Arrythmias

Question 1

PAC

Answer 1

premature atrial contraction

Question 2

PAC can be cause by

Answer 2

stimulatns
hypoxia, respiratory failure
digoxin toxicity
HF
hypokalemia

Question 3

QRS in PAC can be

Answer 3

1) normal
2) absent
3) wide

Question 4

treatment for PAC

Answer 4

anti-arrhythmics if smypotoms occur

Question 5

PAT

Answer 5

paroxysmal atrial tachycardia

Question 6

symptoms of PAT

Answer 6

flutter/palpitation
blurred vision
vertigo
signs of low CO

Question 7

treatment of PAT

Answer 7

carotid sinus massage
vagal maneuvers
synchronized cardioversion

Question 8

A.Flutter
the VR will depend on

Answer 8

conduction ratio

Question 9

treatment for A.Flutter

Answer 9

atrial anti-arrhythmics
calcium channel blockers
carotid massage
cardioversion

Question 10

A.Fib the VR is always

Answer 10

irregular

Question 11

treatment for A.Fib

Answer 11

calcium channel blockers
digoxin/ beta blockers
verapamil to control HR
cardioversion
anticoagulants

Question 12

PJC

Answer 12

premature junctional contraction

Question 13

PJC treatment

Answer 13

usually none
monitor serum digoxin level

Question 14

Junctional Escape Rhythm (Passive junctional rhythm)
rate

Answer 14

40-60 rpm

Question 15

2 dangers with junctional escape rhythm

Answer 15

1) Faster ectopic focus become pacemaker, leading to JT or VT;
2) Downward displacement of impulse formation to the ventricles (leading to IVR or VT)

Question 16

treatment for junctional escape rhythm

Answer 16

atropine if rate if slow
cardiac pacing
d/c drugs thats slowing the HR

Question 17

Accelerated junctional rhythm
rate

Answer 17

60-100 bpm

Question 18

treatment for accelerated junctional rhythm

Answer 18

if digoxin toxicity: d/c drug, digiband
if not digoxin toxicity: verapamil adenosine
cardiac pacing

Question 19

JT

Answer 19

junctional tachycardia

Question 20

symptoms of JT

Answer 20

associated with fast rhythm:
dyspnea, ischemic chest pain
apprehension, decrease LOC

Question 21

treatment of JT

Answer 21

d/c drugs causing arrhythmia
verapamil, adenosine, or lidocaine
carotid sinus massage
synchronized cardioversion of CO is low

Question 22

PVC

Answer 22

premature ventricular contraction

Question 23

causes of PVC

Answer 23

electrolyte imbalacnes
MI, ischemia, hypoxia
drug intoxication (e.g. cocaine)
excessive stimulants (e.g. caffeine, noctine, stress)

Question 24

ECG of PVC

Answer 24

No P wave, no PR interval
QRS is distorted, bizarre and wide (>0.12 seconds)
T wave opposite to QRS

Question 25

Treatment of PVC

Answer 25

Lidocaine, amiodarone, procainamide Correct the causes

Question 26

severe PCV can lead to

Answer 26

VT

Question 27

IVR

Answer 27

idoventricular thythm

Question 28

IVR rate

Answer 28

20-40 bpm

Question 29

causes of IVR

Answer 29

Failure of higher pacemakers (MI, ischemia) AV node conduction disturbances (3rd degree HB) Reperfusion after thrombolytic therapy Pacemaker failure

Question 30

treatment of IVR

Answer 30

Atropine Pacemaker insertion May need CPR

Question 31

NEVER use __ in IVR

Answer 31

lidocaine or anti-arrhythmic drugs

Question 32

ECG og IVR

Answer 32

No P wave, no PR interval QRS 20-40 times per minute, bizarre and wide T wave opposite to QRS

Question 33

VT

Answer 33

ventricular tachy

Question 34

causes of VT

Answer 34

4 or more consecutive PVC (more severe PVC) Advanced myocardial irritability Intoxication of anti-arrhythmic agents

Question 35

VT can lead to

Answer 35

Drop in CO, lead to hypotension, LVF, cardiogenic shock

Question 36

treatment of VT

Answer 36

VT with pulse: amiodarone, lidocaine, pronestyl, cardioversion VT w/o pulse: CPR!! Code blue

Question 37

VFib how much to shock

Answer 37

V-Fib=De-Fib 200  300  360 joules

Question 38

Circus or Reentry tachycardia

Answer 38

a second pathway exists between the atria and the ventricles - faster conduction time - longer refractory period same impulse keels traveling back and forth at a rapid rate, in a self sustaining and circular motion

Question 39

Wolf-Parkinson-White Syndrome (WPW)

Answer 39

pre-excitation syndrome has accessory pathways called bundles of Kent, bypass AV node, connects atria and ventricles directly Short PR interval, QRS occurs quickly after P wave, wider QRS symptomatic SVT best treatment is calcium channel blockers