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P2 Exams > Rhythm Definers > Flashcards

Rhythm Definers Flashcards

1
Q

1 (VT):
2 Definer:
3 note fusion P waves:

A

1= usually reentry prob
2= 100BPM or >, wide QRS
3= P waves trying to insert self in to VT

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2
Q

(Heart Blocks Raps) If the R is far from the P, then you have a:

A

FIRST DEGREE!

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3
Q

(Heart Blocks Raps) Longer, longer, longer, drop, then you have a

A

= WENCKEBACH!

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4
Q

(Heart Blocks Raps) If some Ps don’t get through, then you have a:

A

= MOBITZ II!

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5
Q

(Heart Blocks Raps) If Ps and Qs don’t agree, then you have a:

A

= THIRD DEGREE!

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6
Q

(Heart Blocks Raps) If the R is far from the P, then you have a:
Longer, longer, longer, drop, then you have a:
If some Ps don’t get through, then you have a:
If Ps and Qs don’t agree, then you have a:

A

= FIRST DEGREE!
= WENCKEBACH!
= MOBITZ II!
= THIRD DEGREE!

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7
Q

Junctional Bradycardia) Remember:
Definer:

A

1= AV inherit firing rate 40-60 so <40BPM AV Brady
2= <40BPM, REG/ rhythm, AV P waves, QRS WNL (can be wide)

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8
Q

(PVC) Bigeminy:
Trigeminy
Quadgeminy

A

= 2rd beat uni/PVC regularly “boom PVC” (1:1 pattern)
= 3rd beat is uni/PVC regularly “boom boom PVC)
= 4rd beat is uni/PVC regularly “boom boom boom PVC” 2-3x

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9
Q

(PVC) Unifocal:
Multifocal:

A

= same fire site & shape
= dif fire spots & shape

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10
Q

Accelerated idiopathic (AIVR):
2 Definer:

A

1= SNS anxiety releasing EPI & NORepi
2= wide QRS, 41-100BPM, Reg/ Rhythm

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11
Q

Idiopathic, Ventricle Escape (IVR)
2 Definer:

A

1= AV slows downs so slow Bottom is faster & louder
2= QRS >3SB or 0.12secs w/ cadence & w/o P waves

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12
Q

Torsades De Pointes (TDP) Twisting of points

2 Definer:

A

1= most common polymorphic VT “teeter toter of de & re /polarization of ventricles” (twisting ribbon)
2= Changes in shape w/ size (note w/ change of conduction)

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13
Q

VF) ventricular Fib/quiver
2 Definer:

A

1= “death rattle”, never pulse,
2= Chaos, “wide QRSs”

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14
Q

Artificial Pacemaker) know:
Definers:

A

1= usually L upper chest adults & kids
2=Atrial line w/ P wave following, Ventricular line followed w/ QRS (wide QRS), AV sequential 1 line before the Ps & QRSs, Fail to shut down, Can fail to capture if leads displaced, Runaway pacemaker (Pacemaker running 190Bpm)

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15
Q

Artificial Pacemaker) AV sequential Paced

A

Vertical pace lines before P-wavess & QRS-complexs

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16
Q

Artificial Pacemaker) Failure to capture

A

Failure to shock correctly &/or BRADY (Can fail to capture if leads displaced)

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17
Q

Artificial Pacemaker) Runaway pacemaker

A

Pacemaker running/Shocking 190Bpm

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18
Q

Artificial Pacemaker) Atrial Paced

A

Vertical line with/before P wave following

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19
Q

Artificial Pacemaker) Ventricular Paced

A

Vertical line with/before QRS following WIDE QRS!

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20
Q

1 Premature Ventricular Contractions (PVC):
2 Definers:

A

1= >50% (Don’t + w/ HR) “Pissed off & shouting out”
2= Premature, Wide QRS, no P-wave

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21
Q
  1. (1st Degree AV Block) know:
  2. Definer:
A

1= “add to any rhythm” “gandolf slowly opening door(PRI)”
2= PRI: >than 0.20 seconds for every PRI & P-P cadence

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22
Q
  1. (2nd Degree Type I) AKA & Know:
  2. Definer:
A

1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down”
2= progressive longing PRI till drops beat then resets/starts over

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23
Q
  1. (3rd Degree AV Block) AKA & know
  2. Definer:
A

1= “Complete AV-Block/dissociation” (always TCPP on) “gandalf died”
2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)

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24
Q
  1. (A-Fib) know:
  2. Definer:
A

