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Cardiology > Rhythm Definers > Flashcards

Rhythm Definers Flashcards

1
Q

1 (VT):
2 Definer:
3 note fusion P waves:

A

1= usually reentry prob
2= 100BPM or >, wide QRS
3= P waves trying to insert self in to VT

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2
Q

(Heart Blocks Raps) If the R is far from the P, then you have a:

A

FIRST DEGREE!

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3
Q

(Heart Blocks Raps) Longer, longer, longer, drop, then you have a

A

= WENCKEBACH!

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4
Q

(Heart Blocks Raps) If some Ps don’t get through, then you have a:

A

= MOBITZ II!

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5
Q

(Heart Blocks Raps) If Ps and Qs don’t agree, then you have a:

A

= THIRD DEGREE!

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6
Q

(Heart Blocks Raps) If the R is far from the P, then you have a:
Longer, longer, longer, drop, then you have a:
If some Ps don’t get through, then you have a:
If Ps and Qs don’t agree, then you have a:

A

= FIRST DEGREE!
= WENCKEBACH!
= MOBITZ II!
= THIRD DEGREE!

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7
Q

Junctional Bradycardia) Remember:
Definer:

A

1= AV inherit firing rate 40-60 so <40BPM AV Brady
2= <40BPM, REG/ rhythm, AV P waves, QRS WNL (can be wide)

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8
Q

(PVC) Bigeminy:
Trigeminy
Quadgeminy

A

= 2rd beat uni/PVC regularly “boom PVC” (1:1 pattern)
= 3rd beat is uni/PVC regularly “boom boom PVC)
= 4rd beat is uni/PVC regularly “boom boom boom PVC” 2-3x

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9
Q

(PVC) Unifocal:
Multifocal:

A

= same fire site & shape
= dif fire spots & shape

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10
Q

Accelerated idiopathic (AIVR):
2 Definer:

A

1= SNS anxiety releasing EPI & NORepi
2= wide QRS, 41-100BPM, Reg/ Rhythm

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11
Q

Idiopathic, Ventricle Escape (IVR)
2 Definer:

A

1= AV slows downs so slow Bottom is faster & louder
2= QRS >3SB or 0.12secs w/ cadence & w/o P waves

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12
Q

Torsades De Pointes (TDP) Twisting of points

2 Definer:

A

1= most common polymorphic VT “teeter toter of de & re /polarization of ventricles” (twisting ribbon)
2= Changes in shape w/ size (note w/ change of conduction)

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13
Q

VF) ventricular Fib/quiver
2 Definer:

A

1= “death rattle”, never pulse,
2= Chaos, “wide QRSs”

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14
Q

Artificial Pacemaker) know:
Definers:

A

1= usually L upper chest adults & kids
2=Atrial line w/ P wave following, Ventricular line followed w/ QRS (wide QRS), AV sequential 1 line before the Ps & QRSs, Fail to shut down, Can fail to capture if leads displaced, Runaway pacemaker (Pacemaker running 190Bpm)

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15
Q

Artificial Pacemaker) AV sequential Paced

A

Vertical pace lines before P-wavess & QRS-complexs

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16
Q

Artificial Pacemaker) Failure to capture

A

Failure to shock correctly &/or BRADY (Can fail to capture if leads displaced)

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17
Q

Artificial Pacemaker) Runaway pacemaker

A

Pacemaker running/Shocking 190Bpm

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18
Q

Artificial Pacemaker) Atrial Paced

A

Vertical line with/before P wave following

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19
Q

Artificial Pacemaker) Ventricular Paced

A

Vertical line with/before QRS following WIDE QRS!

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20
Q

1 Premature Ventricular Contractions (PVC):
2 Definers:

A

1= >50% (Don’t + w/ HR) “Pissed off & shouting out”
2= Premature, Wide QRS, no P-wave

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21
Q
  1. (1st Degree AV Block) know:
  2. Definer:
A

1= “add to any rhythm” “gandolf slowly opening door(PRI)”
2= PRI: >than 0.20 seconds for every PRI & P-P cadence

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22
Q
  1. (2nd Degree Type I) AKA & Know:
  2. Definer:
A

1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down”
2= progressive longing PRI till drops beat then resets/starts over

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23
Q
  1. (3rd Degree AV Block) AKA & know
  2. Definer:
A

1= “Complete AV-Block/dissociation” (always TCPP on) “gandalf died”
2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)

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24
Q
  1. (A-Fib) know:
  2. Definer:
A

1= most common, only treated when >150BPM, more Js b/c more sites
2= No definite P waves, Totally Irregular

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25
Q
  1. (Accelerated Junctional) Know by:
  2. Definer:
A

1= “Baby Tachy” faster than 60 not faster than 100
2= 61-100BPM, (from SNS & AV firing), Regular rhythm, AV P waves

