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209 Cards in this Set
- Front
- Back
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What is Leukemia?
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Neoplasia of White Blood cell stem cells.
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What can cause acute Leukemia?
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Radiation
viruses toxins DNA damage association (such as Down Syndrome) genetics |
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What is happening in Leukemia?
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Bone marrow is rapidly replaced with normal cells.
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What are the symptoms of acute Leukemia?
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Bone pain
anemia bruising and bleeding infections lymphadenopathy (not usually painful) hepatosplenomegaly headaches |
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What is acute lymphocytic or lymphoblastic leukemia?
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Mostly affects children around the age of 4, although adults can get but do much worse in treatment. Typically has a 90% remission rate and 85% cure rate for children and 75% remission rate for adults.
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What is acute myelogenous leukemia?
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A group of leukemias that includes other WBCs and effects older groups of young people, teens to 30's and then elderly people. In addition to other leukemia symptoms, includes skin and gum swelling. Typically has a 60-80% remission rate, but adults usually have poor treatment results.
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What does lymphoblastic mean?
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Young cell.
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Describe chronic leukemia.
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Typically happens in adults. Comes on slow then has a "blast crisis". Typically is discovered during a normal blood test.
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What is chronic lymphocytic leukemia?
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Involves t-cell lymphocytes. Typically happens in adults over 50, more men and often farmers. Cells build up slowly. There is lymphadenopathy, respiratory infections and masses that can damage organs. DNA markers are used to coordinate treatment. Younger patients get more aggressive treatment. It needs to be treated as a "blast crisis".
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What is chronic myelogenous leukemia?
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There is a specific swapping of DNA of chromosomes 9 & 22, which results in an overexpression of the enzyme tyrosine kinase. This is called chromosome translocation.
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How do they typically discover chronic myelogenous leukemia?
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Normal blood test would be run because the patient is tired.
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What are the symptoms of Chronic Myelogenous Leukemia?
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Takes about 2 years to go from diagnosis to symptomatic, then a blast crisis. The cells are not crazy abnormal, not unrecognizable. Normally affects working age people 25-60. Anemic, enlarged spleen (until they can feel it). Tired.
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What is the treatment for Chronic Myelogenous Leukemia?
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Inhibiting tyrosine kinase drugs first. Then interferons and hydroxy urea.
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What is Multiple Myeloma?
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Cancer of one mature B-cell that clones and becomes malignant.
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What are the symptoms of multiple myeloma?
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Effects adults of average age of 60. More common in males. Bone infiltration, dissolves out calcium causing hypercalcemia and shows circular shadows on x-ray. Bone pain, bone fractures, anemia, excess of antibodies in the blood (thick blood), high BP, decreased immunity, and at risk for kidney failure.
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What is the treatment for Multiple Myeloma?
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Targeting the oncogene with thalidomide, which turns off the growth factor that the gene turns on. Transfusions, chemo, bone marrow transfusion, plasmapheresis (remove the excess Ig's). Prognosis after treatment is 10-15 years survival.
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What are the symptoms for anemias?
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Tired
Lightheadedness Increased heart rate vasoconstriction syncope (fainting) pale headachy |
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What is anemia of blood loss?
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A loss of hemoglobin by a loss of RBCs due to trauma or surgery.
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What is toxic anemia?
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Also known as aplastic anemia, is caused by radiation poisoning.
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What is megaloblastic anemia?
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Decreased DNA synthesis and decreased cell replacement. Marrow cells in the blood. RBCs are sometimes football shaped. There are 2 causes, Pernicious anemia and folic acid deficiency.
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What is pernicious anemia?
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Low vitamin B12, low RBC count, low WBC count and possible neurological symptoms that are not reversible!
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What is folic acid deficiency?
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Low folic acid, low RBC count, low WBC count and can cause neural tube defects in fetuses.
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What is decreased erythropoiesis?
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Decreased production of blood, nutritionally related. There are two kinds, Megaloblastic and Iron deficiency.
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What is iron deficiency anemia?
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Low hemoglobin production. The RBC count is still either normal or high, but they may be pale, not carrying oxygen. More common in women due to menstruation and in children because of poor diet.
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What are inherited anemias?
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Anemia that can be inherited. There are two kinds, Thalessemia and Sickle Cell anemia.
