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Flashcards in SAM Exam 2 Deck (68):
1

The ___ monitor records ECG continuously for 24-48 hours providing a larger sample of cardiac rhythm an drate while the patient is in their normal environment.

Holter Monitor

2

Where are the ECG wires placed on a dog?

Red- left hind

Green - right hind

Black- left front

White- right front

3

True/False:  What an electrical impulse moves torwards the positive pole an upward deflection in the ECG is seen.

True

4

Where is lead II placed to get a negative and positive conduction?

Right front leg = negative

Left hind leg = positive

5

Where in the heart is electrical impulse generated?

SA node

6

For lead I the negative charge is on the ____ leg and the positive charge is on the ____ leg.

RIght front, Left front

7

Which of the following is false regarding waveforms on the ECG?

a. P wave is atrial depolarization

b. QRS is ventricular depolarization

c. T wave is ventricular depolarization

d. None of the above are false

c. T wave is ventricular depolarization

**vetricular repolarization

8

If the paper speed is 25 mm/s what do you multiply each small box by to get the unit of time?

0.04 s. (40 ms)

9

If the paper speed is 50 mm/s what do you multiply your complexes by to get the unit of time?

0.02s. (20ms)

10

The x-axis of each box on the paper represents a unit of ____ while the y-axis of each box represents a unit of ____.

x- axis = time

y-axis = voltage

11

What part of the sinus complex is not always visible on the ECG?

Q and S

12

Which of the following is false regarding ECG normals?

a. Narrow QRS is considered the normal duration

b. Normal for a dog is >60 ms and >40ms for a cat

c. Wide QRS is a prolonged duration

d. Prolonged in a dog is >60ms and >40ms for a cat

b. Normal for a dog is >60 ms and >40ms for a cat

 

***its supposed to be < those values for both dog and cat

13

When the same impulse depolarizes the atria and the ventricules, this is known as ____.

AV association

14

Which 2 waves and which interval would help us figure out if the atria and ventricles are associated?

PR interval and waves

15

To identify chamber enlargement and conduction disturbances lead ___ should be used and the patient should be in ____ lateral recumbency

Lead II and right lateral recumbency

16

What are the 6 steps of ECG interpretation?

1. General assessment

2. Calcualte the HR

3. Measure RR intervals to determine if the rhythm is regular or irregular

4. Examine each P, QRS, + T

5. Identify ectopic complexes

6. Identify pauses

17

Which of the following is false regarding a sinus rhythm?

a. It is a normal cardiac rhythm

b. It is controlled by the AV node

c. There is a normal P wave for every normal QRS-T complex

d. The RR interavl is relatively constant

b. It is controlled by the AV node

** It's controlled by the SA node

18

Which of the following has an ECG where P waves are not initiated at the SA node but rather elsewhere in the atria? 

 

a. Sinus arrest

b. Wandering Pacemaker

c. Second AV block

d. None of the above

Q image thumb

b. Wandering Pacemaker

19

Which of the following is correct about this ECG?

a. HR = 70 bpm, and its irregular

b. HR = 140 bpm, and its regular

c. HR = 70 bpm, and its regular

d. HR = 140 bpm, and its irregualr

Q image thumb

c. HR = 70 bpm, and its regular

20

Determine the heart rate and if the rhythm is regular or irregular for this ECG

Q image thumb

HR = 120 bpm

Irregular rhythm 

21

What does a high amplitude of the P wave suggest?

RIght atrial enlargement

22

An abnormally long (wide) R wave is suggestive of what? 

Left ventricular enlargement, left BBB, or ectopic ventricular impulse originating in the right ventricle 

23

Which of the following is false regarding this arrhythmia?

a. Its commonly seen in brachycephalic breeds or fit dogs

b. The HR increases with expiration and decreases with inspiration

c. There are normal P waves for every QRS complex but varying RR intervals

d. This is sinus arrhythmia

Q image thumb

b. The HR increases with expiration and decreases with inspiration

 

** It increases with inspiration and decreases with expiration 

24

What are the three mechanisms of arrhythmias?

 

1. Disturbances of impulse formation

2. Disorders of impulse transmission

3. Complex: Disorders involving both impulse formation and impulse conduction 

25

What is the secondary causes of a sinus bradycardia?

Increased/high vagal (PSNS) tone

26

Calculate the HR of this arrhythmia.

Q image thumb

HR = 167 bpm

 

**Count 32 small boxes, the paper speed is 25 so you take 1500/9 = ~170 bpm

27

Calculate the HR of this arrhythmia

Q image thumb

HR = ~ 47 bpm

 

** Count 32 small boxes, the paper speed is 25 so you take 1500 / 32 = ~47 bpm

28

You have an excited dog that comes into the clinic because the owner noted that he was in pain when she tried to touch his paw. On ascultation you noted an HR of about 210 bpm and see that there are short RR intervals on the ECG. What is your primary diagnosis?

Q image thumb

Sinus tachycardia

29

You noted on this ECG that the RR intervals between a sinus beat and ectopic beat is shorter than the RR interval between 2 consecutive sinus beats. What is your diagnosis? 

Q image thumb

Supraventricular premature complex

30

What is the most common cuase of SVPC?

Atrial dilation associated with structural heart disease

31

Which of the following is true regarding the ECG in this picture?

a. There are chaotic and rapid atrial impulses

b. There are no P waves

c. We have irregularly irregular RR intervals

d. All the above are true

Q image thumb

d. All the above are true

32

What is your diagnosis for the ECG in the picture below?

