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ARITMII Flashcards

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1
Q

ARITMIILE POT CAUZA

A
  1. SINCOPA
  2. MOARTE SUBITA
  3. DURERE TORACICA
  4. PALPITATII
  5. INSUFICIENTA CARDIACA
    SAU POT FI ASIMPTOMATICE
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2
Q

CE SISTEM ARE ROL PREDOMINANT LA NIVELUL NODULUI SINUSAL IN CEEA CE PRIVESTE DESCACAREA IMPULSURILOR?

A

SNV PS

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3
Q

FRECVENTA NODULUI SINUSAL ESTE USOR MAI CRESCUTA LA?

A

FEMEI

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4
Q

DE CINE POT FI DETERMINATE TULBURARILE ALE PULSULUI?

A

ARITMIA SINUSALA

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5
Q

Alte recomandari pentru pacientii cu sindroame de bradicardie (cele 3 medicamente)

A

alfa-agonisti: MIDODRINA
beta blocante
medicamente cu efect inotrop negativ: DISOPIRAMIDA

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6
Q

In ce situatie este recomandat ICD ul la pacientii cu BAV complet cu ritm de scapare cu complexe QRS largi?

A

disfunctie ventriculara stanga severa( durata QRS>0,30 secunde)

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7
Q

BRD-clinic

A

dedublare distantata, dar fiziologica a zg cardiac 2

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8
Q

BRS-clinic

A

dedublare inversa a zg cardiac 2

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9
Q

Etiologie BRD

A

DSA, DSV
Stenoza pulmonara, Tetralogie Fallot
HTP, embolie pulmonara
IMA
Fibroza tesutului de conducere
Boala Chagas

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10
Q

Etiologie BRS

A

IMA
HTA
Stenoza Aortica
Boala coronariana severa

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11
Q

Tahicardia sinusala inadecvata-tratament

A

Betablocante in hipertiroidism
Ivabradina (blocant pacemaker)

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12
Q

TPSV-varsta de debut

A

12-30 ani

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13
Q

AVNRT-frecventa cardiaca

A

140-240 bpm

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14
Q

AVNRT slow-fast ecg

A

unde P nu sunt vizibile, fie apar inainte sau dupa complexele QRS datorita activarii simultane a atriilor si ventriculelor

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15
Q

AVNRT fast slow ecg

A

interval RP’ lung

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16
Q

In ce conditii in tabloul clinic AVNRT/AVRT palpitatiile pot avea caracter neregulat?

A

Extrasistole atriale preexistente
Flutter atrial cu transmitere variabila
Fibrilatie atriala
Tahicardie atriala multifocala

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17
Q

AVNRT/AVRT-tablou clinic

A

anxietate
ameteli
dispnee
dureri toracice
pulsatii in zona gatului
slabiciune

AVNRT-poliurie (prin eliberarea PNA), pulsatii jugulare venoase

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18
Q

AVRT/AVNRT-tratament medicamentos in acut

A

Adenozina i.v. 6 mg apoi 12 mg
sau
VERAPAMIL 5-10 mg

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19
Q

Adenozina-R.A.

A

dureri toracice
roseata
senzatie de greutate a membrelor
bronhospasm
senzatie de MS

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20
Q

Adenozina-C.I.

A

astm

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21
Q

Cand este C.I. verapamilul in tahicardii?

A

adm dupa betablocante
QRS largi >0,12 secunde

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22
Q

AVRT/AVNRT-tratament medicamentos pe perioada lunga

A

Diltiazem, Verapamil, Beta blocante
Blocante canale de Na-Flecainida, Propafenona
Blocante canale de K-Sotalol, Dofetilide, Azimilide
Amiodarona

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23
Q

Tahiaritmii atriale-etiologie

A
  1. varsta inaintata
  2. HTA
  3. IC
  4. obezitate
  5. DZ
  6. consum alcool
  7. IMA
  8. CMH
  9. valvulopatii
  10. miocardita
  11. pericardita
  12. CCV
  13. infectii toracice
  14. dezechilibre HE
  15. hipertiroidism
  16. BPOC
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24
Q