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What is Thalessemia?
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There are two kinds: Alpha, seen in Asia, that is genetic recessive and Beta, an autosomal recessive, that effects school age children with bone deformities, heart liver and pancreas. Being a carrier for either protects from malaria.
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What are the symptoms of Thalessemia?
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A chain in the DNA is abnormal. Protein builds up in the cells. Anemia early on, hepatosplenomegaly, iron overload toxicity, bone pain, bone deformity, The body tries to compensate by increasing production of the RBCs.
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What is the treatment for Thalessemia?
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Blood transfusions (which can increase iron overload), Iron chelation (drugs to remove iron storage).
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What is Sickle Cell Anemia?
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It is a homozygous recessive inherited anemia. It typically affects people of Greek, Italian, Spanish and African descent. A change in the hemoglobin makes the RBC look like a football and then a crescent shape.
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What are the symptoms of Sickle Cell Anemia?
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Hepatosplenomegaly, Iron overload, pain. The sickle shaped RBCs may get caught and block blood vessels causing ischemia. Increases risk for necrosis.
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What is the treatment for Sickle Cell Anemia?
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Bone Marrow transfusions. Some people may have another child for the cord blood for a match for bone marrow transfusions. Being a carrier may protect against malaria. If the patient has kidney disease, the kidney disease will progress quicker.
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What is polycythemia?
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Excess Red Blood cells.
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What are the symptoms of polycythemia?
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High viscosity (thicker), risk of high BP, blood can gel in stress, "ruddy" skin color, post-bath pruritis (itchiness), risk of sudden heart attack or stroke during times of stress. There are three kinds, Secondary polycythemia, Polycythemia Vera, and blood doping.
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What is secondary polycythemia?
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Typically occurs after: pneumonia, a heart attack or high altitude training. Symptoms include low oxygen levels and an increase in erythropoietin, increasing production of RBCs.
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What is erythropoietin?
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A hormone that stimulates the production of RBCs.
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What is Polycythemia Vera?
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Meaning "true" polycythemia that is either caused by a kidney tumor (because kidneys make erythropoietin) or it is idiopathic.
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What is the treatment for polycythemia?
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To have blood removed regularly.
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What is blood doping?
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When a person takes erythropietic drugs or gives themselves blood transfusions when not needed. This is typically done by an athlete looking to increase their stamina.
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What is a hemostasis disorder?
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A blood disorder where your blood does not clot well.
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What are some common symptoms of a hemostasis disorder?
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Petechiae
purpura ecchymosis hematoma telangiectases epitaxis. |
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What is petechiae?
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Spot bleeds deep to the epidermis (tiny red spots) . Can get it from capillary damage
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What is purpura?
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Patch of petechiae. Patch of purple.
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What is ecchymosis?
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A flat bruise.
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What is a hematoma?
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Swollen or raised bruise (can be swollen without color)
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What is a telangiectases?
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Spider veins or splinter hemorrhages under the fingernails.
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What is epitaxis?
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Nosebleed
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What is thrombocytopenia?
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Lack of platelets due to anything that suppresses bone marrow. Is found with immune diseases and is idiopathic.
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What is a normal platelet count?
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About 450,000.
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What happens when platelet count is below 100,000?
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There is excessive bruising and prolonged bleeding.
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What level is the platelet count at when theres' petechiae and purpura?
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Below 50,000.
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What happens when the platelet count is below 20,000?
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Spontaneous bleeding without injury.
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What is the treatment for thrombocytopenia?
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Packed platelets.
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Name the genetic bleeding troubles.
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Hereditary Ataxia Telangiectasia
Willibrands Disease Hemophelia |
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What is hereditary ataxia telangiectasia?
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Loss of coordination due to cerebellar damage. There is more DNA damage than normal and it can't be repaired often enough, so cancer often develops. It is often diagnosed due to nosebleeds.
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What is Willibrands Disease?
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An autosomal dominant recessive bleeding disorder. It is lethal. To receive one gene, can live a relatively normal lifespan. To receive two genes, and the baby is miscarried. Affects blood's ability to clot. It slows platelets by about half. Diagnosed by nosebleeds, hematomas, etc. Affects men and women.
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What is Hemophelia A?
