Arrythmias

Question 1

Sinus bradycardia- causes

Answer 1

Meds: beta blockers, CCB, amiodarone, Li, dig
Increased vagal tone: athletes, sleep, IMI
Metabolic: hypoxia, sepsis, mexedema, hypothermia, hypoglycemia
OSA
Increased ICP

Question 2

Sinus brady tx

Answer 2

if no sx: atropine, b1 agonists (short term), pacing

Question 3

Sinus brady- MOST COMMON CAUSE

Answer 3

Dr. Flitter: The most common cause for a pause is a blocked PAC

Question 4

Sick Sinus Syndrome- causes

Answer 4

periods of unprovoked SB
SA arrest
tachy-brady syndrom
chronotropic incompetence with endo trach tube

Question 5

Sick sinus syndrome- tx

Answer 5

often need combo
BB, CCB, dig for tachy
PPM for brady

Question 6

AV block- Type I

Answer 6

prolonged PR (>200ms); 1:1 conduction

Question 7

AV block Type II Mobitz I (Wenckebach)

Answer 7

progressively prolonged PR

worsens with carotid sinus massage, improves with atropine

Question 8

AV T II Mobitz I (Wenckebach)- causes

Answer 8

abnml AV node- IMI, inflammation, myocarditis, high vagal tone, drugs

Question 9

AV T II Mobitz I (Wenckebach)- tx

Answer 9

often paroxysmal, nocturnal, asx

Question 10

Septal MI

Answer 10

V1-V2 +/- avR; proximal LAD

Question 11

Anterior MI

Answer 11

V3-V4; LAD

Question 12

Apical MI

Answer 12

V5-V6; Distal LAD, LCx, RCA

Question 13

Lateral MI

Answer 13

I, avL; LCx

Question 14

Inferior MI

Answer 14

II, III, avF; RCA (85%), LCx (15%)

Question 15

RV MI

Answer 15

V1-V2 & V4R (most sensitive); proximal RCA

Question 16

Posterior MI

Answer 16

ST depression V1-V3, ST elevation in V7-V9 (posterior leads); RCA, LCx

Question 17

SVT- atrial

Answer 17

Sinus tach (pain, fever, hypovolemia, hypoxia, PE, anemia)
Atrial tach (catchols, EtOH, dig, CAD, COPD)
Multifocal atrial tach (increased automaticity at multiple sites; seen with underlying pulm dz)
Atrial flutter (macroreentry- usually in RA)
A fib (irregular AVN bombardment, often from pulm veins)

Question 18

AV Jxn

Answer 18

AVNRT (reentrant circuit)
AVRT: (reentrant circuit and accessory path; may show pre-excitation (WPW))
NPJT: increased jxnal automaticity

Question 19

Unstable SVT tx

Answer 19

cardioversion per ACLS

Question 20

ST tx

Answer 20

treat underlying stressor

Question 21

AT tx

Answer 21

BB, CCB, adenosine
Amiodarone?
Radiofrequency ablation, class IC/II antiarrhythmics

Question 22

AVNRT or AVRT tx

Answer 22

Vagal maneuvers
Adenosine
CCB or BB, DCCV
Ablation

Question 23

NPJT

Answer 23

CCB, BB, amiodarone

Question 24

AF

Answer 24

BB, CCB, dig, AAD

Question 25

AFL

Answer 25

BB, CCB, dig, AAD

Question 26

MAT

Answer 26

CCB and BB