advanced EKG

Question 1

PAC causes

Answer 1

stimulants
acute MI
LV hypertrophy
RA dilation
amyloidosis/sarcoidosis
electrolyte imbalance
thyrotoxicosis
pregnancy

Question 2

PAC treatment

Answer 2

treat underlying cause
decrease stimulant use
low dose B blocker

Question 3

frog sign

Answer 3

rapid, regular expansion of neck veins d/t atrial contraction against closed AV valve

MAT, AT, SVT

Question 4

tachyarrhythmia ID

Answer 4

wide or narrow? irregular or regular?
stable???

wide QRS -treat as VT

vagal maneuvers first if stable

Question 5

PVC meds

Answer 5

beta blockers or calcium channel blockers (not both)

Question 6

cardiac conduction

Answer 6

SA node, AV bundles, AV node, bundle of his, bundle branches (one R, 2 left), purkinje fibers

Question 7

right vs left BBB

Answer 7

look at lead V1, V6 should be positive (if negative = pacer)

QRS up - right
QRS down - left

right - normal physiologic variant
left - sign of underlying heart disease (new=STEMI)

Question 8

first degree AV block

Answer 8

PR >200 ms

no treatment

Question 9

second degree av block (mobitz 1, or winckeback )

Answer 9

PR interval lengthening prior to nonconducted P wave

no treatment unless symptomatic

Question 10

second degree AV block (mobitz II)

Answer 10

PR interval is constant prior to nonconducted P wave

bradycardia symptoms
remove underlying cause & pacemaker

Question 11

third degree AV block

Answer 11

absence of AV conduction

PP intervals are regular and RR intervals are regular

Question 12

third degree AV block

Answer 12

absence of AV conduction

PP intervals are regular and RR intervals are regular

emergency pacing

Question 13

QT prolonging meds

Answer 13

antiarrhythmics
antipsychotics
antidepressants (SSRI, SNRI, TCAs)
antimicrobials (fluoroquinolone)
antihistamines