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X-linked recessive bleeding disorder. Missing factor XIII, part of the intrinsic pathway. Takes longer to make a clot. Similar but milder form of thrombocytopenia. Can't play contact sports, there is extra concern for surgery. Can't take aspirin. Treatment is to give blood factors.
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What is this a slide of?
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Acute lymphocytic leukemia.
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What is this a slide of?
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Chronic lymphocytic leukemia.
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What is this a slide of?
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Acute myelogenous leukemia.
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What is this a slide of?
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Chronic myelogenous leukemia.
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What is this a slide of and what are the dark spots?
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Multiple myeloma. The dark spots are where calcium is missing from the bone.
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What is this a slide of and how can you tell?
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Iron deficiency anemia. The cells appear more pale than normal.
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What is this a slide of and how can you tell?
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Sickle cell anemia. The crescent shaped RBCs.
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What condition is shown here?
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Beta thalessemia.
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What is this a slide of and how do you know?
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Megaloblastic anemia. Fewer cells and marrow cells in the blood (megaloblasts).
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What is wrong with this man and how can you tell?
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Polycythemia. His face is "ruddy" colored.
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What does this baby have?
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Hemolytic disease of the newborn.
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What's wrong with this little girl and how can you tell?
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Anemia. Her eyes should be red around the bottom.
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What is this a slide of?
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Bone marrow aplastic anemia.
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What is this?
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Ecchymosis. (Flat bruise)
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What is this a picture of?
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Embolis (clot) in a lung.
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What is wrong with this man's leg?
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Hematoma from hemophilia.
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What is this a picture of?
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Petechiae.
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What is this a picture of and what do you suspect may be causing it?
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Purpura from age.
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What is this a picture of?
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Purpura.
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What is this a picture of?
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Telangiectasia.
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What is this a slide of and how do you know?
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Thrombocytosis. The extra platelets.
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What is this a picture of?
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Wound hematoma.
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What is thrombosis?
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Excessive clotting.
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What causes thrombosis?
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Anything that causes damage to the epithelium, such as high blood pressure, blood sitting too long (like a long airplane ride), inherited tendencies or traveling metasatic cells such as in burn patients.
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What is the treatment of thrombosis?
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Anticoagulants like aspirin, or blood thinners. Patient must avoid alcohol and/ or eat green leafy vegetables.
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If a person has a family history of thrombosis, what should they avoid?
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Using oral contraception.
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What is peripheral vascular (arterial) disease (PVD)?
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Chronic and progressive loss of circulation to arms and legs.
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What are the risk factors for PVD?
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Atherosclerosis, diabetes, inflammatory diseases, peripheral neuropathy, outlet disorders
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What are the symptoms of PVD?
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Chronic loss of circulation, skin changes (cold, dry and sometimes glossy), fingernails or toenails thick and rough, skin hair may disappear or become patchy, peripheral pulse may become weaker, pain with exercise, wound healing trouble.
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What is the treatment for PVD?
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Vasodilators don't work well, treat the pain, stints like coronary repairs, bypass surgery, though they may heal slowly or surgery to repair outlet
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What is an outlet disorder?
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A compression injury or an irritation to the nerves and blood vessels together (like in the thoracic or neck area in thoracic outlet syndrome).
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What is heart failure?
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When cardiac output is less than needed to supply oxygen to the body.
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What is systolic disfunction?
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Failure in the pumping or emptying of the hear due to muscle failing or weak contraction by heart muscle because of a chemical imbalance.
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What is diastolic disfunction?
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Problems with filling of the heart due to scar tissue, loss of elasticity or stretching, too much fluid in the pericardial sac , valves won’t open , again because of scar tissue or the heart muscle gets too thick
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What causes heart failure?
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Systolic or diastolic dysfunction.
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If the heart starts to fail or there is poor oxygen delivery to the heart, what happens to the heart?
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The brain tells the heart to increase the pumping rate and strength and soon the heart increases in size.
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What is it called when the heart increases in size?
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Cardiomegaly or hypertrophy.
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What happens to the valves if the heart becomes enlarged?
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The valves stretch and have a hard time closing causing leakage at the valves.
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What happens when the walls of the heart become thicker?
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The risk of heart attack increases.
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What is left sided heart failure?
