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MCPHS Patho Exam 2b
MCPHS Patho 2 Exam 2 (2)
| Question | Answer |
|---|---|
| Non-Pharmaco Tx's for Arrhythmias | Pacemakers, Implantable Cardioverter-defibrillator (ICD), Radiofreq Ablation (removal of Ectopic Foci) |
| Name of non-nodal pacemaker cell that interfers with normal AP's? | Ectopic Foci |
| Sinus Tachycardia ? | >100 b/min (short QRS cycles) Origin in Sinus (SA Node) |
| What is normal QRS time? | 1 sec. |
| Atrial Fibrillation? | >400-600 b/min, weak irregular = "pulse deficet" "Irregularly Irregular Rhythm" Sporadic ventricular filling |
| Causes of Atrial Fibrillation? | Mitral Valve Disease, Pericarditis, HTN, MI, Digitalis Tox, HyperThyroidism, Ectopic Foci of Atrial Cells, Coronary Heart Disease |
| AV Nodal Re-Entry? | Palpitations, Regular Rhythm, Narrow QRS, P-Waves Hidden, 170-250 b/min, A type of Supraventricular Tachycardia |
| Causes of AV Nodal Re-Entry? | Electrolyte Imbalance, slowed impulse undergoes retrograde conduction in atrial Loop (Premature atrial depolarization arrives at AV Node). May also be caused by MI & Coronary Artery Disease |
| Wolff-Parkinson-White Syndrome (WPWS) ? | Abnormal Accessory Pathway b/w Atria & Ventricle Short Circuits Usual AV Node Delay |
| Type of WPWS wave & age group this effects? | Delta Wave: Short PR-Interval, Wide QRS. Effects Children & 20-35 YO |
| Name of Congenital Alt. Path inWPWS? | Bundle of Kent |
| Types of Tachy-Dysrhythmias seen with WPWS? | Paroxysmal (Sudden) Supraventricular Tachycardia (PVST) & AFib |
| Ventricular Tachycardias (VTach)? | >100-250 b/min, Bizzare QRS, Regular Rhythm, VTach can deteriorate to VFib or Polymorphic VT (Torsade de Pointes) |
| Causes of VTach? | Ectopic Focus in Ventricles, MI, Myocarditis following surgery, Low K+, pH changes, low O2, anti-arrhythmic medications |
| Polymorphic Ventricular Tachycardias? | Prolonged AP caused by Early After-Depol (EAD's), Prolonged QT wave, 150-250 b/min |
| Causes of VTach's? | Congenital, Anti-arrhythmic Meds, Ca Chn Blkrs, Digitalis, Haloeridol, Erythromycin, Elec Imbalances, MI, HIV, Cocaine |
| Two Types of After-Depolarizations | Early After Depol (EAD) & Delayed After DePol (DAD) |
| Where do EAD's & DAD's occur? | Non-Pacemaker Cells (Spontaneous Self-Sustaining) EAD Occur at Phase 3 & DAD's Occur at End of Phase 3 to 4 |
| Causes of EAD's & DAD's? | Ca++ flowing into cardiac cell & too little K+ flowing out |
| Heart Block? | Defects in Conduction System. Atria Beat Normal, but Ventricles Occasionally Not Stimulated. Can be blocked every second or third atrial impulse (2:1 or 3:1) |
| Complete Heart Block? | Total Dissociation b/w atrial & ventricule activity. SA Node Normal, but Ventricle Generate Own Slower Impulses. ECG P-Wave Normal (QRS & T Regular & SLOW, but independent of P-Wave Rhythm) |
| Causes of Heart Blocks? | Scar Tissue, Fibrosis, Meds (B-Blkrs, Digitalis, Ca Chn Blkrs, Anti-Arrhythmic Class 1A, Elec Imbal, Cardiac Surgery, Inflammatory Diseases |
| Hyperkalemia causes what type of arrhythmia? | Longer AP b/c Increased ECT K+ Heart can not return to Distole. Slows Contractino with Broadening QRS, Aberrant Rhythms, Heart Stops |
| Atrial Fibrillation (AFib) Ventricles Function? | Ventricle fx normally, but Atrial is Irradic |
| Excitation-Contraction Coupled by? | Calcium that enters myocyte during Phase 2 of Depolarization |
| Innotropy? | Force of Contraction (Directly Proportional to Ca++ Released) |
| Mitral Valve? | Valve closing the orfice b/w left Atrium & left Ventricle. AKA Bicuspid, or Left Atrioventricular Valve (AV Valve) |
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MCPHS
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