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26
Q

Atrial Flutter) Know:
Definer:

A

1= “saw tooth Ps”, count bottom of points of flutters “3 to 1 block”
2= Sawtooth Ps w/ regular rhythm

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27
Q

Junctional rhythms) aka know by:
Definer:

A

1= junctional escape: “pick up workload b/c something failed”
2= AV P waves & AV node rate 40-60BPM, Regular rhythm

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28
Q

1Paroxysmal Supraventricular Tachycardia (PSVT)
2 Definer

A

1= “ SVT sudden start & stop” not associated w/ underlying Cdisease
2= same as SVT but sudden onset/ends abruptly

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29
Q

1Supraventricular Tachycardia (SVT)
2Rules:
3 Treat:

A

1= AV going NASCAR
2= No P waves, 150-250 BPM, regular rhythm
3= vagal maneuver, adenosine, unstable= cables (@50-100J) go to max)

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30
Q

1w/ PAC:
2Definer:

A

1= Premature Atrial Contractions “w/”
2= dif P wave shape w/ premature depolarization

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31
Q

2nd-Degree Type 2 AV block) names:

A

Mobitz 2 or intranodal AKA “2:1 block” rhythm

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32
Q

2nd-Degree Type I AV block) names

A

Mobitz 1 or Wenckebach

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33
Q

Rhythm initiated by SA node should have a rate between:
Sinus Tachycardia has a heart rate of:
Sinus Bradycardia has a heart rate of:

A

= 60-100 beats per minute
= 101 & >BPM
= 59 &<BPM

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34
Q

1 Asystole:
2 Definer:

A

1= no activity (most common PEDIS arrest)
2= NONE, NONE, NONE

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35
Q

AV node Heart blocks are

A

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

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36
Q

“AV node P waves” morphology:

A

= inverted before QRS, hidden w/in QRS, after QRS

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37
Q

Cardiac artifacts:
Causes of artifacts:

A

= hard to decipher iso-electrical lines w/ 0 & skewed
= M. tremors/shivering, PT mnt(moves baseline), Loose electrodes, 60-hertz interference(ungrounded electricity near you (AC current alternating in house), Machine malfunction (Dotted flat line),& electrode bad connection/ off

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38
Q

Intranodal/Mobitz 2) Sir name

A

2nd-Degree Type 2 AV block

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39
Q

Lown-Ganong) definer:
Pathway name & path:

A

= has short PRI interval
= Bundle of James connects posterior internodal pathway to bundle of his

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40
Q

Multifocal Atrial Tachycardia (MAT):
Definer:

A

1= multiple firing/pacemaker sites (is a rhythm) “WAP w/ RVR”
2= >100BPM, irregular, at least 3 dif/ P wave shapes

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41
Q

(PVC) Couplet:
Triplets:
Run on VT:

A

= 2PVCs back to back “couple coming” (Can be multi/unifocal)
= 3PVCs in row “poligemist” (Can be multi/unifocal)
= >3PVCs in a consecutive row

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42
Q

Normal Sinus

A

All WNL

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43
Q

only condition A-Fib has cadence:

A

Afib w/ 3rd degree In rhythm “Gandalf dead so Atriums & Ventricles doing own thing

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44
Q

Orthodromic Re-entry loop:
Antidromic Re-entry loop

A

= Clockwise rentry conduction loop >narrow QRS
= counterclockwise reentry conduction loop > wide QRS

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45
Q

P Wave Asystole:

A

P waves ventricles dont pick up b/c 3rd degree HB (type of PEA)

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46
Q

Preexcitation Syndromes Arrhythmias Resulting from Most Common:

A

= Extra/s conduction pathways impulses used in assessory
= (WPW) bundle of Kent
= 2nd Lown-GanongLevine
= 3rd Mahaim Fiber

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47
Q

Re-entry loops

A

= stuck in nascar loop in a chambers pathway causing commonly SVT / no P waves

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48
Q

SA Pacemaker P wave shapes

A

Upright P waves & QRS both WNL

49
Q

Sick Sinus Syndrome

A

Not arrhythmia per se; combination of arrhythmias; sinus node diseased or ischemic. Wild swings in HR, Ischemia of SA node,

50
Q

Sinus Arrest)

A

more than 1 dropped beat & out of cadence

51
Q

Sinus arrhythmia

A

All WNL but is not in cadence

52
Q

Sinus Block)

A

“Block be in cadence” 1 or more dropped beats IN CADENCE “Gandolf Blocks a beat/s”

53
Q

Sinus Brady

A

All WNL but HR <60

54
Q

Sinus Pause

A

“Gandolf messes up flow by pausing it” 1 dropped beat OUT OF CADENCE, SA node, regular rhythms

55
Q

Sinus Tachycardia

A

All WNL but HR >100

56
Q

Systematic approach

A
  1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
57
Q

Ventricular rhythms definer:

