Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiology 2 > Review of Dysrhythmias - Dr. McNeill > Flashcards

Review of Dysrhythmias - Dr. McNeill Flashcards

1
Q

What does a narrow QRS complex indicate regarding heart electricity

A

running through intrinsic circuitry (SA to AV to bundle of His, etc.

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

Definition of sinus rhythm

A
  • even R to R
  • P before every QRS
  • QRS < 0.12 seconds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Asystole

  • EKG appearance
  • best chance of recovery
A
  • flat line

- if d/t drug overdose and have narcan/naloxone on hand

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

Two types of vfib

A

course

fine

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

What causes the courseness of line in course vfib

A
  • differing amts of myocardium fibrillation

- myocytes in diff states of excitation and refraction (not working together) so have multiple points of excitation

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

What is important about fine vfib

A

can look like asystole and the treatments for asystole is very different than vfib

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

Is there a pulse in vfib?

A

never !

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

what happens to rhythm at the end of vfib?

A
  • see little blibs (agonal) that sort of look like PVCs

- is myocardium dying

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

Agonal/idioventricular rhythm

  • treatment
  • length can stay in this rhythm
A
  • treat like asystole, stop the code (take leads off so family doesn’t get upset)
  • can stay in this stage for 30-40 minutes until all myocardium dies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What rhythms does AED recognize?

A

V fib

V tach

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

What is width of QRS in all heart blocks?

A

narrow - means electricity flows through AV node

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

First degree AV block

- EKG findings

A
  • prolonged PR, conduction delay
  • P to Q is >0.2 seconds
  • SA node is fine but extra long slow down in AV node
  • does not progress to 2nd or 3rd degree blocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Second degree AV block Mobitz type I

  • EKG findings
  • pulse
A
  • PRI is short, longer, longest, dropped QRS

- pulse will feel abnormal

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

Second degree AV block Mobitz type II

  • EKG findings
  • pulse
A
  • PRI always the same except when a QRS is dropped
  • All QRS have a P
  • Not all P have a QRS
  • Pulse will feel abnormal
  • can progress to 3rd degree block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Third degree AV block

  • EKG findings
  • rate
A
  • R to R the same
  • P to P the same
  • Rs not related to Ps, atrium and ventricle doing their own thing
  • rate usually brady <40
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

STAT treatment for 3rd degree AV block

A

pacemaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens with P on T (R on T) phenomena

- when does it happen

A
  • causes fibrillation
  • why cardiovert doesn’t fire until after the T wave
  • can happen in 3rd degree block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sinus bradycardia

- cause

A
  • SA node is slowed down

- often due to BB or CCB overdose, thyroid issues, low cortisol, etc

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

PEA

A

organized rhythm on EKG but no pulse

20
Q

A fib

  • EKG findings
  • biggest worry
A
  • no P waves
  • narrow QRS (still using AV node)
  • irregular rhythm bc AV node fires erratically
  • biggest worry is thrombus/embolus formation
21
Q

A flutter

  • EKG findings
  • what’s happening with atria
A
  • Sawtooth or picket fence waves
  • organized atrial contraction at a regular rate
  • only certain atrial contractions result in QRS
22
Q

Causes of PEA trick to remember

A

Hs and Ts

23
Q

H’s (correctable) causes of PEA

A
  • Hypovolemia (#1)
  • Hypoxia (#2)
  • Hypothermia
  • Hypo/hyperkalemia
  • Hydrogen ion (acidosis)
  • Hypoglycemia
  • Tension pneumo
  • Tamponade
  • Toxins
24
Q

T’s (not correctable) causes of PEA

A
  • thrombosis (MI, PE)

- Trauma (increased cranial pressure ICP)

25
Q

When do you stop a code when person is in PEA

A

NEVER

- will turn into vfib if don’t fix underlying cause

26
Q

Sinus tachycardia

  • EKG findings
  • rate
A
  • narrow QRS
  • P before every QRS
  • rate usually not greater than 150
27
Q

Supraventricular tachycardia

  • EKG findings
  • rate
A
  • narrow QRS
  • no P wave
  • rate can go above 150
28
Q

ventricular tachycardia

  • EKG findings
  • three types
A
  • wide QRS

- can be pulseless, stable, unstable

29
Q

Pulseless vtach treatment

A

treat like vfib, defibrillate

30
Q

Unstable vtach

A

likely to have low bp, wet lungs full of fluid, likely to pass out

31
Q

AED and three types of vtach

A

can’t distinguish between all three types, will shock them all. Don’t want to shock stable vtach…

32
Q

Monomorphic vs. polymorphic QRS

A
  • monomorphic means one foci, all electrical impulses from same place outside of intrinsic circuitry, all QRS will look the same
  • polymorphic means multiple foci, all outs intrinsic circuitry, QRS will look different
33
Q

Junctional rhythm

- EKG findings

A
  • Narrow QRS
  • No P, no atrial contractions
  • AV node is pacemaker, why rate is so slow
34
Q

Multifocal PVCs

  • how serious
  • how treat
A
  • more ominous sign than random PVC here or there

- need to suppress/stabilize myocardium to raise vfib threshold… usually via medication

35
Q

How many PVCs a minute are ok

A

6 or fewer - as long as look the same (monomorphic)

36
Q

Premature atrial contractions (PAC)

  • EKG
  • pulse
  • how common
A
  • early SA node firing
  • irregular rate
  • not common
37
Q

What two things feel like “my heart just skipped a beat”

A
  • PAC

- PVC

38
Q

Torsades de pointes

A
  • associated with long QT and drugs
  • if stable, mag sulfate
  • if not stable, treat like vfib even if pt has a pulse
39
Q

Where is P wave in re-entry phenomena

A
  • often hidden in QRS

- inverted bc atria are depolarizing from AV node and moving up atria

40
Q

What is super important in reentry

A

timing - myocytes have to be excitable, if still in refractory period, won’t get reentry

41
Q

Are most reentry local or global? Where do they enter?

A

Local

Enter at AV node

42
Q

What causes reentry

  • one example
  • QRS and rate
A
  • most d/t ischemic changes from aging
  • ex. SVT
  • narrow but rapid QRS
43
Q

WPW

  • local or global reentry
  • what is the bypass called
  • life expectancy
A
  • global
  • Bundle of Kent
  • 42 yo if untreated
44
Q

How to treat global or local reentry?

A

change the ANS input, vagal stimulation for example

45
Q

what do you not give to someone with WPW

A

BB, CCB, adenosine - will wipe out normal pathway and make things worse.

46
Q

Three things required for reentry

A
  1. unidirectional block with conducting pathway
  2. critical timing
  3. length of effective refractory period of normal tissue
47
Q

To know more about reentry…

A

… read the long slide at the end of Dr. McNeill’s lecture :)

Cardiology 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions