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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
How does Afib look on EKG?
NO discernible P waves Irregularly irregular QRS complexes
26
What is the pneumonic to remember treatment for Afib?
ABCD - Anticoagulate - Beta blocker to control rate - CCB or Cardioversion if unstable - Digoxin if refractory
27
What is the treatment for Afib?
ABCD - Anticoagulate - Beta blocker to control rate - CCB or Cardioversion if unstable - Digoxin if refractory
28
What causes Atrial Flutter?
Circular movement of electrical activity around the atrium
29
How will Atrial Flutter look on EKG?
LOTS of SAWTOOTH P waves with a regular QRS
30
How will Atrial Flutter look on EKG?
Lots of SAWTOOTH P waves with regular QRS
31
How do you treat Atrial Flutter?
ABCD - Anticoagulate - Beta blocker - CCB or Cardioversion - Digoxin
32
What causes Multifocal Atrial Tachycardia?
Multiple reentrant pathways
33
How will Multifocal Atrial Tachycardia look on EKG?
> 3 P wave morphologies
34
What causes Wolff-Parkinson White Syndrome?
Abnormal fast accessory conduction pathway (Bundle of KENT) from atria to ventricles
35
What causes Wolff-Parkinson White Syndrome?
Abnormal fast accessory conduction pathway (Bundle of KENT) from atria to ventricles
36
How will Wolff-Parkinson White Syndrome look on EKG?
Delta wave = slow upstroke of wide QRS
37
What medication is used to treat Wolff-Parkinson White Syndrome?
Procainamide -- Amiodarone 2nd line
38
What 2 medications are contraindicated in Wolff-Parkinson White syndrome?
CCBs Digoxin -- USE PROCAINAMIDE
39
Ventricular Tachycardia
TOMBSTONE appearance = wide QRS
40
Ventricular Fibrillation
Totally erratic wide complex tracing
41
What is the usual treatment for Ventricular Tachycardia/Fibrillation when the patient is unstable?
Defibrillation and ACLS protocol
42
If there is a rhythm like Afib for example on telemetry but no pulse... what is that?
Pulseless Electrical Activity
43
What do you do if Pulseless Electrical Activity is present?
CPR + epinephrine -- NOT A SHOCKABLE RHYTHM/NOR IS ASYSTOLE
44
If Asystole is present, what do you do?
CPR + epinephrine
45
What are the usual shockable rhythms?
Vtach Vfib

COMAT - IM (17 decks)

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