A

QRS >0.12secs or 3 small boxes w/ no P waves

58
Q

w/ (PJC) Premature Junctional Contraction) 1Rules:

2CANNOT HAVE B/C:
3Compensatory pause
4Non-compensatory pause

A

1= rate by rhythm, usually slightly irregular, P waves are either inverted before, +after, or hidden w/in QRS
2=have upright P wave (up P= PAC)
3= keeps cadence
4= doesn’t keep cadence

59
Q

Wenckebach) Sir name

A

2nd-Degree Type I AV block

60
Q

WPW definer:
Name of assessory pathway:

A

= has delta wave “wave leaning into R wave”
= Bundle of Kent

61
Q

WPW) Orthodromic loop;
Antidromic loop:
Treatmeats:

A

= Clockwise reentry w/ narrow complex
= Counterclockwise reentry w/ wide QRS
= procainamide 1a Na blocker, (if no procain) sedate & cardiovert) cardioversion

62
Q

(AV pace impulses relation w/ P waves)Atriums fire 1st then ventricles:
Atriums & Ventricles fire at same time:
Ventricles fire 1st then atriums fire 2nd:

A

= inverted P wave before QRS
= P wave hidden w/in QRD
= P wave after QRS (before T wave)

63
Q
  1. (Junctional rhythms) aka know by:
  2. Definer:
  3. S/S:
  4. Rules:
  5. Treatment:
A

1= junctional escape “pick up workload b/c something failed”
2= AV P waves & AV node rate 40-60BPM, Regular rhythm
3= Slow heart rate can decrease CO; angina
4= AV: Pace site, rate, & P-waves> regular rhythm, can have >PRI
5= O2 as needed, 15 Lead ECG, underlying cause (MI commonly), If signs poor perfusion, prepare for transcutaneous pacing (TCP)

64
Q

Junctional Bradycardia)Remember:
Definer:

A

1= AV inherit firing rate 40-60 so <40BPM AV Brady
2= <40BPM, REG/ rhythm, AV P waves, QRS WNL (can be wide)

65
Q

Junctional Tachycardia) Know by:
Definer:

A

1= “Tachy is Tachy”
2= >100BPM, AV P waves, in cadence, QRS WNL

66
Q
  1. (1st Degree AV Block) know:
  2. Definer:
A

1= “add to any rhythm” “gandolf slowly opening door(PRI)”
2= PRI: >than 0.20 seconds for every PRI & P-P cadence

67
Q
  1. (2nd Degree Type I) AKA & Know:
  2. Definer:
A

1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down”
2= progressive longing PRI till drops beat then resets/starts over

68
Q
  1. (2nd Degree Type II) AKA & know:
  2. Definer:
A

1= “Mobitz 2/Intranodal” & “random extra Ps”
2= some P’s w/o QRS & same PRI/No longing before drop beat

69
Q
  1. (3rd Degree AV Block) AKA & know
  2. Definer:
A

1= “Complete AV-Block/dissociation” (always TCPP on) “gandalf died”
2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)

70
Q

Premature ectopic beat presents w/ a inverted P wave & narrow QRS:
Premature ectopic beat presents w/ an upright P wave & narrow QRS:

A

= Premature Junctional Contraction (PJC)
= Premature Atrial Contraction

71
Q

A-Fib w/ RVR) definer
type:

A

= AFib w/ >150BPM
Uncontrolled

72
Q

A-Fib w/ SVR:
Type:

A

= AFib w/ <60BPM
= Uncontrolled

73
Q

Lown-Ganong

A

Bundle of James connects posterior internodal pathway to bundle of his (short PRI)

74
Q

Mahaim

A

Accessory connects to Below bundle of his (wide QRS) looks like VTach

75
Q
  1. (Preexcitation Syndromes SVT (AVRT)) Know:
    3rd most common PS:
A

1= needs accessory pathway & “Ventricles’ back-door w/o passing AV”
4= 3rd Mahaim Fiber Tcardia

76
Q
  1. (Preexcitation Syndromes SVT (AVRT)) Know:
    Most common PS & Etiology:
A

1= needs accessory pathway & “Ventricles’ back-door w/o passing AV”
2= WPW most common Wolff-Parkinson bundle of Kent (allows SA fired impulse use accessory path to pass AV to prefire) usually R-side dif/ wave morph ) delta wave “2nd P wave slides/slurs to QRS” to pre excite

77
Q

Preexcitation Syndromes SVT (AVRT)) Know:
2nd Accessory Pathway:

A

1= needs accessory pathway & “Ventricles’ back-door w/o passing AV”
3= 2nd lown ganong Levine

78
Q

A-Fib) know:
Definer:
types:

