

Answer 16

streptokinase, Retavase, tissue plasminogen activator (TPA), Plavix

Question 17

What is electrical conduction pathway from AV node?

Answer 17

AV node, Bundle of His (up to bifurcation), Bundle Branches (L and R), Purkinje Fibers (the little fibers that branch off from the bundle branches)

Question 18

What is pre-excitation?

Answer 18

Signal traveling from atria to ventricles too fast, usually bypassing the AV node via an accessory pathway

Question 19

Name of pathway that current follows in Lown-Ganong-Lavine?

Answer 19

James fibers

Question 20

Name of pathway that current follows in WPW?

Answer 20

Bundle of Kent

Question 21

PVC treatment?

Answer 21

Beta blockers, anti-arrhythmics, balance electrolytes, Ca++ channel blockers

Question 22

A fib treatment?

Answer 22

Rate control (Meoprolol, Amiodarone, Diltiazem), Anticoag meds (Aspirin, low molec wt Heparin, Warfarin)

Question 23

Artery involved in each infarction: anterior, posterior, lateral wall?

Answer 23

anterior: L anterior descending, R coronary artery, L circumflex

Question 24

Artery involved in anterolateral infarction?

Answer 24

L anterior descending, L circumflex, obtuse marginal (circles around back)

Question 25

Artery involved in anteroseptal infarction?

Answer 25

L anterior descending

Question 26

What are the anterior leads?

Answer 26

V1-V4

Question 27

What are the lateral leads?

Answer 27

V5, V6, I, aVL

Question 28

What are the inferior leads?

Answer 28

III, aVF, II