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44 Cards in this Set
- Front
- Back
ECG Criteria for VT vs. SVT + aberrancy
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1. Broad Complex > 0.16 msec
2. Tachycardia > 120 3. Absence of typical RBBB / LBBB morphology 4. Extreme Axis Deviation 5. AV dissociation 6. Capture Beats 7. Fusion Beats 8. Chest Lead Concordance 9. Brugada’s Sign {RS length > 100msec} 10. Josephson’s Sign {notching near nadir of S wave} 11. Rsr V1 [ not rsR of RBBB] |
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Which is incorrect in regards to Multifocal
Atrial tachycardia {MAT}? |
4. It is a stable rhythm
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Causes of Atrial Flutter
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VITAMIN D+E
Vascular - CCF / valve dysfunction Infection Sepsis Trauma x Autoimmune x Metabolic x Idiopathic / Inflammation pericarditis Neoplastic x Drugs Stimulants Endocrine Hyperthyroidism Environmental |
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Prognostic factors in CHA2DS2 VASC scoring
{for Embolic stroke reduction and anticoagulation in AF} |
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Anticoagulation Guidelines for CHA2DS2 VASC
{Scores and Rx} |
aspirin OR warfarin / NOACS
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in comparing AVNRT and AVRT, which is
incorrect? |
4. AVNRT is not usually associated with structural cardiac disease
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In regards to AVRT, which is incorrect?
1. Orthodromic conduction with AVRT is more common than antidromic conduction 2. Orthodromic conduction in AVRT involves retrograde conduction along the normal conducting AV pathway 3. Orthodromic conduction with AVRT tachycardia is difficult to distinguish from AVNRT tachycardia |
2. Retrograde conduction occurs up the
Accessory pathway |
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Causes of completely irregular rhythms {7}
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1. Atrial Fibrillation
2. Atrial tachycardia with variable conduction 3. Atrial flutter with variable conduction 4. Multifocal atrial tachycardia {MAT} 5. Multiple extrasystoles 6. Wandering pacemaker 7 Parasystole |
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Which is incorrect regarding narrow complex tachycardias?
1. Atrial flutter is usually via a re-entrant mechanism 2. Normal AV nodal tissues rarely allow a ventricular response rate of more than 170-180 bpm 3. Atrial fibrillation is the result of multiple micro-reentry circuits. 4. Atrial fibrillation limits diastolic filling AND stroke volume of the ventricles. |
2. 150-165bpm
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Which is the association with atrial flutter:
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5.
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Ashman Phenomenon rhythm associations {3}
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1. Atrial fibrillation
2. Atrial ectopy 3. Atrial tachycardia |
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Causes of Atrial fibrillation :
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S sick sinus syndrome
H hyperthyroidism H hypertensive heart disease Idiopathic I ischaemic heart disease C cardiomyopathy C CCF C cardiac surgery V valve disease {mitral*} P pericarditis P Pulmonary embolus WPW |
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IN regards to WPW, which is incorrect?
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5. 70-80%
AF seen in 10-30% patients with WPW. |
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In regards to WPW, which is incorrect?
1. Patients with WPW often have one or more classic features MISSING on the ECG. 2. The Kent fibres are the most common accessory pathway 3. Type A WPW = QRS mostly positive in V1. 4.The short PR interval is the result of the absent Av node conduction delay. |
5. Orthodromic tachycardia = narrow QRS and no delta wave ==> AV node anterograde
conduction and retrograde accessory pathway conduction conduction. |
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In regards to WPW, which is incorrect?
1. Unstable patients should be cardioverted -synchronised-starting at 50-100J other nodal blockers} are contraindicated. |
4. VF
ventricular rate > 250bpm is HIGHLY SUGGESTIVE OF AF AND WPW |
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Diseases associated with WPW {7}
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1. Idiopathic ***
2. Cardiomyopathy {HOCM} 3. Transposition of the great vessels {TOGV} 4. Ebstein's Disease 5. Mitral valve prolapse {MVP} 6. Tricuspid atresia 7. Endocardial fibroelastosis |
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4 ECG characteristics of Sinus tachycardia
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1. Normal P waves
2. Normal P-R intervals 3. 1:1 atrioventricular conduction 4. Atrial rate 100-160 bpm |
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3 categories of sinus tachycardia stimuli
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1. Physiologic
2. Pharmacologic 3. Pathologic |
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3 ECG characteristics of AVNRT
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1. P wave buried in QRS complex-and not visible
2. 1:1 conduction 3. normal QRS complex |
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Which is incorrect regarding management of SVT?
1. Vagal manoevres have a success rate of 25% 2. The valsalva manouevre is the most effective vagal manouevre for conversion of reentrant SVT-particularly in supine position |
5.Adenosine is not Contraindicated in
NARROW COMPLEX WPW |
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Which is an incorrect association?
1. WPW and kent bundle 2. Lown-Ganong-Levine (LGL) Syndrome and James fibres 3. James fibres of LGL syndrome connect atrium and proximal HIS bundles |
5. Short PR interval and narrow QRS
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Mahaim bundles with AVRT originate from:
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4.
