Ross Arrhythmia lecture

Question 1

List the ross 6 steps of EKG assessment.

Answer 1

1. Mantra
2. Stable or Unstable?
3. Too fast or too slow?
4. Wide or narrow?
5. Regular or irregular
6. P waves

Question 2

What is the Ross mantra?

Answer 2

IV
O2
Monitor

Question 3

What helps you determine if a patient is stable?

Answer 3

Vitals - hypotension

Evidence of hypoperfusion

Question 4

Name the 4 most common tachycardias?

Answer 4

Sinus tach
A fib/flutter
SVTs (AVNRTs and AVRTs)
V tach

Question 5

Narrow QRS complexes are < ___.

Answer 5

.12 seconds (3 small boxes)

Question 6

Wide QRS complexes can be caused by?

Answer 6

V tach
Ischemic heart disease
Electrolyte abnormality (Hyperkalemia)
Drug toxicity

Question 7

What is the most common irregular rhythm?

Answer 7

A fib

Question 8

P waves prior to QRS means the rhythm is?

Answer 8

Sinus

Question 9

P waves after qrs are called ______ and are seen in?

Answer 9

retrograde

SVT

Question 10

What is the difference between orthodromic WPW and antedromic WPW?

Answer 10

Orthodromic - impulse travels down av node and up through accessory tract.
Antedromic - impulse travels down accessory tract and up AV node.

Question 11

Which is wide and which is narrow between orthodromic and antedromic WPW?

Answer 11

orthodromic - narrow

antedromic -wide

Question 12

What is the most common form of a flutter?

Answer 12

HR of 150 with a 2:1 block

Question 13

HR for AVNRT is typically?

Answer 13

180-200

Question 14

HR for AVRT is typically?

Answer 14

> 200

Question 15

Most common patient population to have AVNRT?

Answer 15

young healthy women

Question 16

What is the treatment for AVRT (WPW)?

Answer 16

Procainamide

Question 17

Name some EKG findings in WPW.

Answer 17

Short PR

Delta waves

Question 18

What medication converts fast rhythms by blocking AV node?

Answer 18

Adenosine

Question 19

What medications control the rate of fast rhythms?

Answer 19

CCBs, BBs, or amiodarone.

Question 20

What is the risk of using an AV node blocker on an AVRT patient?

Answer 20

Converting orthodromic to antedromic and dropping cardiac output

Question 21

Name some common comorbid conditions with a fib.

Answer 21

COPD, HTN, ischemic heart disease, alcohol intox, PE, thyrotoxicosis

Question 22

Treatment for monomorphic v tach?

Answer 22

Amiodarone then cardioversion

Question 23

Treatment for polymorphic v tach?

Answer 23

Think torsades and give magnesium

Question 24

Before you shock someone, you should sedate them. What medications can you use?

Answer 24

Ketamine or propafol

Question 25

What is more concerning, a second degree type I or second degree type II block?

Answer 25

Second degree type II

Question 26

What is the bradycardia mantra?

Answer 26

Electrolytes (hyperK)
Ischemia
Drugs (CCBs, BBs)