Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Medicine II > Conduction disorders > Flashcards

Conduction disorders Flashcards

(67 cards)

Start Studying
1
Q

What are some symptoms of atrial fibrillation?

A

Fatigue and exertional dyspnea, palpitations, dizziness, angina, syncope, irregularly irregular pulse, reduced exercise capacity, HOTN, insidious onset of HF, weakness – from low CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can atrial fibrillation and flutter cause that should be concerning and treated for?

A

clot that can cause a risk for stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What’s the most common chronic arrhythmia?

A

afib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause a fib?

A

cardiac, lung diseases, valvular disease, hyperthyroidism, systemic illness, stress, alcohol, hyperadrenergic state, extreme activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are indications for hospitalization of afib?

A

Active ischemia
Heart failure
Hypotension
Difficult rate control
Evidence of organ hypoperfusion
(confusion, renal injury)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are indications for rhythm control in a fib?

A

Hemodynamic instability
Failure of rate control
First episode
Young patient
CHF
Reversible cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does this ECG indicate:
irregularly irregular rhythm w/ narrow QRS, no p wave, atrial rate 300-600 BPM, ventricular 75-175 BPM

A

a fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If the a fib’s if HR>100, what do you call it?

A

a fib w/ RVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is paroxysmal a fib?

A

terminates spontaneously or w/ intervention in <7 days (reoccur/not reoccur)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is persistent a fib?

A

continuous >7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is permanent Afib?

A

joint decision between clinician + patient to not puruse treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is nonvalvular afib?

A

absence of rheumatic MS, replaced heart valve, or valve repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If there is new onset a fib in a patient, what should you order?

A

thyroid study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What score dictates the need for anticoagulation therapy in a fib?

A

CHA2DS2VASC criteria - >2 in men or >3 in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CHA2DS2-VASc criteria

A

CHF
HTN
Age>75 (2)
DM
Stroke, TIA, thrombus (2)
Vascular disease
Age 65-74
Sex (female)
total of 9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the three steps to consider maintenance of afib?

A

1) rate control (1st line for minimal w/ no symptoms) w/ BBs or CCBs
2) reversion + return to sinus rhythm w/ cardioversion if new onset or if remains symptomatic
3) a fib –> anticoagulation therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the ultimate backup rate control drug?

A

amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What rate control drug do you use in HF?

A

digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Can you use BBs in lung disease?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Warfarin is for anyone with ____

A

mechanical valves, mitral disease, assistant devices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why are DOACs preferred?

A

no monitoring necessary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you treat a fib>48 hours with unkown cause?

A

3 weeks of anticoagulation before cardioversion OR rule out thrombus with TEE and then 4 weeks of anticoagulation after cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Who needs aspirin treatment in a fib?

A

everyone who has CHD or peripheral vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you treat an unstable a fib patient?