Fibrilatie atriala-AV

A

300-600 bpm

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25
Fibrilatie atriala-de cine depinde raspunsul ventricular?
1. frecventa+regularitatea activitatii atriale mai ales la intrarea in NAV 2. proprietatile electrice ale acestuia 3. echilibrul intre tonusul simpatic si cel parasimpatic
26
Cum e pulsul in extrasistolele atriale?
regulat cu neregularitati ocazionale
27
Cum e pulsul in blocul Wenckebach?
pattern recurent neregulat
28
FiA-tratament medicamentos in acut
i.v.: Flecainida, Propafenona, Vernakalant (pt FiA paroxistica), Amiodarona oral (pill in pocket): Flecainida, Propafenona
29
In ce cazuri este recomandata doar Amiodarona pt un pacient varstnic cu FiA?
insuficienta cardiaca HVS
30
FiA+varstnic+BCI-tratament
Amiodarone/Sotalol
31
Flutter atrial-AV
250-350 bpm
32
Flutter atrial antiorar tipic-focar ectopic
circuit de macroreintrare atrial drept in jurul inelului tricuspidian. Unda de depolarizare se propaga de-a lungul peretelui lateral al atriului drept prin creasta lui Eustachio intre inelul tricuspidian si VCI
33
Flutter atrial antiorar ecg
Unde F negative in deriv inf si pozitive in V1, V2
34
Flutter atrial-medicamente in acut
AA Ic-Propafenona, Flecainida AA III-ibutilid, dofetilid
35
Tahicardia atriala prin reintrare-etiologie
dupa interventii pentru boli cardiace
36
Tahicardia atriala cu bloc-etiologie
intoxicatie digitalica
37
Tahicardia atriala prin automatism crescut-localizare focar
crista terminalis in AD aproape de vena pulmonara in AS in jurul uneia dintre urechiusele atriale
38
Flutter atrial-cum se poate face demascarea undelor F?
incetinim conducerea prin NAV prin -masaj de sinus carotidian -adenozin
39
TV sustinuta-semne clinice de disociatie AV
-unde ''a'' intermitente la nivelul jugularelor -variabilitatea intensitatii zgomotului cardiac 1
40
TV sustinuta-semne ecg disociatie AV
-unde P vizibile aparute aleator pe traseul ecg -capturi ventriculare: complexe QRS inguste intermitente datorita activarii normale prin NAV -batai de fuziune: aspect intermediar intre complexele QRS inguste din cadrul tahicardiei si capturilor ventriculare
41
Fibrilatie ventriculara-singurul tratament eficient
Defibrilarea electrica
42
Sdr Brugada-prevalenta
tineri de sex masculin Asia Sud Est
43
Sdr Brugada-ecg
BRD cu supradeniv concava ST in V1-V3
44
TV pe cord structural normal-cand e incesanta
Tahicardia Gallavardin
45
TVNS-in ce conditii ICD imbunatateste supravietuirea?
FEVS<30%
46
ESV-ce determina o frecventa crescuta a batailor premature?
disfunctie ventricul stang
47
ESV-cand ablatia cu cateter este foarte eficienta?
cand focarul e localizat in ventriculul DREPT
48
ESV-ecg
R/T (ESV ce apar simultan cu panta ascendenta sau varful undei T ale bataii precedente) ce poate duce la FiV
49
Care este principalul risc al procedurii de ablatie a caii accesorii stangi?
TROMBEMBOLISM
50
Ablatie-riscuri
AVC pericardita hemoragica stenoza de vene pulm fistule atrio-esofagiene
51
Ce aritmie se asociaza cel mai frecvent cu boala pulmonara cronica semnificativa?
Tahicardia atriala multifocala
52
BAV complet-cauze congenitale
LES matern Transpozitia de vase mari
53
BAV complet-infectii etiologice
b. Lyme b. Chagas endocardita
54
Distrofia miotonica-etiologie pentru..?
sdr QT lung dobandit
55
Distrofia musculara Duchenne-etiologie pentru...?
BAV complete
56
Sotalol-efecte adverse grave
QT lung torsada vf
57
Dronaderona-C.I.
insuficienta cardiaca disfunctie ventriculara stanga
58
Sindroamele mediate neural-consecinte
BRADICARDIE -bradicardie sinusala -oprire sinusala -BAV VASODILATATIE PERIFERICA REFLEXA
59
Caile accesorii-ecg cu preexcitatie
interval PR SCURT complex QRS LARG
60
Controlul frecventei cardiace ca strategie primara in FiA
se foloseste la pacientii cu FiA PERSISTENTA dupa esecul cardioversiei si a tratamentului profilactic cu mai multe antiaritmice
61

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