Q image thumb

Atrial fibrillation

33

You noted more than 3 consecutive SVPC's with an abnormally high heart rate and narrow QRS complexes on the ECG in the image below. What is most likely your diagnosis? 

Q image thumb

Supraventricular tachycardia (SVT)

34

What is your diagnosis of the ECG below that is usually associated with organized rapid atrial impulses? 

Q image thumb

Atrial Flutter

35

Which of the following is true based on this ECG?

a. This is supraventricular premature complexes

b. This is ventricular tachycardia

c. This is ventricular fibrillation

d. This is ventricular premature complex

Q image thumb

d. This is ventricular premature complex

36

There are more than 3 VPC's and an abnormally high heart rate noted in this ECG, along with AV disassociation. What is the diagnosis?

Q image thumb

Ventricular tachycardia (VT)

37

What is the diagnosis of the fatal rhythm in this ECG with erratic waves of variable morphology?

Q image thumb

Ventricular fibrillation

38

Which of the following is false regarding this ECG?

a. Its accelerated idioventricular rhythm 

b. Its fast just like VT

c. It usuaslly does not require anti-arrhythmic therapy

d. We need to address the underlying cause 

Q image thumb

b. Its fast just like VT

** It has the same features as VT except its not fast

39

What is the most common cause of the ECG in this picture that has a delayed AV node conduction?

Q image thumb

High vagal tone

 

*** this is a first degree AV block

40

In this ECG we note a prolonged PR interval prior to the block and that there is a P wave without a QRS complex. What is the diagnosis? 

Q image thumb

Mobitz type I Second- degree AV block

41

What is the arrow pointing to in this ECG?

Q image thumb

Ventricular Escape complex

42

What type of AV block is seen in this ECG?

Q image thumb

Second- degree AV block

43

What's the different between Mobitz type I second degree AV block and Mobitz type II?

Mobitz type I: prolonged PR interval

Mobitz type II: no prolonged PR interval

44

What kind of AV block is seen in this ECG?

Q image thumb

Third degree AV block

45

What is the ECG criteria seen in a third degree AV block?

P's without QRS, PR intervals are not consistent, QRS's are proceeded by a pause, the heart rate is low

46

What is the most common cause of a first degree AV block and a Mobitz type I second degree AV block?

High vagal tone

47

What is the most common cause of a third degree AV block and a Mobitz type II second degree AV block?

structural disease of the AV node

48

What kind of AV block is pictured in this ECG?

Q image thumb

third degree AV block

49

What kind of AV block is seen in this ECG?

Q image thumb

Mobitz type II (High grade) second degree AV block

50

Is this a right or a left bundle branch block? 

Q image thumb

RIght

51

No P waves (no fibrillation/ flutter waves), normal QRS appearance seen in the ECG is consistent with which arrhythmia?

Q image thumb

Atrial Standstill 

52

A miniature schnauzer is presented with this ECG is most likely associated with:

a. Sick Sinus Syndrome

b. Atrial Standstill

c. Hyperkalemia

d. None of the above

Q image thumb

a. Sick Sinus Syndrome

53

Which electrolyte abnormality could be the casue of this abnormal ECG?

Q image thumb

Hyperkalemia

54

Which AV block is associated with this ECG where there are more conducted P waves than non conducted P waves?

Q image thumb

Second degree AV block Mobitz type II (low grade)

55

Which arrhythmias are associatedw ith hypokalemia?

VPC and SVPC

56

What would be the drug of choice for a dog that comes in with an ECG looking like this? 

Q image thumb

Diltiazem or electric cardioversion drugs

 

** Dog has atrial fibrillation. If you calculate the HR its 160 bpm which means hes tachycardic and we want to use a rate control drug or rhythm control drug

57

If a dog comes in and you suspect atrial fibrillation and he is bradycardic what would be the frist line of choice for treatment? 

Electrical or Pharmacological Cardioversion

58

What is the drug of choice to treat supraventricular tachycardia? 

Diltiazem

59

What anti-arrhythmic drug class do esmolol, atenolol, propanolol, and metoprolol fall under?

Class II: beta adrenergic blockers

60

What are the drugs for class I sodium channel blockers? 

Lidocaine, Procainamide, Quinidine, and Mexiletine

61

What are the Class III Potassium channel blocker drugs?

Sotalol, and Amiodarone

62

Which drug is considered a digitalis glycoside and helps to increase vagal tone in the SA and AV nodes? 

Digoxin

63

What is the drug of choice to treat a dog with this kind of ECG?

Q image thumb

Lidocaine

 

** He has ventricular tachycardia

64

What does a positive atropine response test indicate?

Bradyarrhythmia was most likely due to high vagal tone

65

What does a negative or partial atropine response test indicate?

Bradyarrhythmia was likely due to a structural heart disease

66

True/False: In cases of frequent or sustained bigeminy or frequent couplets like the ones seen in this ECG anti-arrhythmic therapy is ususally not considered.

Q image thumb

False

67

Which of the following is not eccentric hypertrophy?

a. Patent Ductus Arteriosus 

b. Ventricular Septal Defect

c. Subaortic Stenosis

d. Tricuspid valve dysplasia 

c. Subaortic Stenosis

68