Conduction Disorders

Question 1

Sinus tachycardia is a normal sinus rhythm but with a heart rate over ________ bpm

Answer 1

100 bpm

Question 2

Sinus bradycardia is a normal sinus rhythm with a rate of _________ bpm

Answer 2

< 60 bpm

Question 3

EKG: no discrete P waves and an irregularly irregular pattern of QRS complexes

Answer 3

Atrial Fibrillation

Question 4

EKG: Regular, sawtooth pattern (F-waves), narrow QRS complex

Answer 4

Atrial Flutter

Question 5

EKG: PR interval > .2 seconds

Answer 5

First degree AV block

Question 6

EKG: Progressive prolongation of the PR interval culminating in a non-conducted P wave

Answer 6

Mobitz I Wenckebach block (longer, longer, drop now you’ve got a Wenckebach)

Question 7

EKG: Intermittent non-conducted P waves without progressive prolongation of the PR interval

Answer 7

Type II Mobitz block (some get dropped some get through now you’ve got Mobitz 2)

Question 8

EKG: there is complete absence of AV conduction - none of the supraventricular impulses are conducted to the ventricles

Answer 8

Third degree AV block (P’s and Q’s don’t agree now you’ve got 3rd degree)

Question 9

EKG: R and R’ (upward bunny ears) in V4-V6

Answer 9

Left bundle branch block

Question 10

EKG: R and R’ (upward bunny ears) in V1-V3

Answer 10

Right bundle branch block

Question 11

A faster than normal heart rate beginning above the heart’s two lower chambers in the atria, AV junction or SA node

Answer 11

Supraventricular Tachycardia (SVT)

Question 12

EKG: Shorter PR Interval, longer QRS complex and a delta wave - slurring slow rise of initial portion of the QRS

Answer 12

Wolff-Parkinson-White Syndrome

Question 13

EKG: Rapid irregular rhythm > 100 bpm. At least 3 distinct P-wave morphologies

Answer 13

Multifocal Atrial Tachycardia (MAT)

Question 14

EKG: An abnormal (non-sinus) P wave is followed by a QRS complex

Answer 14

Premature Atrial Complex (PAC)

Question 15

EKG: Narrow QRS complex, either (1) without a preceding P wave or (2) preceded by an abnormal P wave with a PR interval of < 120 ms

Answer 15

Premature Junctional Complex (PJC)

Question 16

Broad QRS complex (≥ 120 ms) with abnormal morphology

Answer 16

Premature ventricular contractions (PVC)

Question 17

Every 3rd beat

Answer 17

trigeminy

Question 18

Every other beat

Answer 18

bigeminy

Question 19

EKG: Alternating bradycardia with paroxysmal tachycardia, often supraventricular in origin

Answer 19

Sinus Node Dysfunction (Sick Sinus Syndrome)

Bradycardia - tachycardia syndrome

Question 20

EKG: Broad complex tachycardia originating in the ventricles

Answer 20

Ventricular Tachycardia (VT)

Question 21

EKG: Chaotic irregular deflections of varying amplitude

No identifiable P waves, QRS complexes, or T waves

Answer 21

Ventricular Fibrillation

Question 22

EKG: Polymorphic ventricular tachycardia that appears to be twisting around a baseline

Answer 22

Torsades de Pointes (TdP)

Question 23

Treatment of Torsades de Pointes (TdP)

Answer 23

IV Magnesium sulfate

Question 24

EKG: Vertical spikes of short duration, usually 2 ms.

May be difficult to see in all leads

Answer 24

Pacemaker Rhythm with *pacing spikes”

Question 25

Which antihypertensive medications can cause bradycardia?

Answer 25

Beta blockers Non-dihydropyridine CCB Central agents (clonidine)

Question 26

Which antihypertensive medications can cause AV block?

Answer 26

``` Non-dihydropyridine CCB Central agents (clonidine) ```

Question 27

What is the most likely cause of syncope which occurs in a child during an argument?

Answer 27

Long QT syndrome

Question 28

Non-cardiac hypoxia (e.g. pneumonia, COPD) commonly causes what arrhythmia?

Answer 28

Atrial fibrillation

Question 29

What arrhythmia can occur with structural changes such as hypertrophy or dilatation of the ventricle?

Answer 29

Ventricular tachycardia

Question 30

What two murmurs are most associated with atrial fibrillation?

Answer 30

Mitral stenosis | Mitral regurgitation

Question 31

What HTN med classes can cause bradycardia?

Answer 31

Beta Blockers Central agents (clonidine) Verapamil and Cardizem

Question 32

What arrhythmia is associated with arterial embolism?

Answer 32

Atrial fibrillation

Question 33

A 24 year old has a syncopal event. EKG demonstrates a short PR interval with an upswept initial QRS. What underlying condition caused the syncope?

Answer 33

Wolf Parkinson White

Question 34

A 30 year old male has a syncopal event three days after taking an antibiotic. EKG at the scene reveals ventricular tachycardia. What disease condition do you suspect?

Answer 34

Acquired long QT syndrome due to the antibiotic or medications

Question 35

Upon auscultation of a patient's carotid artery they become bradycardic with a three second pause. What is the suspected underlying condition?

Answer 35

Carotid sinus hypersensitivity

Question 36

A 13 year old boy passes out while having an argument with his principal. His examination findings are normal. What heart conduction condition do you suspect?

Answer 36

Long QT syndrome

Question 37

Prolonged absence of sinus node activity (absent P waves) > 3 seconds

Answer 37

Sinus arrest

Question 38

Prolonged absence of sinus node activity (absent P waves) < 3 seconds

Answer 38

Sinus pause