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Valve issue, ventricular wall issue (usually post MI), blood is not going to get pushed forward effectively and gets backed up in the lungs and pulmonary vessels.
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What are the symptoms of left sided failure?
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- Edema (fluid in the lungs)
- decreased respiratory sounds - coughing - pallor or cyanosis - trouble breathing – dyspnea - orthopnea (position related breathing trouble) - trouble with oxygen delivery to the brain - hypoxic or low O2 encephalopathy (head – bad) - irritable, restless, foggy |
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What is right sided heart failure?
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Could be a valve issue, a heart muscle issue or "cor pulmonale" (caused by a lung disease).
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What are the symptoms of right sided failure?
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- blood builds up in the body in the systemic vessels
- pitting edema, especially in the ankles - ascites because liver is congested with fluid - splenomegaly - if poor O2 delivery to the limbs, necrosis will develop and clubbing of the fingers and toes |
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What are the two conditions seen here?
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Cyanosis and clubbing of the toes.
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What is the treatment of heart failure?
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Surgery
muscle may use left ventricle assist devices diuretics heart transplants |
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What are the other names for Ischemic Heart Disease?
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Coronary Artery Disease and Coronary Heart Disease.
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What is Ischemic Heart Disease?
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Oxygen delivery to the heart muscle is less than needed.
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What are the risk factors for Ischemic Heart Disease?
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- Anything that puts someone at risk for atherosclerosis
- cardiomegaly - embolus - stress |
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What are the symptoms of ischemic heart disease?
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Plaque rupture, clot, artery spasm, traveling clot, increased workload for the heart
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What are the three levels of Ischemic or Coronary Heart Disease?
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Angina Pectoris
Myocardial Infarction Sudden Cardiac Death |
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What is Angina Pectoris?
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Pain stemming from the heart. It is sub-lethal to the heart muscle and there is no ischemia.
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What is myocardial infarction?
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Heart attack severe enough to cause muscle death if not stopped.
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What is the pathogenesis of a heart attack?
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Blocked oxygen delivery to the heart. Ischemia causes cell death and inflammation and hopefully scarring (instead of missing tissue).
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What is a transmural heart attack?
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Thickness of the heart muscle wall, scarring and stiffness possibly leading to an aneuryism (floppy wall) and possibly a rupture.
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What is a sub-endocardial heart attack?
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A heart attack deep to the endocardium causing scarring, increased clot risk, and anchors to the Atrioventricular valves could fail if the muscle is damaged too badly.
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What is a septal heart attack?
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A heart attack affecting the interventricular wall, or septum, interrupting the signal conduction possibly causing heart block or heart arrhythmias.
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What determines how well a person recovers most MI?
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How long they lacked oxygen and how the scar tissue is formed.
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What are the clinical manifestations of an MI?
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- stress or sympathetic NS response (epinephrine) - anxiety - can’t sleep - sweating - nausea - flu-like symptoms - pressure on chest, neck, left shoulder or pain - numbness or pins and needles – paresthesia (both sides) - cardiac enzymes - creatine - high - Asystole - ventricular fibrillation - potassium - high SED rate - low fever - inflammation - high WBC count - vomiting and diarrhea - EKG ST elevation - T inversion - uphill ECG
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What are the treatments for MI?
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MONA - Morphine, Oxygen, Nitroglycerin and Aspirin, immediately then possibly, stints, anticoagulants, bypass surgery and meds for arrhythmias.
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What looks like a heart attack, isn't one, but could lead to one?
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Acute stress cardiomyopathy.
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What is acute stress cardiomyopathy?
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Emotional stress triggers really high epinephrine to the point where it becomes toxic to the heart muscle (7 to 34 times normal stress). Epinephrine decreases the contraction strength while increasing the rate of contraction. The heart quivers and sort of pumps but not very well.
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What is the cause of acute stress cardiomyopathy?
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Extremely high stress hormones that effect someone already high stress situation (such as someone with a recently dead partner).
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What are the symptoms of acute stress cardiomyopathy?
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Lousy pumping, high heart rate, chest pain, passing out, sweaty, nausea, ST elevations that convert to T inversions over time, enzyme levels are up but don't keep rising, but epinephrine levels are through the roof.
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What is the treatment for acute stress cardiomyopathy?
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Bed rest, epi blockers, fluids, load reducers and over time they may be okay.