A

= most common, (treat >150BPM), more Jules b/c more sites
= No definite P waves “Fib P waves”, Totally Irregular
= Controlled 60-150BPM & Uncontrolled <60 & >150BPM

79
Q

Heart blocks are

A

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

80
Q

wide QRS w/ sharp edge “knife” bc:

A

firing from 1 side of heart to other side

81
Q

Ventricular rhythms definer:

A

QRS >0.12secs or 3 small boxes w/ no P waves

82
Q

1 (IVR)
2 Definer:

A

1= AV slows downs so slow Bottom is faster & louder
2= QRS >3SB or 0.12secs w/ cadence & w/o P waves

83
Q

1 (AIVR):
2 Definer:

A

1= SNS anxiety releasing EPI & NORepi
2= wide QRS, 41-100BPM, Reg/ Rhythm

84
Q

1 Premature Ventricular Contractions (PVC):
2 Definers:

A

1= >50% (Don’t + w/ HR) “Pissed off & shouting out”
2= Premature, Wide QRS, no P-wave

85
Q

1 (VT):
2 Definer:
3 note fusion P waves:

A

1= usually reentry prob
2= 100BPM or >, wide QRS
3= P waves trying to insert self in to VT

86
Q

Dotted line on ECG means

A

monitor not connected properly

87
Q

1 Artificial Pacemaker:
2 definers:

A

1= usually L upper chest adults & kids
2=Atrial line w/ P wave following, Ventricular line followed w/ QRS (wide QRS), AV sequential 1 line before the Ps & QRSs, Fail to shut down, Can fail to capture if leads displaced, Runaway pacemaker (Pacemaker running 190Bpm)

88
Q

ECG change represents active myocardial injury:

A

ST-Segment Elevation

89
Q

Which of the following ECG changes represents myocardial ischemia:

A

Hyperacute T-Waves

90
Q

V8 & V9 STEMI criteria:

A

0.5mm or greater

91
Q

3 I’S of cardiac) ST depression, Hyperacute or flipped T Wave:

A

Ischemia

92
Q

3 I’S of cardiac) ST Elevation:

A

Injury

93
Q

STE leads criteria) Lead I
Lead II
Lead III

A

Lead I
Lead II
Lead III

94
Q

STE leads criteria) Lead aVR
Lead aVL
Lead aVF

A

Lead aVR
Lead aVL
Lead aVF

95
Q

STE leads criteria) Lead V1
Lead V2
Lead V3

A

Lead V1
Lead V2
Lead V3

96
Q

STE leads criteria) Lead V4
Lead V5
Lead V6

A

Lead V4
Lead V5
Lead V6

97
Q

STE leads criteria) Lead V4R
Lead V8
Lead V8

A

Lead V4R
Lead V8
Lead V8

98
Q

ECG Camera views) LMCA - 3 vessel disease

A

Lead aVR

99
Q

ECG Lead views) Lead aVR

A

LMCA - 3 vessel disease

100
Q

ECG Lead views) Lead V5 V6

A

Posterior

101
Q

ECG Lead views) Lead V3 V4

A

Anterior

102
Q

ECG Lead views) Lead V1 V2

A

Septal

103
Q

ECG Lead views) Lead I, aVL, V4, V5

A

Left Lateral

104
Q

ECG Lead views) Lead V4R

A

Right

105
Q

Left & Right BBB

A
106
Q

Wellen’s wave type A:

A

Biphasic T waves in V2 or V3, min STE <1mm (V2 usually biggest shower
Highly specific for for a critical blockage of the LAD

107
Q

Wellen’s wave type B:

A

DEEP inverted T waves V2 or V3,

108
Q

De Winter’s T Waves:

A

V2 V3 most commonly but can happen any lead
ST depression at the J-point & upsloping ST-segments w/ tall, symmetrical T- waves in the precordial leads (LMCA or LAD occlusion)
“Hyper T w/ STD”

109
Q
A
110
Q
A
111
Q

ECG change represents active myocardial injury:

A

ST-Segment Elevation

112
Q

Which of the following ECG changes represents myocardial ischemia:

A

Hyperacute T-Waves

113
Q

3 I’S of cardiac) ST Elevation:

A

Injury

114
Q

3 I’S of cardiac) Pathologic Q

A

Infarction

115
Q

STE leads criteria) Lead I-III

A

≥ 1mm

116
Q

STE leads criteria) Lead aVR, aVL, aVF

A

≥ 1mm

117
Q

STE leads criteria) Lead V1
Lead V2-3

A

Lead V1 ≥ 1mm
Lead V2-3}≥ 2mm M>40, 2.5mm M<40 1.5 all women

118
Q

STE leads criteria) Lead V4-6

A

≥ 1mm

119
Q

STE leads criteria) Lead V4R
Lead V8-9

A

Lead V4R ≥ 1mm
Lead V8-9 ≥ 0.5mm

Cardiology (20 decks)

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