WEEK 7

Question 1

Cardiac arrhythmias can be classified by…

Answer 1

site of origin

Question 2

Name the 3 types of cardiac arrythmias

Answer 2

Sinus rhythms, atrial rhythms and ventricular rhythms

Question 3

Sinus tachycardia or bradycardia may be considered normal/clinical under specific circumstances. In which circumstance would bradycardia be considered normal?

Answer 3

During sleep

Question 4

Sinus tachycardia or bradycardia may be considered normal/clinical under specific circumstances. In which circumstance would tachycardia be considered normal?

Answer 4

During physical activity

Question 5

Atrial flutter, atrial fibrillation and Av nodal re-entrant tachycardia are all forms of ….

Answer 5

Supraventricular tachycardiac (SVT)

Question 6

An atrial flutter is caused by an electrical impulse that travels in a … and … loop

Answer 6

localised
self perpetuating

Question 7

Where are atrial flutters most commonly located?

Answer 7

In the right atrium

Question 8

T or F
Not all atrial impulses make their way to the ventricles

Answer 8

T
Due to the refractory properties of the AV node

Question 9

What do the numbers refer to in the following statement?
“Patient A has a 3-1 heart block.”

Answer 9

Patient A’s atrium is pumping 3 times faster than their ventricle.

Question 10

Atrial fibrillation is caused by multiple electrical impulses from many ectopic sights. These sights are typically near the roots of the…

Answer 10

pulmonary veins

Question 11

T or F
Atrial fibrillation is caused by multiple electrical impulses that are initiated sequentially.

Answer 11

F
They are initiated randomly

Question 12

What does atrial fibrillation look like on an ECG?

Answer 12

• Absence of p waves
• An undulating baseline (depending on the number of ectopic sights)
• Irregular QRS complexes

Question 13

What does atrial flutter look like on an ECG?

Answer 13

• Absence of normal p waves
• flutter or f waves are present in “sawtooth” patterns

Question 14

What does AVNRT stand for?

Answer 14

AV nodal reentrant tachycardia

Question 15

T or F
Atrial and ventricular rhythms are equally dangerous

Answer 15

F
Ventricular rhythms are more lethal

Question 16

T or F
The atrial and ventricular rates are identical in AV nodal reentrant tachycardia (AVNRT).

Answer 16

T

Question 17

T or F
Ventricular tachycardia is caused by multiple strong firing circuits in one of the ventricles.

Answer 17

F
It is typically caused by just one strong firing circuit

Question 18

T or F
Ventricular tachycardia causes ventricular beats that are regular and fast

Answer 18

T

Question 19

Ventricular tachycardias that last more than … seconds require immediate treatment to prevent cardiac arrest

Answer 19

30

Question 20

T or F
In ventricular fibrillation the ventricles pump little blood

Answer 20

T

Question 21

Injecting atropine blocks the effect of the …. on your heart.

Answer 21

vagus nerve

(thus increasing the hearts rate)

Question 22

An isoprenaline infusion
stimulates …. on the heart.

Answer 22

beta receptors

Question 23

T or F
Drugs are more effective when you have atrial or supraventricular arrhythmias than when you have a ventricular arrhythmia.

Answer 23

T

Question 24

T or F
Drugs are not very effective at all in preventing ventricular arrhythmias.

Answer 24

T

Question 25

T or F
Antiarrhythmic drugs with a principal site of action at the AV node, will speed up conduction within the node.

Answer 25

F
slow down

Question 26

T or F
There are great mortality benefits of antiarrhythmic drugs.

Answer 26

F
limited mortality benefits

Question 27

T or F
Torsades de Pointes is always preceded by a prolonged QT interval

Answer 27

T

Question 28

A prolonged QT is generally accepted as greater than … milliseconds for men and greater than … milliseconds for women.

Answer 28

440
470

Question 29

A prolonged QT interval leads to a chance of …., and this is why we measure the QT interval.

Answer 29

re-entrant pathways

Question 30

(If a QT nomogram suggests that a patient is at risk of Torsades de Pointes)
Before suggesting the cessation of antiarrhythmic medication, a pharmacist should first rule out what things?

Answer 30

• electrolyte disturbances
• a history of congenital long QT syndrome.
• optimise their potassium, magnesium and calcium
• make sure that the patient is not hypoxic
  or acidotic.
• The patient should have telemetry until the QT normalises.