1= most common, only treated when >150BPM, more Js b/c more sites
2= No definite P waves, Totally Irregular

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25
1. (Accelerated Junctional) Know by: 2. Definer:
1= “Baby Tachy” faster than 60 not faster than 100 2= 61-100BPM, (from SNS & AV firing), Regular rhythm, AV P waves
26
Atrial Flutter) Know: Definer:
1= “saw tooth Ps”, count bottom of points of flutters “3 to 1 block” 2= Sawtooth Ps w/ regular rhythm
27
Junctional rhythms) aka know by: Definer:
1= junctional escape: “pick up workload b/c something failed” 2= AV P waves & AV node rate 40-60BPM, Regular rhythm
28
1Paroxysmal Supraventricular Tachycardia (PSVT) 2 Definer
1= “ SVT sudden start & stop” not associated w/ underlying Cdisease 2= same as SVT but sudden onset/ends abruptly
29
1Supraventricular Tachycardia (SVT) 2Rules: 3 Treat:
1= AV going NASCAR 2= No P waves, 150-250 BPM, regular rhythm 3= vagal maneuver, adenosine, unstable= cables (@50-100J) go to max)
30
1w/ PAC: 2Definer:
1= Premature Atrial Contractions “w/” 2= dif P wave shape w/ premature depolarization
31
2nd-Degree Type 2 AV block) names:
Mobitz 2 or intranodal AKA "2:1 block” rhythm
32
2nd-Degree Type I AV block) names
Mobitz 1 or Wenckebach
33
Rhythm initiated by SA node should have a rate between: Sinus Tachycardia has a heart rate of: Sinus Bradycardia has a heart rate of:
= 60-100 beats per minute = 101 & >BPM = 59 &
34
1 Asystole: 2 Definer:
1= no activity (most common PEDIS arrest) 2= NONE, NONE, NONE
35
AV node Heart blocks are
blocks in AV node partial or complete “Putting a rock or pebble on a cable”
36
"AV node P waves" morphology:
= inverted before QRS, hidden w/in QRS, after QRS
37
Cardiac artifacts: Causes of artifacts:
= hard to decipher iso-electrical lines w/ 0 & skewed = M. tremors/shivering, PT mnt(moves baseline), Loose electrodes, 60-hertz interference(ungrounded electricity near you (AC current alternating in house), Machine malfunction (Dotted flat line),& electrode bad connection/ off
38
Intranodal/Mobitz 2) Sir name
2nd-Degree Type 2 AV block
39
Lown-Ganong) definer: Pathway name & path:
= has short PRI interval = Bundle of James connects posterior internodal pathway to bundle of his
40
Multifocal Atrial Tachycardia (MAT): Definer:
1= multiple firing/pacemaker sites (is a rhythm) "WAP w/ RVR" 2= >100BPM, irregular, at least 3 dif/ P wave shapes
41
(PVC) Couplet: Triplets: Run on VT:
= 2PVCs back to back "couple coming" (Can be multi/unifocal) = 3PVCs in row "poligemist" (Can be multi/unifocal) = >3PVCs in a consecutive row
42
Normal Sinus
All WNL
43
only condition A-Fib has cadence:
Afib w/ 3rd degree In rhythm "Gandalf dead so Atriums & Ventricles doing own thing
44
Orthodromic Re-entry loop: Antidromic Re-entry loop
= Clockwise rentry conduction loop >narrow QRS = counterclockwise reentry conduction loop > wide QRS
45
P Wave Asystole:
P waves ventricles dont pick up b/c 3rd degree HB (type of PEA)
46
Preexcitation Syndromes Arrhythmias Resulting from Most Common:
= Extra/s conduction pathways impulses used in assessory = (WPW) bundle of Kent = 2nd Lown-GanongLevine = 3rd Mahaim Fiber
47
Re-entry loops
= stuck in nascar loop in a chambers pathway causing commonly SVT / no P waves
48
SA Pacemaker P wave shapes
Upright P waves & QRS both WNL
49
Sick Sinus Syndrome
Not arrhythmia per se; combination of arrhythmias; sinus node diseased or ischemic. Wild swings in HR, Ischemia of SA node,
50
Sinus Arrest)
more than 1 dropped beat & out of cadence
51
Sinus arrhythmia
All WNL but is not in cadence
52
Sinus Block)
"Block be in cadence" 1 or more dropped beats IN CADENCE "Gandolf Blocks a beat/s"
53
Sinus Brady
All WNL but HR <60
54
Sinus Pause
"Gandolf messes up flow by pausing it" 1 dropped beat OUT OF CADENCE, SA node, regular rhythms
55
Sinus Tachycardia
All WNL but HR >100
56
Systematic approach
1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
57
Ventricular rhythms definer:
QRS >0.12secs or 3 small boxes w/ no P waves
58
w/ (PJC) Premature Junctional Contraction) 1Rules: 2CANNOT HAVE B/C: 3Compensatory pause 4Non-compensatory pause
1= rate by rhythm, usually slightly irregular, P waves are either inverted before, +after, or hidden w/in QRS 2=have upright P wave (up P= PAC) 3= keeps cadence 4= doesn't keep cadence
59
Wenckebach) Sir name
2nd-Degree Type I AV block
60
WPW definer: Name of assessory pathway:
= has delta wave “wave leaning into R wave” = Bundle of Kent
61
WPW) Orthodromic loop; Antidromic loop: Treatmeats:
= Clockwise reentry w/ narrow complex = Counterclockwise reentry w/ wide QRS = procainamide 1a Na blocker, (if no procain) sedate & cardiovert) cardioversion
62
(AV pace impulses relation w/ P waves)Atriums fire 1st then ventricles: Atriums & Ventricles fire at same time: Ventricles fire 1st then atriums fire 2nd:
= inverted P wave before QRS = P wave hidden w/in QRD = P wave after QRS (before T wave)
63
1. (Junctional rhythms) aka know by: 2. Definer: 3. S/S: 4. Rules: 5. Treatment:
1= junctional escape “pick up workload b/c something failed” 2= AV P waves & AV node rate 40-60BPM, Regular rhythm 3= Slow heart rate can decrease CO; angina 4= AV: Pace site, rate, & P-waves> regular rhythm, can have >PRI 5= O2 as needed, 15 Lead ECG, underlying cause (MI commonly), If signs poor perfusion, prepare for transcutaneous pacing (TCP)
64
Junctional Bradycardia)Remember: Definer:
1= AV inherit firing rate 40-60 so <40BPM AV Brady 2= <40BPM, REG/ rhythm, AV P waves, QRS WNL (can be wide)
65
Junctional Tachycardia) Know by: Definer:
1= "Tachy is Tachy" 2= >100BPM, AV P waves, in cadence, QRS WNL
66
1. (1st Degree AV Block) know: 2. Definer:
1= “add to any rhythm” “gandolf slowly opening door(PRI)” 2= PRI: >than 0.20 seconds for every PRI & P-P cadence
67
1. (2nd Degree Type I) AKA & Know: 2. Definer:
1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down” 2= progressive longing PRI till drops beat then resets/starts over
68
1. (2nd Degree Type II) AKA & know: 2. Definer:
1= "Mobitz 2/Intranodal" & “random extra Ps” 2= some P's w/o QRS & same PRI/No longing before drop beat
69
1. (3rd Degree AV Block) AKA & know 2. Definer:
1= “Complete AV-Block/dissociation" (always TCPP on) "gandalf died" 2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)
70
Premature ectopic beat presents w/ a inverted P wave & narrow QRS: Premature ectopic beat presents w/ an upright P wave & narrow QRS:
= Premature Junctional Contraction (PJC) = Premature Atrial Contraction
71
A-Fib w/ RVR) definer type:
= AFib w/ >150BPM Uncontrolled
72
A-Fib w/ SVR: Type:
= AFib w/ <60BPM = Uncontrolled
73
Lown-Ganong
Bundle of James connects posterior internodal pathway to bundle of his (short PRI)
74
Mahaim
Accessory connects to Below bundle of his (wide QRS) looks like VTach
75
1. (Preexcitation Syndromes SVT (AVRT)) Know: 3rd most common PS:
1= needs accessory pathway & “Ventricles' back-door w/o passing AV” 4= 3rd Mahaim Fiber Tcardia
76
1. (Preexcitation Syndromes SVT (AVRT)) Know: Most common PS & Etiology:
1= needs accessory pathway & “Ventricles' back-door w/o passing AV” 2= WPW most common Wolff-Parkinson bundle of Kent (allows SA fired impulse use accessory path to pass AV to prefire) usually R-side dif/ wave morph ) delta wave “2nd P wave slides/slurs to QRS” to pre excite
77
Preexcitation Syndromes SVT (AVRT)) Know: 2nd Accessory Pathway:
1= needs accessory pathway & “Ventricles' back-door w/o passing AV” 3= 2nd lown ganong Levine
78
A-Fib) know: Definer: types:
= most common, (treat >150BPM), more Jules b/c more sites = No definite P waves "Fib P waves", Totally Irregular = Controlled 60-150BPM & Uncontrolled <60 & >150BPM
79
Heart blocks are
blocks in AV node partial or complete “Putting a rock or pebble on a cable”
80
wide QRS w/ sharp edge "knife" bc:
firing from 1 side of heart to other side
81
Ventricular rhythms definer:
QRS >0.12secs or 3 small boxes w/ no P waves
82
1 (IVR) 2 Definer:
1= AV slows downs so slow Bottom is faster & louder 2= QRS >3SB or 0.12secs w/ cadence & w/o P waves
83
1 (AIVR): 2 Definer:
1= SNS anxiety releasing EPI & NORepi 2= wide QRS, 41-100BPM, Reg/ Rhythm
84
1 Premature Ventricular Contractions (PVC): 2 Definers:
1= >50% (Don't + w/ HR) “Pissed off & shouting out” 2= Premature, Wide QRS, no P-wave
85
1 (VT): 2 Definer: 3 note fusion P waves:
1= usually reentry prob 2= 100BPM or >, wide QRS 3= P waves trying to insert self in to VT
86
Dotted line on ECG means
monitor not connected properly
87
1 Artificial Pacemaker: 2 definers:
1= usually L upper chest adults & kids 2=Atrial line w/ P wave following, Ventricular line followed w/ QRS (wide QRS), AV sequential 1 line before the Ps & QRSs, Fail to shut down, Can fail to capture if leads displaced, Runaway pacemaker (Pacemaker running 190Bpm)
88
ECG change represents active myocardial injury:
ST-Segment Elevation
89
Which of the following ECG changes represents myocardial ischemia:
Hyperacute T-Waves
90
V8 & V9 STEMI criteria:
0.5mm or greater
91
3 I’S of cardiac) ST depression, Hyperacute or flipped T Wave:
Ischemia
92
3 I’S of cardiac) ST Elevation:
Injury
93
STE leads criteria) Lead I Lead II Lead III
Lead I Lead II Lead III
94
STE leads criteria) Lead aVR Lead aVL Lead aVF
Lead aVR Lead aVL Lead aVF
95
STE leads criteria) Lead V1 Lead V2 Lead V3
Lead V1 Lead V2 Lead V3
96
STE leads criteria) Lead V4 Lead V5 Lead V6
Lead V4 Lead V5 Lead V6
97
STE leads criteria) Lead V4R Lead V8 Lead V8
Lead V4R Lead V8 Lead V8
98
ECG Camera views) LMCA - 3 vessel disease
Lead aVR
99
ECG Lead views) Lead aVR
LMCA - 3 vessel disease
100
ECG Lead views) Lead V5 V6
Posterior
101
ECG Lead views) Lead V3 V4
Anterior
102
ECG Lead views) Lead V1 V2
Septal
103
ECG Lead views) Lead I, aVL, V4, V5
Left Lateral
104
ECG Lead views) Lead V4R
Right
105
Left & Right BBB
106
Wellen’s wave type A:
Biphasic T waves in V2 or V3, min STE <1mm (V2 usually biggest shower Highly specific for for a critical blockage of the LAD
107
Wellen’s wave type B:
DEEP inverted T waves V2 or V3,
108
De Winter’s T Waves:
V2 V3 most commonly but can happen any lead ST depression at the J-point & upsloping ST-segments w/ tall, symmetrical T- waves in the precordial leads (LMCA or LAD occlusion) “Hyper T w/ STD”
109
110
111
ECG change represents active myocardial injury:
ST-Segment Elevation
112
Which of the following ECG changes represents myocardial ischemia:
Hyperacute T-Waves
113
3 I’S of cardiac) ST Elevation:
Injury
114
3 I’S of cardiac) Pathologic Q
Infarction
115
STE leads criteria) Lead I-III
≥ 1mm
116
STE leads criteria) Lead aVR, aVL, aVF
≥ 1mm
117
STE leads criteria) Lead V1 Lead V2-3
Lead V1 ≥ 1mm Lead V2-3}≥ 2mm M>40, 2.5mm M<40 1.5 all women
118
STE leads criteria) Lead V4-6
≥ 1mm
119
STE leads criteria) Lead V4R Lead V8-9
Lead V4R ≥ 1mm Lead V8-9 ≥ 0.5mm

P2 Exams (11 decks)

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