conduction disorders

Question 1

what is the primary pacemaker of the heart

Answer 1

SA node

Question 2

what is the position of V1

Answer 2

4th intercostal space to the right of the sternun

Question 3

what is the position of V2

Answer 3

4th intercostal space to the left of the sternum

Question 4

What is the position of v3

Answer 4

middle of 2 and 4

Question 5

what is the position of V4

Answer 5

5th intercostal space midclavicular

Question 6

what is the position of V5

Answer 6

middle of 4 and 6

Question 7

What is the position of V6

Answer 7

5th intercostal space mid axillary

Question 8

what are the limb leads

Answer 8

RA, RL, LA, LL
These four are the frontal plane that adds 6 views of the heart so that’s I, II, III, aVR, aVF, aVL

Question 9

what are standard limb leads

Answer 9

I, II, III

Question 10

what are the augmented limb leads

Answer 10

aVR, aVL, aVF

Question 11

which leads view the heart from the frontal plane

Answer 11

I, II, III, aVR, aVL, aVF

Question 12

which leads have an inferior view

Answer 12

II, III, aVF

Question 13

which leads have a septal view

Answer 13

V1, V2

Question 14

Which leads have an anterior view

Answer 14

V3, V4

Question 15

Which leads have a lateral view

Answer 15

I, aVL, V5, V6

Question 16

what leads may be used in right sided heart failure?

Answer 16

right sided precordial leads

Question 17

what are the three pacemakers of the heart and their rates

Answer 17

SA node 60-100
AV node 40-60
ventricular pacemaker 30-40

Question 18

what does the p wave indicate

Answer 18

atrial depolarization

Question 19

where is the p wave always positive

Answer 19

leads I and II

Question 20

where is the p wave always negative

Answer 20

aVR

Question 21

where is the p wave biphasic

Answer 21

V1

Question 22

What does the QRS wave indicate?

Answer 22

Ventricular depolarization
Atrial repolarization

Question 23

What is the Q wave?

Answer 23

The first negative deflection after the P wave

Question 24

What is the R wave?

Answer 24

The first positive deflection after the P wave

Question 25

What is the S wave?

Answer 25

The first negative deflection after the R wave

Question 26

What does the T wave indicate?

Answer 26

Ventricular repolarization

Question 27

What does the QT indicate?

Answer 27

The depolarization and repolarization phase

Question 28

What does the PR indicate

Answer 28

AV conduction time PP =RR

Question 29

what can cause a prominent U wave

Answer 29

hypokalemia

Question 30

what are the symptoms of hemodynamic instability?

Answer 30

altered mental status chest discomfort hypotension

Question 31

treatment for symptomatic brady

Answer 31

Atropine 0.5mg given rapidly as an IV bolus every 3-5 minutes to a max dose of 3mg Make sure they’re taking stool softener to decrease risk of vasovagal reaction

Question 32

what is the POTS criteria

Answer 32

Greater than 30 bpm increase changing position without hypotension

Question 33

What is the treatment for POTS

Answer 33

Increase salt and fluid Limit triggers: caffeine, big meals, prolonged standing

Question 34

treatment for symptomatic tachy?

Answer 34

Synchronized cardioversion if there’s hemodynamic instability Vagal maneuvers Narrow QRS: adenosine Wide QRS: procainamide, amiodarone, and sotalol

Question 35

what is the pattern of sinus arrhythmia

Answer 35

regularly irregular

Question 36

what is the precursor to a fib?

Answer 36

PAC

Question 37

treatment of artrial flutter

Answer 37

adenosine

Question 38

what is the most common heart dysrythmia

Answer 38

a fib

Question 39

what is the pattern of afib?

Answer 39

irregular irregular

Question 40

what is the treatment for afib

Answer 40

- antithrombolytics - heart rate control - amiodarone as pharmocologic cardioversion - electrical cardioversion if there is hemodynamic instability

Question 41

junctional rhythm pacemaker

Answer 41

AV node

Question 42

what is the treatment for junctional rhythm?

Answer 42

atropine, dopamine, epi

Question 43

What rhythms are SVT?

Answer 43

A fib, a flutter, junctional tachy

Question 44

What is the treatment for SVT?

Answer 44

Adenosine if stable 6mg rapidly with fluid bolus Warn patient of chest pressure Synchronized cardioversion if unstable

Question 45

What is a PVC initiated by

Answer 45

purkinje fibers

Question 46

How is v tach defined?

Answer 46

Three of more PVC’s in a row

Question 47

What is the treatment for v tach

Answer 47

Stable monomorphic → monitor Symptomatic monomorphic → cardioversion Pulseless → defibrillation EF <35% → implantable cardioverter defibrillator (ICD) EF >35% → amiodarone

Question 48

what is the most common dysrhythmia in patients with cardiac arrest?

Answer 48

v fib

Question 49

what is the treatment for v fib

Answer 49

early defibrillation

Question 50

what is the treatment for asystole

Answer 50

high quality CPR

Question 51

What is the rhythm of a 2nd degree type 1 heart block

Answer 51

regularly irregular

Question 52

What is the initial treatment of choice for heart block

Answer 52

atropine emergency defibrillation, cardioversion, or pacing pacemaker for Bradycardia ICDs for tachycardia

Question 53

which medication do you withhold before cardioversion

Answer 53

Digoxin

Question 54

What medications do you give after defibrillation

Answer 54

epinephrine or vasopressin

Question 55

What do you give before trans cutaneous pacing

Answer 55

sedative for pain

Question 56

When would you do pacemaker therapy

Answer 56

symptomatic bradycardia and symptomatic heart block

Question 57

During what part of heart rhythm would cardioversion be done?

Answer 57

During R wave

Question 58

What is performed before cardioversion?

Answer 58

TEE to check for blood clots, may put patient on anticoagulants beforehand

Question 59

What heart blocks does atropine not work for?

Answer 59

Second degree type 2 and third degree