Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardiology Med-Study > Lecture 10; Arrythmias > Flashcards

Lecture 10; Arrythmias Flashcards

1
Q

sawtooth pattern

A

atrial flutter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where does atrial flutter originate

A

cavo-tricuspid isthmus counterclockwise between IVC and tricuspid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

treatment of atrial flutter

A

same as afib

  • rate and anticoagulation
  • most need to be ablated because they are hard to control with medicaitons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

unstable atrial arrythmia tx

A

cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

stable atrial arrhythmia

A
  • vagal/ AV manuevers

- BB, diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

goal HR in atrial fibrillation

A

HR < 80 at rest

HR < 110 with exercize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medications for rate control in afib

A

BB (proponalol, metoprolol, esmolol)
non-hydropyradime (diltiazem, verapamil)
digoxin
amioadorane

AV blockers (allow the conduction from the atrium to be conducted to the ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Amiodarone toxicity

A

What A BITCH

B: bradycardia, Blue man sydnrome
I: interstitial lung disease, increased QTC
T: thyrdoid
C: - corneal micro
- cytochrome P450
- Increase Warfarin/Simvitastatin/digoxin levels - needs dose reduction
H: Hepatic, Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which rhythm control is used if structural heart disease

A

amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which rhythm control if no structural heart disease

A

flecanide
dofetilide
propafenone
ibutilide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

lone a fib tx

A

nothing or ASA

CHADS2VASC 0-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

valvular afib tx

A

wafarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

tx non-valvular afib

A

CHA2DS2-VASc
Condition Points
C Congestive heart failure (or Left ventricular systolic dysfunction) 1
H Hypertension: blood pressure consistently above 140/90 mmHg (or treated hypertension on medication) 1
A2 Age ≥75 years 2
D Diabetes Mellitus 1
S2 Prior Stroke or TIA or thromboembolism 2
V Vascular disease (e.g. peripheral artery disease, myocardial infarction, aortic plaque) 1
A Age 65–74 years 1
Sc Sex category (i.e. female sex) 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

HAS BLED

A

> 3
caution
Condition Points
H Hypertension: (uncontrolled, >160 mmHg systolic) 1
A Abnormal renal function: Dialysis, transplant, Cr >2.26 mg/dL or >200 µmol/L ==> 1
Abnormal liver function: Cirrhosis or Bilirubin >2x Normal or AST/ALT/AP >3x Normal 1
S Stroke: Prior history of stroke 1
B Bleeding: Prior Major Bleeding or Predisposition to Bleeding 1
L Labile INR: (Unstable/high INR), Time in Therapeutic Range 65 years
1
D Prior Alcohol or Drug Usage History (≥ 8 drinks/week) == >1
Medication Usage Predisposing to Bleeding: (Antiplatelet agents, NSAIDs)
1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

goal for INR afib

A

2-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

direct thrombin inhibitor

2 things to remember

A

digatraban

  • renally adjusted
  • no bridge needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

RAEF

A

rivoraxaban
Apixiban
Endoxaban
Factor XA inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which NOAC can be used in dialysis patients

A

apixiban - acting up kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

timing of anticoagulation around cardioversion

A

If cardioversion is planned, anticoagulation therapy is based on the duration of atrial fibrillation. For patients who are known to have been in atrial fibrillation for less than 48 hours, preprocedural anticoagulation is not necessary as the risk of thrombus formation is low. Patients with atrial fibrillation of unclear duration or those with atrial fibrillation for more than 48 hours require preprocedural anticoagulation. These patients should receive 3 weeks of therapeutic anticoagulation prior to cardioversion. Alternatively, transesophageal echocardiography (TEE) can be performed to look for an intracardiac thrombus. If TEE is negative for thrombus, acute cardioversion can be performed immediately

minimum of 4 weeks owing to an increased risk of thromboembolic events after restoration of sinus rhythm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CAD + afib triple therapy management

A

if < 12 mo + stent ==> triple therapy
if < 12 mo, no stent = ASA + anticoagulation
if > 12 mo –> anticoagulation only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the contraindictations to ablation

A
  1. cannot be anticoagulated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

wpw with afib

A

procainamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

best med post op afib

A

sotolal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when are PVC required to be treat

A

symtomatic/frequent (> 10,000 in 24 hours)

