4

Question 1

B. PR Interval - SHORT (<0.12 sec)

Answer 1

Pre-Excitation Syndromes

Question 2

for which AV block do you have NSR

Answer 2

1st degree AV

Question 3

why would you see an . AV block type 1

4

Answer 3

enhanced vagal tone
or congenital
acute MI or
electrolyte imabalances

Question 4

what PRI do we see with 1st degree AV block

Answer 4

greater than .2 seconds

Question 5

second degree AV block type I is usually due to

Answer 5

result of myocardial damage or atrial hypertrophy

Question 6

sxs of av block 2 type 1

Answer 6

irregular heartbeat

Light-headedness, dizziness, or syncope (more common in type II)

Chest pain, if the heart block is related to myocarditis or ischemia

A regularly irregular heartbeat

Bradycardia may be present

Symptomatic patients may have signs of hypoperfusion, including hypotension

Question 7

sxs of seocnd degree av block type 2

Answer 7

Light-headedness, dizziness, or syncope (more common than in type I)

Chest pain, if the heart block is related to myocarditis or ischemia

A regularly irregular heartbeat

Bradycardia may be present

Symptomatic patients may have signs of hypoperfusion, including hypotension

Question 8

3 degree AV block is seen as what measurement

Answer 8

if the P to P interval is regular

R to R IS can also regular

Question 9

for 3rd degree AV blocks the tx is a

Answer 9

pacemaker

Question 10

when do you need a pacemaker for a block

Answer 10

second degree type two and third degree block

Question 11

CCB and BB in AV blocks

Answer 11

use with caution because they can block further

Question 12

Pre-Excitation Syndromes two major ones

Answer 12

wolf . parkinsons white and

lown ganong levine

Question 13

In Pre-Excitation Syndromes two major ones we see Early activation of the ventricles due to

Answer 13

” Early activation of the ventricles due to impulses bypassing the AV node via an accessory pathway.

Question 14

bundle of kent

Answer 14

pathophysiolog of WPW

Question 15

James fibers

Answer 15

exist in the AV node and the issue with Lown Ganong Levine

Question 16

Accessory pathways are formed during cardiac development and can exist in a variety of anatomical locations includin

Answer 16

anterograde =towards the ventricle
retrograde= away from the ventricle

but majority of the time= it goes in both direction

Question 17

what is the major risk for a patient with pre excitation syndrome with accessory pathways in both direction

Answer 17

three impulses going on at the same time and therefore you risk the pt PSVT

paroxysmal supraventricular tachycardia

Question 18

delta wave symbolizes

Answer 18

signal fomr bundle of kent

Question 19

which pre excitation syndrome is more common?

how many of those are symptomatic

Answer 19

WPW

50-60% become symptomatic

first peak early childhood 2nd peak in young adulthood

Question 20

syncope

palpations syncope in young adult?

Answer 20

need ECG work up for WPW

Question 21

bundle of kent is located in what part of the heart

Answer 21

can be on either side of the atrium L or R

Question 22

two types of WPW

Answer 22

” Type A (MC): Kent’s –> LV: tall R waves in V1 & V2)

“ Type B: Kent’s –> RV:

Question 23

what is the difference in ECK finding with LGL and WPW

Answer 23

No Delta Wave)

Question 24

TYPICAL FINDINGS with type B WPW

Answer 24

predominantly NEGATIVE R waves & Delta waves in V1 & V2, deep QS waves
in V1& V2 –> anteroseptal pseudoinfarct

Question 25

Type A WPW is different than type b b/c

Answer 25

tall R wave in V1 and V2

Question 26

what V1 and V2 findings do you see with Type B

Answer 26

RS QS waves are negative in v1 and V2

Question 27

WPW if left untreated will cause

Answer 27

Can cause ventricular fibrillation & sudden death. Be suspicious of a healthy, young patient w/ syncopal episode. need to cardiovert them and find out the underlying problem

Question 28

TX of WPW

Answer 28

Stable/asymptomatic---> Cardiology referral. Patient dying? D/C cardioversion or Unsynchronized Radiofrequency catheter ablation - heats the tissue enough to destroy the accessory pathway.

Question 29

QRS Interval - LONG (>0.12 sec) indicates

Answer 29

C. QRS Interval - LONG (>0.12 sec) ---?>Bundle Branch Blocks (LBBB vs. RBBB) Recall ventricular depolarization = 0.08-0.12 sec (2-3 small boxes

Question 30

BBB on EKG in what lead as what

Answer 30

R- S-R prime in V1 or bunny ears SLURRED s WAVE IN v6

Question 31

RBB

Answer 31

left ventricle contracting first followed by the right ventricle

Question 32

S wave in RBBB

Answer 32

goes down to the isoelectric line | can go below too

Question 33

Left BBB in what lead as what

Answer 33

R knotch R seen in v6

Question 34

what leads do you look at to diagnose BBB

Answer 34

V1 and V6

Question 35

What is more common LBB or RBBB

Answer 35

RBBB

Question 36

RBBB is usually caused by

Answer 36

usually caused by MI

Question 37

LBBB usually indicated

Answer 37

possible MI

Question 38

in V1 LBBB will be

Answer 38

QRS deeply negative

Question 39

V5 V6

Answer 39

QRS wide

Question 40

two types of fascicular blocks

Answer 40

Left anterior fascicular block | Left posterior fascicular block

Question 41

Left anterior fascicular blocks are commonly seen with what other EKG finding

Answer 41

LAD

Question 42

left posterior fascicular blocks are usually associated with

Answer 42

RAD

Question 43

hemiblocks are also known as

Answer 43

fascicular blocks

Question 44

V1 rabbit ears V6 slurred S wave with LAD

Answer 44

left anterior block with RBBB also known as a bi-fascicular block

Question 45

QRS intervals are long can be the result of these 4 situtations

Answer 45

>.12 bb BLOCKS fascicular/hemiblockes premature ventricular contraction idioventircular rhythm

Question 46

A long QT is interval can be the sign of what electrolyte imbalnces

Answer 46

hypokalemia hypomagnesemia hypocalcemia

Question 47

second degree block type one is the result of

Answer 47

myocardial damage or atrial hypertrophy

Question 48

which pre-excitation syndrome is intranodal

Answer 48

Lown Ganong Levine exists around the AV node

Question 49

paroxysmal supraventricular tachycardia (PSVT) usually arises through a ___________

Answer 49

paroxysmal supraventricular tachycardia (PSVT) usually arises through a reentrant mechanism.

Question 50

ventricular escape would be seen as

Answer 50

20-40 bpm

Question 51

junctional escape would be seen as

Answer 51

40-60 bpm

Question 52

unifocal and bifocal as well as trigemeny and bigemeney refer to

Answer 52

PVC | seen with wide opposing T

Question 53

first you're cute and then you're slurred

Answer 53

RBBB

Question 54

first you hit the floor hard then you're a couple of small bunny ears

Answer 54

LBBB