A

IV heparin + IV rate control (beta blocker, CCB) + cardioversion (120-200 joules)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What can atrial flutter look like in symptoms?
Palpitations, dizziness,, tachycardia, fatigue, weakness, dyspnea, presyncope, hypotension, angina, reduced exercise capacity Can have AMS
26
Are men or women more predisposed to atrial flutter?
men with CAD or HTN heart disease
27
What can cause atrial flutter?
similar to a fib
28
How do you treat a flutter?
rate control w/ BBs or non di-CCBS cardioversion 50-100 joules atrial flutter ablation can be used to prevent coagulation therapy
29
Can you use pharmacological cardioversion in atrial flutter?
no not recommended
30
In who is MAT most seen?
COPD patients
31
What's the HR of MAT?
>100 BPM
32
How do you treat MAT?
oxygen, treatment of underlying condition, and rate control -- preserved LV function: BBs, non-di CCBs, digoxin, adenosine, IV flecainide, IV propafenone non-LV: digoxin, diltiazem amiodarone
33
How do you treat sinus tach?
underlying disease BB for inappropriate sinus tach
34
How do you treat sinus brady?
atropine if symptomatic, repeated every 3-5 min up to 3 mg
35
In who is sinus brady normal?
athletes
36
In who is sick sinus syndrome the most common?
fibrous tissue in older people
37
How can sick sinus syndrome present?
sinus brady --> pause --> atrial tachy --> a fib
38
Can you get sick sinus syndrome on an EKG?
maybe but unlikely, need Holter
39
How do you treat sick sinus syndrome?
identify and correct factors (could be anything), symptom control, permanent pacemaker placement symptomatic = permanent pacemaker w/ dual chamber pacing + atropine With bradycardia + alternating ventricular tachycardia = permanent pacemaker with automatic implantable cardioverter-defibrillator (AICD)
40
Sinus arrhythmia increases during ______ and decreases during _______
inspiration,, expiration
41
What can cause a 1st degree heart block?
increase in vagal tone or meds like digoxin, BBs, verapamil, dilitiazem
42
How do you treat a second degree Type I block?
asymptomatic = observation symptomatic = atropine, epi w/ or w/o pacemaker
43
How do you treat a second degree Type II block?
Symptomatic = atropine, pacing Permanent pacemaker
44
How do you treat a third degree block?
Temporary pacing, permanent pacemaker, atropine for bradycardia
45
which block rarely progresses?
1
46
How do you treat PACs?
none if asymptomatic if symptomatic, beta blockers, and stopping precipitating factors
47
What's the difference between RBBBs and LBBBs?
left is more from disease like CAD, HTN, aortic valve, cardiomyopathy RBBB common in people without structural defects
48
3 or more consecutive PVCs
non sustained v tach
49
How do you treat PVCs
asymptomatic = no tx treat underlying cause, remove precipitating factors symptomatic or with high PVC burden in patient w/ CHF = beta blockers High PVCs in CHF = catheter ablation
50
What are torsades de points caused from?
v tach, acquired or congenital, >100 BPM
51
Are torsades or v fib taller waves?
torsades
52
How do you treat torsades?
cardioversion, IV magnesium sulfate, discontinue drugs
53
What's the MCC of v fib?
ischemic heart disease
54
What's the normal BPM of v fib?
300
55
How do you treat v fib?
Immediate DC defibrillation + CPR Up to 3 sequential shocks to establish rhythm If persists – Continue CPR Intubation if necessary IV epi Refractory - Add IV amiodarone Lidocaine, magnesium, procainamide
56
If you are successful w/ v fib, what else do you start the patient on?
Continuous IV infusion of amiodarone Implantable defibrillators (at risk) Long term amiodarone
57
What is sustained v tach?
>30s + HOTN + symptomatic that leads to v fib
58
What is non sustained v tach?
brief, self-limiting, asymptomatic (+CAD or LV dysfunction = risk for death)
59
Does v tach respond to vagal manuevers or adenosine?
no -- SVT will, so differentiate if you can't interpret the EKG
60
How do you treat sustained v tach?
Implant cardioverter defibrillator for all! Mild + stable = IV amiodarone Unstable = immediate synchronous DC cardioversion → IV amiodarone
61
How do you treat nonsustained v tach?
Asymptomatic: treat underlying cause Symptomatic: beta blockers (metoprolol, carvedilol), CCB (verapamil, diltiazem), antiarrhythmic drugs (amiodarone), radiofrequency ablation Chronic = beta blocker therapy
62
What are the two causes of SVT?
reentry with AV node + using accessory pathway causing either orthodromic (narrow) or antidromic (wide) pathways
63
In who are SVTs common?
younger, female, ischemic heart disease, digoxin toxicity, flutter w/ RVR, excessive caffeine/alcohol
64
SVT Is usually _____ and _____
paroxysmal and self-limiting
65
How do you treat SVT?
narrow = vagal maneuvers, adenosine BBs or CCBs unstable = direct cardioversion
66
How do you treat WPW syndrome?
radiofrequency ablation can do medically IV procainamide or ibutilide
67
What must you avoid with WPW syndrome?
digoxin, BBs, CCBs, adenosine

Clinical Medicine II (50 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions