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step 2: Cardio4
Cardio 4
| Question | Answer |
|---|---|
| 1st degree HB involves a PR >____sec. | > 0.2sec (1 big box) |
| 2nd degree Mobitz I is also known as? What does it entail? | Wenkebach (one-kebach). W-warning. Prolonging PR, then dropped beat. |
| 2nd degree Mobitz II involves what phenomenon on ECG? | Randomly skipped QRS. |
| Which do you treat: Mobitz I or Mobitz II? What is the Rx? | You only treat Mobitz II. Rx is ventricular pacemaker |
| What type of HB is common after MI? How do you Rx it? | Type III (no relationship btwn P waves and QRS). Rx with pacemaker (never give adenosine, which affects AV node) |
| What is the definition of Paroxysmal Supraventricular Tachycardia? What causes it? What population? | PVST = tachycardia originating in atria. Usually caused by re-entry rhythm. Occurs in healthy young pt's. |
| What are the AV re-entry pathways? | AV nodal and extranodal (WPW). Both cause PSVT |
| What ECG finding is may be found in PSVT? | narrow QRS |
| Rx of PSVT? Any difference if cause is WPW? | vagal maneuvers (carotid massage, cold water) + adenosine. If pt is hemodynamically unstable, do CARDIOVERSION. If cause is WPW, give AMIADARONE OR PROCAINAMIDE (adenosine slows AVnode, which is useless in WPW) |
| What does variable morphology of P waves imply? | multifocal atrial tachycardia |
| How do you treat Multifocal atrial tachycardia? | B blockers or CCB acutely. ablation/surgery for long term. correct K+/Mg+. (no Rx for asymptomatic) |
| What arrhythmia does digoxin cause? Why? | Atrial tachycardia. creates ectopic foci + increased vagal tone |
| Rx for premature atrial beats(P waves)? | no Rx necessary, usually normal due to caffeine, anxiety, etc |
| What are the only shockable rhythms? | VTach of Vfib (never PEA!!) |
| Bradychardia with dizziness, what is Rx? with hypotension? | dizzy= atropine. hypotension= add epinephrine |
| Irregularly Irregular pulse signifies _________. | Afib |
| What is the MCC of Afib? What are other causes? | MCC= HTN, hypothyroidism, valve disease (s/p CABG or AV replacement) |
| Rx protocol for Afib (its a long one)? | warfarin + rate control (BB,CCB,Digxn) for all. If presenting w/i 2 days (or TEE shows no thrombi after 2 days), add cardioversion (electrical or chemical w/ drugs). If thrombus present after 2 days, anti coagulate with warfarin (or ASA) then cardioverzn. |
| what causes Aflutter? | ectopic foci (like MAT) in atria, due to re-entry d/t abnormal AV condxn |
| What is the diff btwn Afib and A flutter on ECG | Afib= QRS present with no P waves. Aflutter = sawtooth |
| Aflutter can progress to ________ | Afib |
| What is PVC? What's its Rx? | Premature ven contraction. Similar to MAT, but ectopic foci are in ventricles. No Rx if asymptomatic (Rx can be harmful in asympt.) |
| How many PVCs in a row can cause Vtach? | 3 in a row |
| What electrolyte abnormality is a common cause of Torsades? What congenital abnormality is a common cause? | low Mg+. LQTS |
| How do you treat Torsades? | B Blockers |
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jsad
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