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COMAT - IM > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

Describe how you determine axis and the possible options?

A
  • Look at Leads 1 and AVF
  • Normal = Both positive
  • Left Axis = Positive in 1 and Negative in AVF
  • Right Axis = Negative in 1 and Positive in AVF
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2
Q

Normal axis deviation degrees

A

-30 – +90

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3
Q

Left axis deviation degrees

A

-30 – -90

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4
Q

Right axis deviation degrees

A

+90 – +180

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5
Q

For a LBBB, what is the pneumonic and what will you see in leads V1 and V6?

A

WiLLiaM
V1 = W pattern
V6 = M pattern

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6
Q

For a RBBB, what is the pneumonic and what will you see in leads V1 and V6?

A

MaRRoW
V1 = M pattern
V6 = W pattern
– “bunny ears” –

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7
Q

What are 2 physiology items that cause HF with REDUCED EF? (systolic dysfunction)

A

Decreased LV contractility
Increased afterload

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8
Q

What physiology item can cause HF with PRESERVED EF? (diastolic dysfunction)?

A

Impaired diastolic relaxation = decreased compliance

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9
Q

What condition often causes HF with Preserved EF?

A

HTN that results in LV hypertrophy

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10
Q

What is the treatment for an acute HF exacerbation?

A

LMNOP
- Lasix
- Morphine
- Nitrates
- O2
- Position

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11
Q

What are things used to treat chronic HF? (5)

A
  • Diuretics
  • Beta blockers
  • ACEi/ARB
  • Spironolactone
  • Digoxin for symptoms
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12
Q

What are things used to treat chronic HF? (5)?

A
  • Diuretics
  • Beta blocker
  • ACEi/ARB
  • Spironolactone
  • Digoxin for symptoms
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13
Q

What drug can actually cause an AV block arrhythmia?

A

Digoxin

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14
Q

1st degree AV block

A

PR interval is prolonged (>1 big box/200msec)

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15
Q

PR interval is > 200msec or 1 big box?

A

1st degree AV block

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16
Q

Type 1 Wenckebach 2nd degree AV block

A

Progressive PR interval lengthening until a QRS is dropped

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17
Q

Progressive PR interval lengthening until a QRS is dropped?

A

Type 1 Wenckebach 2nd degree AV block

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18
Q

Type 2 2nd degree AV block

A

Random dropped QRS complexes with no change in the PR interval

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19
Q

Random dropped QRS complexes with no changed in the PR interval?

A

Type 2 2nd degree AV block

20
Q

3rd degree AV block

A

NO relationship between the P and QRS waves

21
Q

No relationship between the P and QRS waves

A

3rd degree AV block

22
Q

What is the treatment for the different types of AV block?

A

Pacemaker placement

23
Q

What is Sick Sinus Syndrome?

A

Degeneration of the SA node that leads to intermittent arrhythmias

24
Q

What most often causes Atrial Fibrillation?

A

Ectopic foci in the pulmonary veins

25
Q

How does Afib look on EKG?

A

NO discernible P waves
Irregularly irregular QRS complexes

26
Q

What is the pneumonic to remember treatment for Afib?

A

ABCD
- Anticoagulate
- Beta blocker to control rate
- CCB or Cardioversion if unstable
- Digoxin if refractory

27
Q

What is the treatment for Afib?

A

ABCD
- Anticoagulate
- Beta blocker to control rate
- CCB or Cardioversion if unstable
- Digoxin if refractory

28
Q

What causes Atrial Flutter?

A

Circular movement of electrical activity around the atrium

29
Q

How will Atrial Flutter look on EKG?

A

LOTS of SAWTOOTH P waves with a regular QRS

30
Q

How will Atrial Flutter look on EKG?

A

Lots of SAWTOOTH P waves with regular QRS

31
Q

How do you treat Atrial Flutter?

A

ABCD
- Anticoagulate
- Beta blocker
- CCB or Cardioversion
- Digoxin

32
Q

What causes Multifocal Atrial Tachycardia?

A

Multiple reentrant pathways

33
Q

How will Multifocal Atrial Tachycardia look on EKG?

A

> 3 P wave morphologies

34
Q

What causes Wolff-Parkinson White Syndrome?

A

Abnormal fast accessory conduction pathway (Bundle of KENT) from atria to ventricles

35
Q

What causes Wolff-Parkinson White Syndrome?

A

Abnormal fast accessory conduction pathway (Bundle of KENT) from atria to ventricles

36
Q

How will Wolff-Parkinson White Syndrome look on EKG?

A

Delta wave = slow upstroke of wide QRS

37
Q

What medication is used to treat Wolff-Parkinson White Syndrome?

A

Procainamide
– Amiodarone 2nd line

38
Q

What 2 medications are contraindicated in Wolff-Parkinson White syndrome?

A

CCBs
Digoxin
– USE PROCAINAMIDE

39
Q

Ventricular Tachycardia

A

TOMBSTONE appearance = wide QRS

40
Q

Ventricular Fibrillation

A

Totally erratic wide complex tracing

41
Q

What is the usual treatment for Ventricular Tachycardia/Fibrillation when the patient is unstable?

A

Defibrillation and ACLS protocol

42
Q

If there is a rhythm like Afib for example on telemetry but no pulse… what is that?

A

Pulseless Electrical Activity

43
Q

What do you do if Pulseless Electrical Activity is present?

A

CPR + epinephrine
– NOT A SHOCKABLE RHYTHM/NOR IS ASYSTOLE

44
Q

If Asystole is present, what do you do?

A

CPR + epinephrine

45
Q

What are the usual shockable rhythms?

A

Vtach
Vfib

COMAT - IM (17 decks)

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