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3- arrhythmia Flashcards

1
Q

why do you never hear normal atrial rhythms

A

tachy flutter fibrillation

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2
Q

atrial flutter is how many bpm

A

250-300

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3
Q

atrial fibrillation

A

400-600 bpm

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4
Q

multifocal tachy (MAT)

A

100-200/250

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5
Q

types of atrial rhythms

A

Atrial Flutter = 250 -350 bpm Atrial Fibrillation (afib) = 400 – 600 bpm Multifocal Atrial Tachycardia (MAT) Premature Atrial Complex (PAC) Supraventricular Tachycardia (SVT)

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6
Q

P wave positive, different shape than a NSR d/t

A

the electrical impulse follows a different path to the AV node also known as

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7
Q

wandering atrial pacemaker is seen as

A

fluctuating P waves HR<100 bpm

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8
Q

Junctional rhythm the rate is

A

40-60 bpm

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9
Q

Junctional rhythm is seen with

A

positive or negative P in lead II can be before or after QRS complex

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10
Q

Pacemaker cells located near the AV node are called

A

Pacemaker cells located near the AV node, called junctional pacemakers,

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11
Q

With junctional escape, depolarization originates near the AV node, and the usual pattern of atrial depolarization does not occur.

A

With junctional escape, depolarization originates near the AV node, and the usual pattern of atrial depolarization does not occur. as a result no P wave or neg P wave in II or positve in AVR

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12
Q

wide QRS is how long

A

>.12 second

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13
Q

if more htan 40 to 60 and you have the absence of a P wave or an inverted P wave it is

A

accelerated ventricular rhythm?

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14
Q

There are no P waves, the QRS complexes are wide, and the rate is between 50-100 beats per minute.

A

accelerated idioventricular rhythm

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15
Q

Accelerated idioventricular rhythm is benign or nah?

A

benign

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16
Q

There are no P waves, the QRS complexes are wide, and the rate is below 50

A

idioventricular rhythm

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17
Q

Single ectopic supraventricular beats can originate where?

A

Single ectopic supraventricular beats can originate in the atria or in the vicinity of the AV node. this happens in the middle of a regular rhythm

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18
Q

normal P wave occurs before the next P wave is due

A

atrial premature beats (or premature atrial contractions PAC

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19
Q

atrial premature beats junctional premature beats which one can initiate more sustained arrhythmias?

A

junctional premature beats

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20
Q

wide QRS seen with what

A

idioventricular rhythm premature ventricular contraction bundle branch block

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21
Q

no P wave is present, stimulus originates from ventricles and a wide QRS is seen with this

A

PVC

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22
Q

how can you describe PVC

A

UNIFORCAL OR BIFOCAL couplet triplet, etc bigeminy, trigeminy, qudrageminy

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23
Q

super-ventricular arrhythmia

A

Any tachy-dysrhythmia arising from above the level of the Bundle of His

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24
Q

list all the types of super-ventricular arrhythmia

A

Atrial flutter Atrial fibrillation A-fib with rapid ventricular response Supraventricular tachycardia (SVT)/Paroxysmal supraventricular tachycardia (PSVT), Multi-focal atrial tachycardia (MAT) Junctional rhythm - tachycardia

25
super-ventricular arrhythmia seen with narrow complex
Supraventricular tachycardia (SVT)
26
super-ventricular arrhythmia seen with wider QRS complez
bundle branch block
27
Atrial flutter rate
= Atrial rate is 250-350 bpm “saw tooth” flutter waves
28
Atrial fibrillation = Atrial rate is
is 400-600 bpm
29
“tremulous” waves or no decirnable P
Atrial fibrillation
30
ventricular response
R-R interval is normal
31
saw tooth appearance is associated w/ what super-ventricular arrhythmia
Atrial flutter
32
when the ventricular response is 100 bpm
3:1
33
atrial flutter 150 bpm ventricular response of
2: 1
34
atrial flutter of 100 bpm will have a ventricular response of
1:1
35
which atrial flutter av block is the most common
2:1
36
how do you distinguish between a fib and atrial flutter
ventricular response is irregular in atrial fibrilation
37
irregularly irregular appearance of QRS complexes in the absence of discrete P waves
usually atrial fibrillation
38
what is more common atrial fibrillation or atrial flutter
a fib
39
paroxysmal svt lasts only
30 minutes
40
rate is 150-250 rhythm is regular P waves are frequently buried in T PR interval is not possible to measure
SVT
41
coming from different areas in the atrai and seen as at least three different forms of P and variable PR interval with normal QRS
Multifocal atrial tachycardia
42
what does the QRS look like in MAT
normal
43
would you have normal sinus rhythm with MAT
no because the atrial contraction is coming from different areas and seen as different P waves
44
what underlying diagnoses would we have with MAT
acute MI COPD
45
ventricular arrhytmias
ventricular tachycardia ventricular fibrillation torsade de pointes
46
run of consecutive PVCs
ventricular tachycardia
47
difference between sinus and ventricular tachycardia
p wave for every QRS seen in sinus tachycardia ventricular tachycardia is trickier
48
Ventricles fibrillate & quiver asynchronously & ineffectively w/o coordinated fashion
Ventricular fibrillation No cardiac output occurs & patient becomes unconscious immediately
49
Ventricular fibrillation tx
Requires immediate defibrillation w/ an unsynchronized DC shock Generally stat dose of IV anti-arrhythmic drug in attempt to suppress further ventricular ectopy
50
Polymorphic VT
Polymorphic VT --\> “twisting of the points” Torsade de pointes
51
Occurs in the setting of delayed ventricular repolarization
Torsade de pointes delayed T waves
52
Evidenced by prolongation of the QT intervals or presence of U waves is indicative of
Torsade de pointes
53
* Visible P wave but **different shape and/or PR interval** ~ looks like T on top of P wave * Narrow QRS complex
premature atrial contraction
54
Premature\_Atrial\_Contraction\_Aberrantly\_Conducted.j
55
* P wave may be hidden / Premature / Abnormal * Wide/oblong QRS complex
PVC à delay in AV node in order to get proper filling + cardiac output
56
PVC * **Premature Ventricular Contractions (PVC)**: stimulus originates from ventricles * P wave may be hidden / Premature / Abnormal * Wide/oblong QRS complex à delay in AV node in order to get proper filling + cardiac output ![]()
57
normal amplitude of QRS
1-6 small boxes
58
steps of evlauating EKG
determine the rhythm -regular or nah (60-100 bpm, P up in II, PR normal, P for every, QRS norma, T wave up) determien the rate- 300 150 100 75 60 50 43 measure the PR interval 3-5 determine the QRS interval 2-3 examine the T wave measure QT interval 11-13 check for abnormalities
59
atrial flutter ratios
75 bpm 4:1 100 bpm 3:1 150 bpm 2:1 300 bpm 1:1

EKG (7 decks)

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