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Which is incorrect in regards to Type A WPW:
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5. V1 delta wave-positive deflection
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Type B WPW: which is incorrect?
1. V1 delta wave has initial positive deflection 2. May resemble an inferior wall MI 3. Lead V1 can have an RS or QS pattern 4. Delta wave has initial negative deflection in V1 5. Ventricular activation occurs in the inferior-posterior region of the Right ventricle |
1. V1 delta wave has initial negative deflection
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In regards to Type C WPW, which is incorrect?
1. Ventricular activation occurs first in the posterior lateral region of the Left ventricle. 2. Leads V5 has negative OR isoelectric pattern 3. Lead V6 can have a negative OR isoelectric pattern 4. Both Type A and Type C WPW have positive initial delta wave deflections |
5. Positive delta wave deflection in V1.
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Brugada Criteria for VT
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1. Absent RS complex in all V leads==> VT
2. R to S nadir > 100msec in any V lead==> VT 3. AV Dissociation ==> VT 4. Typical BBB pattern ==> not VT |
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Main causes of VT
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1. Coronary artery disease (CAD)
2. Cardiomyopathy 3. Myocarditis 4. Valvular heart disease |
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Treatment options for VT with pulse.
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1. DC cardioversion
2. pharmacological - Amiodarone 3. Rapid Right ventricular pacing {Overdrive pacing} |
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Which of the following is incorrect regarding
Torsades de pointes? monomorphic VT hypomagnesaemia. |
B. Repolarisation abnormality
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List the causes of Torsades de Pointes.
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1. Hypo-electrolytes
a. magnesium b. calcium 2. Antiarrhythmic drugs [ I and II ] 3. TCA 4. Antidepressants / Antipsychotics a. phenothiazines b. citalopram 5. Congenital prolonged QT syndrome 6. Organophosphates 7. Complete heart Block [CHB] 8 Drug interactions a. erythromycin-terfenadine |
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Treatment options for Torsades de Pointes?
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1. Magnesium (MgSO4) ***
2. Cardioversion [ haemodynamically compromised ] 3. Overdrive pacing [ rate 90-120] 4. Isoprenaline 20mcg IV push + infusion 1-4 mug / minute 5. Lignocaine 1mg/kg IV + infusion 4 mg / min. |
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Which is incorrect regarding Torsades
de Pointes (TdP) Ventricular tachycardia (PVT) is drugs |
B. Ischaemia
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Which is incorrect regarding the
pathophysiology regarding TdP? after-depolarisations (EADs) |
D. Prolonged repolarisation
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Which is incorrect regarding
Long QT Syndromes? duration at a Heart Rate of 60. bradyarrhythmia. |
C. rate should be less than 90.
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In regards to overdrive pacing in Torsades de Pointes, which is incorrect ?
A. In the ED, it refers to setting the pacing greater than the rate of the bradyarrhythmia. B. There is little actual data to support its efficacy in the ED C. Monomorphic VT can also be directly overdrive paced-but requires transvenous pacing. D. Pacing occurs continuously, in the asynchronous mode. |
D. It actually occurs as brief trains of 6-10 beats of asynchronous pacing.
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Which is incorrect regarding Long QT and
Torsades? extrasystole. |
D. Lange-Nielson is associated with nerve
deafness. |
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Which electrolyte abnormality is least associated with Increased QT interval?
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D.
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Which is an unlikely drug cause of Long QT
interval ?
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C. Class Ia , Ic and III.
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Which of the following Clinical conditions is least likely to cause a prolonged QT interval?
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D.
C. "Severe" Hypothermia does prolong QT interval |
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Which of the following is incorrect regarding the immediate Treatment for TdP ?
A. Arrested = Defibrillate B. Conscious + Sustained = Cardiovert C. Conscious and non-sustained = External pacing D. Correct bradyarrhythmia and underlying cause ( MgSO4 ; atropine ; isoprenaline ) |
C. External pacing only after : correcting
1. Bradyarrhythmia and 2. Underlying cause ( Hypokalaemia ; Hypocalcemia ; Hypothermia ) |
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List the 5 main ECG phenomena (Types)
associated with Syncope in the young adult / athlete. |
1. HOCM
2. ARVC [ arrhythmogenic right ventricular cardiomyopathy] 3. Brugada Syndrome |
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In regards to the ECG of HOCM, which of the
following is incorrect? |
A. Left atrial enlargement = broad bifid
P waves Peaked P waves = right atrial abnormality |
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which is incorrect regarding HOCM?
A. It is the leading cause of sudden cardiac death in healthy athletes < 35 years. B. Its murmur is increased with valsalva and standing. C. It has Epsilon waves present. D. Handgrip reduces the murmur of HOCM. |
C. No -this is present in ARVC
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In regards to Arrhythmogenic Right
Ventricular Cardiomyopathy (ARVC), which of the following is incorrect? Hypothermia. |
C. QRS > 0.11 seconds in V1-3.
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