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CP Test 1 > B4-001 Big Case: Tachycardia > Flashcards

B4-001 Big Case: Tachycardia Flashcards

1
Q

maximum predicted HR

A

220-patients age

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2
Q

3 consecutive beats greater than >100 bpm

A

tachycardia

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3
Q

sequence of excitation in the heart

A
  1. SA node
  2. atrial muscle
  3. AV node
  4. common bundle
  5. bundle branches
  6. purkinje fibers
  7. ventricular muscle
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4
Q

what could a narrow QRS indicate?

A
  • atrial tissue only
  • sinus tachycardia
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5
Q

what could a wide QRS indicate?

A
  • ventricular tachycardia
  • any narrow complex tachycardia with aberrant conduction
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6
Q

irregularly irregular without P waves

A

atrial fibrillation

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7
Q

most common sustained arrhythmia, increases with age

A

a fib

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8
Q

cardiac causes of a-fib

A
  • hypertension
  • CAD
  • heart failure
  • cardiomyopathy
  • valvular disease
  • arrhythmias
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9
Q

non-cardiac causes of a-fib

A
  • sleep apnea
  • obesity
  • hyperthyroidism
  • drugs
  • electrocution
  • pneumonia
  • pulmonary embolism
  • alcohol (holiday heart syndrome, dose dependent)
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10
Q

“A-fib begets a-fib”
progression of a-fib

A

paroxysmal, persisent, longstanding persistent, permanent

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11
Q

what studies should always be done to evaluate a-fib?

A
  • 12 lead ECG
  • labs
  • TTE
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12
Q

causes of valvular atrial fibrillation

3

A
  • rheumatic mitral stenosis
  • moderate-to-severe mitral stenosis
  • mechanical valve
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13
Q

ABCs of A-fib management

A

A: anticoagulation/avoid stroke
B. better symptom control
C. cardiovascular risk factors and comorbidities

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14
Q

score system used to evaluate risk of thromboembolism

A

CHA2DS2-VASc

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15
Q

score system to evaluate risk of bleeding

A

HAS-BLED

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16
Q

most concerning complication of a-fib?

A

increased stroke risk

from blood pooling and forming clots

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17
Q

most concerning complication of a-fib?

A

increased stroke risk

from blood pooling and forming clots

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18
Q

patients with a-fib have an increased risk of?

[4]

A
  • ischemic stroke (5x)
  • heart failure (3x)
  • dementia (2x)
  • death (2x)
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19
Q

why are a-fib related strokes worse than other strokes?

A
  • increased 30 day mortality (almost 2x)
  • more likely to recur
  • more severe functional deficits
20
Q

oral anticoagulation is strongly recommended for a CHA2DS2-VASc score greater than

A
  • 2 for men
  • 3 for women
21
Q

factors that have a CHA2DS2-VASc value greater than 2

2

A
  • age >75
  • hx of stroke, TIA, or embolism
22
Q

HAS-BLED score greater than 3

A
  • warrants additional monitoring
  • address modifiable bleeding risks
23
Q

modifiable bleeding risks

5

A
  • uncontrolled hypertension
  • abnormal renal function
  • labile INR (<60% in therapuetic range)
  • antiplatelets or NSAID use
  • greater than 8 drinks per week
24
Q

only anticoagulation for valvular a-fib

A

warfarin

25
Q

oral direct thrombin inhibitor

A

dabigatran

26
Q

oral direct Xa inhibitor

3

A
  • rivaroxaban
  • apixaban
  • endoxaban
27
Q

lowest conduction velocity in heart

A

SA and AV node

28
Q

fastest conduction velocity in heart

A

purkinje fibers

29
Q

MAP=

A

COxTPR

30
Q

CO=

A

HRxSV

31
Q

SV=

A

EDV-ESV

32
Q

MAP

A

mean arterial pressure

33
Q

CO

A

cardiac output

34
Q

TPR

A

total peripheral resistance

35
Q

HR

A

heart rate

36
Q

SV

A

stroke volume

preload
contractibility
afterload

37
Q

SV

A

stroke volume

preload
contractibility
afterload

38
Q

EDV

A

end diastolic volume

39
Q

ESV

A

end systolic volume

40
Q

rate or rhythm control?

  • beta blockers
  • non-dihydropyridine calcium channel blockers
  • cardiac glycoside
  • amiodarone
A

rate

41
Q

IV beta blockers

3

A
  • metoprolol
  • tartrate
  • esmolol
42
Q

PO beta blockers

A
  • metoprolol succinate
  • bisoprolol
  • carvedilol
  • atenolol
43
Q

non-dihydropyridine calcium channel blockers

2

A
  • diltiazem
  • verapamil

both IV and PO

44
Q

non-dihydropyridine calcium channel blockers

2

A
  • diltiazem
  • verapamil

both IV and PO

45
Q

cardiac glycoside that is not first line and not monotherapy

A

digoxin

46
Q

used for critically low pressures or acute heart failure

A

amiodarone

CP Test 1 (16 decks)

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