Arrythmias

Question 1

adenosine mechanism?

Answer 1

slows conduction by increasing K influx and decreasing Ca infulux

Question 2

mechanism of BB?

Answer 2

slow conduction by blocking sympathetic input

Question 3

mechanism of CCB?

Answer 3

reducing Ca influx thereby reducing the upstroke of the action potentional

Question 4

new onset afib in ICU consequences?

Answer 4

inc mortality and inc LOS in ICU, inc risk of death after DC

Question 5

first degree AV block?

Answer 5

long PR

Question 6

second degree mobitz type 1?

Answer 6

lengthening PR until dropped beat

Question 7

second degree mobitz type II?

Answer 7

constant PR with random dropped beat

Question 8

RF for mobitz II?

Answer 8

age related fibrosis, AVN blockade, MI

Question 9

tx for mobitz II?

Answer 9

PPM

Question 10

what worsens prognosis in a CHB?

Answer 10

if its distal to AVN

Question 11

MOA of WPW?

Answer 11

rapid accessory pathway bypassing the AVN

Question 12

findings of WPW?

Answer 12

short PR, delta wave, can develop illegularly irregular wide QRS

Question 13

tx for WPW?

Answer 13

procainamide, flecanide, sotalol, amio, ibutilide, cardioversion

Question 14

AVNRT finding?

Answer 14

narrow QRS regular, like SVT. different morphology P wave

Question 15

how long to give AC for post afib cardioversion?

Answer 15

4 weeks despite CHADSVASC

Question 16

difference from dabigatran and rivaroxaban when comapred to warfarin?

Answer 16

non inferior and less bleeding events

Question 17

congenital Long QT syndrome with exercise as trigger, what is the mutation in?

Answer 17

outward potassium channel

Question 18

congenital long QT with rest or sleep?

Answer 18

sodium channel mutation

Question 19

treatment of sick sinus syndrome?

Answer 19

dual chamber pacing

Question 20

type of pacing done for heart failure with QRS widening, reduced EF?

Answer 20

biventruclar pacing

Question 21

only arrythmia in which there is irregularly irregular wide and narrow complex tachycardia?

Answer 21

WPW

Question 22

why no BB in WPW?

Answer 22

if you slow the atrial rate it will pass through the faster conducting accessory pathway instead of the AV node

Question 23

MOA of procainamide in WPW?

Answer 23

increases the refractory period and decreases conduction through the accessory pathway

Question 24

TOC in WPW?

Answer 24

procainamide and synchronized cardioversion

Question 25

tx for brugada?

Answer 25

ICD and also quinidine if refractory

Question 26

medication contraindicated in Brugada?

Answer 26

flecanide, procainamide, sodium channel blockade can precipitate brugada

Question 27

who would get dual chamber pacing versus biventricular pacing?

Answer 27

DC is for heart block but biventricular is for patient with low EF

Question 28

medical tx for torsades de pointes?

Answer 28

Mag (first line)
isoproterenol
lidocaine
overdrive pacing

Question 29

how does propofol cause bradycardia?

Answer 29

vasovagal response

Question 30

intubation meds that can cause bradycardia?

Answer 30

fentanyl, succinylcholine, propofol

Question 31

electrolyte disturbances that cause prolonged QT?

Answer 31

hypomagnasemia, hypoclacemia, hypokalemia

Question 32

hypothermia and SAH can predispose you to what arrythmia?

Answer 32

prolonged QT

Question 33

anticoagulation post cardioversion despite CHADS2VASC?

Answer 33

4 weeks with warfarin, direct rhombin, Xa blockers

Question 34

who with AF is CI to get DOAC AC?

Answer 34

moderate to severe MS or mechanical mitral

MR not a CI

Question 35

dosing for eliquis in afib with normal kidneys?

Answer 35

5 bid

kidneys 2.5 bid or old >80 yo

Question 36

other antiarrythmics for WPW?

Answer 36

procainamide, flecanide, sotalol, amiodarone

Question 37

magnet over AICD does what?

Answer 37

prevents detection of tachycarrythmias, but pacing retained

Question 38

magnet over pacemaker?

Answer 38

goes to asynchronous pacing at 60 bpm