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S20 Clin-Med > cardio 3 > Flashcards

cardio 3 Flashcards

(70 cards)

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1
Q

causes of dysrhytmias

A

ischemia, SNS stimulation, electrolyte imbalances, drugs

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2
Q

sick sinus syndrome

A

aka tachy-brady syndrome; usually brady episodes are what prompt patient to seek help

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3
Q

treatment of sick sinus treatment

A

if asymptomatic leave it alone; symptomatic needs pacemaker

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4
Q

causes of AV block

A

damage to the AV node or medications (BB, CCB, digoxin)

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5
Q

findings in first degree heart block

A

PR prolongation

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6
Q

treatment of first degree av block

A

no need if asymptomatic; catacholamine responsive

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7
Q

cause of mobitz 1

A

inferior MI with AV node ischmia (AVN artery is a branch of RCA)

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8
Q

findings in mobitz 1 winchebach

A

gradual prolongation of PR interval then drop; QRS usually normal

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9
Q

treatment for mobitz 1 winchebach

A

catecholamine responsive; no need for pacing if no bradycardia

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10
Q

cause of mobitz 2

A

diseased bundle of HIS

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11
Q

findings in mobitz 2

A

PR interval constant w dropped QRS; QRS likely to be wide if below bundle of HIS

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12
Q

treatment of mobitz 2

A

not catecholamine responsive because below the AV node= worsens number of dropped beats

prophylactic pacemaker

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13
Q

mobitz 2 may be a precursor for what

A

complete heart block

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14
Q

findings in 3rd degree heart block

A

atria beat faster than they did before the block occured as a CNS response to low CO
AV and VA block

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15
Q

treatment of 3rd degree heart block

A

pacemaker

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16
Q

major causes of LBBB

A

cardiomyopathy, CAD, extensive conduction system disease

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17
Q

how is the septum normally activated?

A

from left to right

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18
Q

how is the septum activated with a LBBB

A

right to left; impulse goes to the RV first then to the LV via septum

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19
Q

how does a LBBB affect the QRS

A

extended duration and eliminates normal septal q waves in lateral leads

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20
Q

EKG findings in LBBB

A

tall r waves and loss of s and q waves in the lateral leads; deep s waves in the right precordial leads’ LAD

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21
Q

ekg findings in RBBB

A

bunny ears in lateral leads; axis is unchanged because depolarization is normal

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22
Q

most common bifasicular block

A

RBBB plus LAFB

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23
Q

which bifasicular block causes RAD

A

LPFB

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24
Q

which bifasicular block causes LAD

A

LAFB

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25
cause of bifasicular block
ischemic heart disease
26
treatment for bifasicular block
pacemaker if syncope occurs
27
indications for a pace maker
symptomatic brady asymp HR<40 persistent/symptomatic mobitz/3rd deg overdrive pacing for tachy
28
factors that enhance automaticity
SNS stim, high co2, high pH, high stretch, high calcium, low PNS, low o2, low potassium, sympathomimetics
29
parasystole
automaticity that affects only an isolated small region of atrial or ventricular cells
30
what operates SA and AV node
slow calcium channels that are quick to recover
31
what is bachmans bundle
crosses to activate left atrium
32
what operates atria, bundle of HIS and perkinge finbers
fast sodium channels that are slow to recover
33
findings in MAT
more than 3 types of P waves
34
causes of SVT
increased automaticity and re-entry
35
who is more likely to get PSVT
young women
36
acute treatment of WPW
no use of agents that further slow AV node because accessory pathway will be more prominent; amioderone/CV
37
general treatment for SVT (not AVRT)
vagal maneuvers, adenosine/verap/BB; ablation
38
what is the most common dysrythmia
a fib
39
mechanism of afib
multiple reentry wavelets involving one or more circuits
40
where is the usual source of rentry signals in afib
around entry of pulmonary veins into the LA
41
what does a fib put patient at risk of
blood clot
42
paroxysmal afib
episodes last less than a week but usually less then 24 hours; prevent triggers
43
persistant a fib
more than 7 days; cardioversion; restore NSR and prevent triggers
44
permanent Afib
more than a year; no cardioversion; control rate and anticoagulation
45
lone a.fib
any of the other types in a young person with no structural heart disease
46
what is the rate goal
less than 100
47
indications for rhythm control
persistent symptoms despite adequate rate control, inability to attain adequate rate control, patient preference, contraindication or patient preference to avoid anticoagulation
48
when do you do CV immediatly
urgent symptomatic cases- chest pain, MI, cardio collapse
49
what can you CV afib without anticoagulation
duration less than 48 hours or if absence of thrombus is assured by trans esophageal ultrasound
50
what do you do if a thrombus is present of if history is uncertain in the absence of ultrasound capabilities?
anti coagulate with warfarin for 3 weeks before and 4 weeks after
51
CHADS2
``` CHF HTN Age greater than 75 DM Stroke or tia ```
52
CHA2DS2-VASc
``` CHF HTN Age greater than 75 DM stroke or TIA vascular disease age 65-74 sex (female) ```
53
who is more at risk of having a stroke with a fib
women
54
chad score 0
no anticoag; aspirin
55
chad score 1
can be untreated or put on oral anticoag..if female give anticoag
56
chads score more than 2
oral anticoagulation
57
who gets anticoag regardless of chads scrore
people with prosthetic valves, or valvular conditions
58
watchman device
reduces the risk of left atrial appendage blood clot embolization
59
what should patients take after watchman device implanted
2-3 months of aspirin
60
what increases risk of vtach
hypokalemia and hypomagnesemia
61
what is nonsustained VT
3 or more ventricular beats in a roq but lasts less than 30 sec
62
when should nonsustains vt be treated?
if associated with hypertophic cardiomyopathy; not for valvular or dilated
63
cause of tosades
drugs that increase Qt interval, hypokalemia, hypomagnesemia, hypocalcemia, bradycardia
64
what is the most common dyshythmia resulting in out of hospital cardiac arrest
vfib
65
tx for vfib
defibrillation and amioderone
66
what class are BB
2
67
what class is amioderone
III, Ib
68
what is amioderoe useful for treating
SVT, VT, afib/flutter
69
what do you have to monitor for when using amioderone
hepatotoxicity, pulm fibrosos, hypothyroidism, pro-arrythmic effects
70
indications for magnesium sulfate
torsades, dysthymia in patient with hypomagnesemia, digoxin induced dysrhythmias, acute ischemia to prevent ventricular dysrthymias

S20 Clin-Med (10 decks)

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