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Cardiovasc 5 Arrhyth
Arrhythmias
| Question | Answer |
|---|---|
| Name the antidote!: salicylates | charcoal, sodium bicarb, dialysis |
| Name the antidote!: beta blockers | atropine, glucagon, calcium, insulin + glucose |
| Name the antidote!: digoxin | Dig Ab fragments, charcoal |
| Name the antidote!: iron | desFEroxamine |
| Name the antidote!: copper | PENIcillamine |
| Name the antidote!: t-PA, streptokinase | aminocaproic acid |
| A pt is found to have HTN, mild hypernatremia, hypokalemia, and metaolic alkalosis. What is the dx? | Primary hyperaldosteronism (Conn's) |
| What is the tx for an MI due to cocaine OD? | Benzos and CCB. Do NOT use beta blockers! |
| What type of heart block is described by the following statements?: PR interval prolonged more than 0.2s (5 sm boxes or 1 big box) | 1st degree block |
| What type of heart block is described by the following statements?: no relationship btwn P waves and QRS | 3rd degree block |
| What type of heart block is described by the following statements?: PR interval becomes progressively longer until a beat blocks (dropped QRS) | 2nd degree (Mobitz) type 1: Wenkebach gives a Warning |
| What type of heart block is described by the following statements?: PR interval fixed, but with occasional blocked beats (dropped QRS) | 2nd degree (Mobitz) type 2 |
| Which heart block needs a pacemaker? | 3rd degree |
| What is the drug of choice in paroxysmal supraventricular tachycardia? | IV adenosine |
| What basic EKG rhythm matches the following?: narrow QRS not a/w P waves, rate 60 | 3rd degree heart block, junctional rhythm |
| What basic EKG rhythm matches the following?: chaotic, erratic, wide QRS | Ventricular fibrillation |
| What basic EKG rhythm matches the following?: wide QRS not a/w P waves, rate 40-100 | Accelerated ventric rhythm |
| What basic EKG rhythm matches the following?: narrow QRS not a/w P waves, rate >100 | Junctional tachycardia (QRS narrow b/c coming from above/junction) |
| What basic EKG rhythm matches the following?: wide QRS not a/w p waves, rate 20-40 | Ventricular escape rhythm |
| What basic EKG rhythm matches the following?: wide QRS, not a/w P waves, rate >100 | V tach |
| What basic EKG rhythm matches the following?: narrow QRS not a/w P waves, rate 60-100 | Accel j'nl rhythm (QRS narrow b/c coming from above/j'n) |
| What basic EKG rhythm matches the following?: erratic QRS that varies in amplitude in repeating pattern | Torsades |
| Which endocrine d/o can cause a fib? | Hyperthyroidism |
| A pt is in the hospital and begins to have a fib with RV. This pt has had chronic a fib previously. What study is need b/f cardioconversion? | TEE |
| What is the tx for premature atrial contractions? | Nada. Observation only. |
| Which antiarrhythmic should be avoided in pts with pre-existing lung disease? | Amiodarone (causes pulmonary fibrosis, along with thyroid and liver probs) |
| What is the durg of choice for acute-onset a fib with RVR in a pt with WPW? | Electrical cardioversion or procainamide |
| An EKG shows complete independence of P waves and QRS complexes. What is the next step in mgmt? | Pace maker. |
| Where is the conduction defect in a second degree Mobitz I (Wenckebach) block? | Intranodal (or His bundle) |
| Where is the conduction problem in Second degree Mobitz II block? | Infranodal (His, Purkinje) |
| What drugs can cause a Mobitz I? | beta blockers, CCB, or digoxin. Tx is dose adjustment. |
| What drug should NOT be used to treat paroxysmal supraventricular tach in WPW? | Adenosine (instead use amiodarone or procainamide) |
| Long-term mgmt of paroxysmal supraventricular tach? | Catheter ablation of accessory conduction pathway |
| Irregularly irregular pulse is characteristic of which arrhythmia? | A fib |
| Name 3 drug classes used for rate control in a fib. | beta blockers, CCB, digoxin |
| How long should you anticoagulate a pt with a fib b/f cardioconverting them | 3-4 weeks |
| What drugs should be used for anticoag in a fib pts? | Heparin + warfarin. Contin heparin until warfarin is in therapeutic range |
| What is the cutoff for cardioversion without prior anticoag in a fib? Why is this time significant? | <48h. Not enough time to form a mural thrombus which could get dislodged during cardioversion. |
| What drugs can be used for chemical cardioversion? | Sotolol and amiodarone |
| Sawtooth pattern of P waves on EKG is characteristic of which arrhythmia? | A flutter |
| Tx for PVCs? | None if pt is healthy. Beta blockers in pts with CAD or symptoms. |
| At what point do PVCs become concerning for V tach? | >3 per min. V tach= 3+ PVCs with HR 160-240bpm |
| Tx for torsade? | IV mag |
| What about v fib is so flippin dangerous? | No cardiac output! Uh-oh! |
| What are the 4 classes of antiarrhythmics? | No Bad Boy Keeps Clean (seriously I still remember the right brain bonus video for this!): 1. Na channel blockers, 2. Beta blockers, 3. K channel blockers, 4. CCB |
Created by:
sarah3148
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