(>10% of all beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
tx symptomatic pvc
BB, NDP-C
26
definition non=sustained v-tach vs. sustained
> 3 PVC sequential running at 100 bpm vs. no association + 30 seconds
27
stable Vt tx
amio
28
Pacemaker indications
Symptomatic bradycardia without reversible cause Asymptomatic bradycardia with significant pauses (>3 seconds in sinus rhythm) or persistent heart rate <40/min Atrial fibrillation with 5-second pauses Asymptomatic complete heart block or Mobitz type 2 second-degree atrioventricular block Alternating bundle branch block
29
CRT
Patients with left ventricular ejection fraction (LVEF) of less than or equal to 35%, sinus rhythm, LBBB (left bundle branch block), New York Heart Association (NYHA) Class II, III or IV symptoms while on optimal medical therapy with a QRS duration of greater than or equal to 150 ms
30
DOC Brugada
quinidine
31
DOC SVT
Adenosine
32
common 2/2 causes of bradycardia
elevated intracranial pressure, hypothyroidism, hyperkalemia, Lyme disease, and medication effects
33
DOC HF and afib
digoxin
34
AC despite CHADS
left atrial appendage thrombus, and hypertrophic cardiomyopathy require oral anticoagulation regardless of risk score
35
NOAC reversal
The FDA recently approved idarucizumab, a monoclonal antibody that can be used in emergency situations to reverse the anticoagulant effects of dabigatran.
36
pulmonary vein stenosis
Patients who develop dyspnea months to years after an atrial fibrillation ablation
37
high likelihood of familial arrhythmia issue
The presence of unexplained premature (younger than 35 years) death or sudden death in a first-degree family member should raise suspicion for the possible presence of an inherited arrhythmia syndrome and referral to a cardiovascular specialist
38
definition of long-QT syndrome
prolonged QTc interval (>440 msec in men and >460 msec in women) accompanied by unexplained syncope or ventricular arrhythmia
39
tx long QT syndrome
irst-line therapy for long QT syndrome is β-blocker therapy. Patients with cardiac arrest or those who have recurrent events (syncope or VT) despite β-blocker therapy should undergo ICD implantation.
40
definition and treatment of short QT syndrome
short QT interval, usually less than 340 msec (or QTc <350 msec). high risk for SCD, and ICD placement is recommended for all patients.
41
ACS for asystole PEA
asystole or pulseless electrical activity (PEA), CPR is continued with reassessment of rhythm status for a shockable rhythm every 2 minutes. Epinephrine (1 mg intravenously) should be given every 3 to 5 minutes, although vasopressin (40 units intravenously) can replace the first or second dose of epinephrine.
42
ACS for VT/VF
In patients with VT/VF, a shock is advised with immediate resumption of CPR and reassessment of the rhythm in 2 minutes. Epinephrine should be given after the second shock and every 3 to 5 minutes thereafter. If VT/VF continues despite three shocks and epinephrine, amiodarone should be given as a bolus.
43
bradycardia symptomatic tx
ymptomatic bradycardia and hemodynamic distress should first be treated with atropine. If atropine is ineffective, dopamine or epinephrine infusions can be attempted until transcutaneous pacing or a temporary pacing wire (preferred) can be implemented
44
what should you not do in suspected device infecton
he device pocket should never be aspirated for diagnostic purposes because puncturing the pocket can damage the leads or introduce infection.
45
QTC in female and man considered prolonged
450 in women and 470 in men
46
treatment of congenital Long QT
1. avoidance of Low MG/low K 2. Antipsychotics/FQ/Anti-emetics/marcolides/antiarrythmics 3. tx with BB
47
Cheyne-stoke breathing
creascendo-decrescendo osillation in tidal volume and intervals of hyponea and apena - central sleep apnea - advanced Hf
48
treatment atrial flutter
most effective and first line treatment is radiofrequency ablation
49
treatment of pericarditis
NSAIDS and cholchine | NOT STEROIDS
50
anticoagulation around cardioversion
3 weeks and then 4 weeks after
51
triple DAPT and AC therapy
ACS < 12 months - triple | > 12 months - only AC
52
when do you treat PVC with medication
BB | > 10,000 in 24 hours or > 10% of all beats are PVV
53
pacemaker indications
1. symptomatic bradycardia 2. 2nd degree type 2 or third degree heart block 3. sinus pauses > 3 seconds with afib 4. alternating bifisciular block
54
anticoagulation around surgery
low risk surgery - no interruption in warfarin without bridging high risk surgery - temp interruption in wafarin
55
who requires bridging
CHADS2VASC > 6
56
QRS duration for BIV pacing
QRS > 150
57
risk stratification for WPW
exercize stress test with increased HR or procainimide challenge. Intermittent loss of delta waves is a good prognostic factor and don't have to do anything else
58
what medication need to be avoided in WPW
AV nodal blockers
59
tx high risk WPW
catheter ablation
60
INR goal mitral stenosis/afib
2.5

Cardiology Med-Study (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions