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Clinical Decision Making Exam 2 > Ross - Don't LoOse Your Lunch" > Flashcards

Ross - Don't LoOse Your Lunch" Flashcards

1
Q

this is a mess, i did my best

my jaynstein deck is much better and has all the EKG pictures

A
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2
Q

2 indications for unstable pt

A

CP

SOB

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3
Q

how to determine stable vs unstable pt

A

vitals → esp hypotn

e.o hyperperfusion → appearance, AMS, CP, dyspnea

PMH

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4
Q

on an ekg, 6 seconds =

A

30 boxes

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5
Q

when is unsynchronized cardioversion used

A

pulseless pt

vtach, vfib

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6
Q

5 common tachycardias

A

sinus tachy

afib

a flutter

SVT

v tach

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7
Q

narrow + regular rhythm makes you think of

A

sinus tachy

SVT/PSVT

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8
Q

types of SVT

A

AVNRT (AV node reentrant tachy)

AVRT (AV reciprocating reentrant tachy)

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9
Q

3 causes of v tach

A

ischemia

lyte disturbance

toxicity

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10
Q

AVRT is caused by

A

reciprocating reentrant tachy

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11
Q

HR in AVRT is

A

>200

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12
Q

what pt makes you think of AVRT

A

young pt w. HR > 200

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13
Q

what is an orthodromic p wave

A

retrograde → after QRS

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14
Q

what is antidromic p wave

A

wide QRS + tachy

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15
Q

in regards to the p wave, most WPW rhythms are

A

orthodromic

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16
Q

what do you think when you see AVRT w. a delta wave

A

WPW

very pathologic

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17
Q

tx for AVRT

A

AVNB drugs

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18
Q

tx for AVRT w. WPW

A

procainamide

OR

shock

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19
Q

what pt makes you think of AVNRT

A

healthy young women

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20
Q

AVNRT is caused by

A

circular movement w.in AV node

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21
Q

causes of AVNRT

A

etoh

caffeine

stimulants

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22
Q

HR in AVNRT

A

180-200

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23
Q

is AVNRT pathologic

A

not usually

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24
Q

tx for any fast, narrow rhythm in an unstable pt

A

shock w. 50-100 joules

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25
Q

fx for fast, narrow rhythm in stable pt

A

try vagal

adenosine

AVNB drugs

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26
Q

what drug is used for rhythm control

A

adenosine

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27
Q

what drugs are used for rate control

A

AVNB → amiodarone, bb, ccb, dig

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28
Q

pt ed for adenosine

A

they will feel flushed and anxious

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29
Q

narrow + irregular rhythm makes you think of

A

afib

aflutter w. variable block

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30
Q

afib is usually seen w. what conditions

A

COPD

HTN

ischemia

etoh

PE

thyroidtoxicosis

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31
Q

HR w. a flutter

A

>150

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32
Q

3 causes of a flutter

A

ischemia

cardiomyopathy

dig toxicity

33
Q

mc type of aflutter

A

2:1 block

34
Q

macro reentry

A

a flutter w. consistent block

35
Q

how do you differentiate a.flutter from AVNRT

A

a flutter is slower than AVNRT

~150

36
Q

tx for a flutter w. consistent block

A

vagal maneuver

adenosine → unmasks flutter

37
Q

tx for stable afib

A

rate control: AVNB

if hypotensive: shock at 200 joules PLUS heparin

CHADS score

38
Q

tx for unstable afib

A

shock first

THEN

amiodarone

39
Q

is rate control or rhythm control preferred in afib tx

A

rate → AVNB drugs

40
Q

nl for QRS for peds pt

A

< 0.08 sec

41
Q

a fast and wide rhythm is __ until proven otherwise

A

v tach

42
Q

rate in v tach

A

150-200

43
Q

indication for sustained v tach

A

lasts > 30 sec

44
Q

tx for stable vtach

A

amiodarone

THEN

cardioversion

45
Q

tx for unstable v tach

A

shock w. 200 joules of electricity

46
Q

tx for torsades

A

Mg

47
Q

basically the treatment for wide QRS is

A

when in doubt, shock it out

48
Q

pre shock tx (3)

A

sedate

ketamine

propofol

49
Q

wide and irregular =

A

afib w. blocks (abberency)

50
Q

fx for v fib

A

chest compressions early

then shock until rhythm is established

51
Q

meds to try for fib

A

epi

vasopressin

amiodarone

Mg

52
Q

which AVNB are concerning

A

mobitz II

third degree

53
Q

tx for mobitz II and third degree blocks

A

card consult

unstable: transcutaneous pacing
meds: epi, atropine, dopamine

54
Q

3 causes of brady arrhythmias

A

lytes

ischemia

drugs

55
Q

are brady arrhythmias usually responsive to atropine

A

no

56
Q
A

afib

fast, narrow, irregular

57
Q
A

SVT

58
Q
A

sinus tachy

59
Q
A

v tach

60
Q
A

vtach

61
Q
A

vtach

p waves present → NOT SVT

62
Q
A

AVRT

rate: >200

pathologic

consider WPW

63
Q
A

aflutter 3:1

64
Q
A

AVNRT vs Aflutter 2:1

clue: rate 150 → too slow to be AVRT

??? what?!

65
Q
A

flutter 2:1

66
Q
A

AVNRT

67
Q
A

SVT

68
Q
A

WPW

short PR

delta wave

69
Q
A

WPW

short PR

delta wave

70
Q
A

AVRT

rate: 225

71
Q
A

AVRT

rate 220

72
Q
A

afib

73
Q
A

afib

74
Q
A

no atrial activity

75
Q
A

vtach

76
Q
A

vtach

77
Q
A

afib w. avrt antidromic

78
Q
A

third degree AV block

Clinical Decision Making Exam 2 (10 decks)

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