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What is a load reducer?
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Anything that makes it easier for the heart to pump: diuretics, pain relievers, BP reducers, vasodilators, etc.
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What is stenosis?
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A narrowing such as of a heart valve or blood vessel.
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What is a heart murmur?
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A valve stenosis.
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What is displayed here?
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Pitting edema.
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Can you identify the issue with this heart?
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Right sided congestive heart failure. The right side is much bigger than the left.
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What is wrong with this heart?
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Left side hypertrophy.
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Name some causes of valve disorders.
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Congenital
Rheumatic heart disease Endocarditis Autoimmune conditions. |
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What is rheumatic heart disease?
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A strep infection with rheumatic fever which causes arthralgia, polyarthritis, erythema marginatum, strawberry tongue and carditis, which then causes a ring lesion on the heart valve which eventually causes stenosis. RHD is making a comeback epidemiologically.
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What is arthralgia?
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Joint pain.
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What is carditis?
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Inflamed heart.
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What is polyarthritis?
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Visibly inflamed joints.
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What is erythema marginatum?
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Red disc lesions with raised edges.
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What is this a picture of?
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A ring lesion common of rheumatic heart disease.
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What is this a picture of?
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Erythema Marginatum.
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What is endocarditis?
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An inflammation of the endocardium often caused by a bacterial infection from dental procedures, oral infections or unsterile injections. The infection makes emboli causing spot infections, random abscesses, splinter hemorrhages, and vegetations on the heart valve that can form emboli or WBCs to eat through the valve.
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What is a cardiomyopathy and name three kinds.
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Muscle diseases that lead to heart failure.
Dilated cardiomyopathy Hypertrophy cardiomyopathy Restrictive cardiomyopathy |
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Describe dilated cardiomyopathy.
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The heart gets larger, but the valves don't so they can't close properly. The causes include toxin exposure, genetics and autoimmune attack. Doesn't respond well to stress (like food poisoning).
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Describe Hypertrophic cardiomyopathy.
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Sub-aortic stenosis. Poor filling. The cells of the muscle fibers are disorganized in appearance and can’t pump well triggering hypertrophy. The muscle walls get very thick leaving smaller space in the ventricle. Develops atrial fibrillation. Poor response to exercise. Genetic disorder.
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What is the treatment for hypertrophic cardiomyopathy?
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Load reducing drugs, surgically reduce the thickness of the muscle wall, especially the left side or heart transplant.
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Describe restrictive cardiomyopathy.
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The walls of the ventricles don't stretch due to scar tissue. Poor filling, Can be caused by many small heart attacks, infection, or inflammation of the heart muscle. It is very progressive and decreases the ability to exercise and pump blood to the body. The only treatment is transplant.
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What is myocarditis?
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Inflamed heart muscle. Caused by an infection, autoimmune disorder, or toxin such as cocaine. It is asymptomatic except in an EKG, which looks like it's dancing. There may be pain, or passing out with exercise or just dropping dead (like Reggie Lewis).
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What is pericarditis?
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Inflammation of the pericardial sac. There are acute forms, chronic forms and one caused by effusion.
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What is effusion?
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The escape of fluid from the blood vessels or lymphatics into the tissues or a cavity such as the pericardium.
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What are the acute forms of pericarditis?
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1. Serous
2. Fibrinous 3. Purulent 4. Hemorrhage 5. Caseous |
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What are the chronic forms of pericarditis?
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1. Constrictive
2. Adhesive mediastinopericarditis |
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Describe serous pericarditis.
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There is a low volume of fluid inside the pericardial sac. Could be from pulmonary edema.
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Describe fibrinous pericarditis.
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There is protein in the fluid with the inflammation which causes a friction rub that can be heard with a stethoscope. There can be a fever and pain and can be caused by a heart attack.
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Describe purulent pericarditis.
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Pus in the pericardial sac. Caused from an infection. The amount of liquid may be high. Have to treat the infection and drain the liquid.
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Describe hemorrhagic pericarditis.
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Blood in the pericardial sac. May be a large amount of fluid. Causes are typically from cancer, TB or post MI.
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Describe Caseous pericarditis.
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Cheesy necrosis fluid in the pericardial sac. Has a very high friction rub. Usually converts to fibrinous over time. Due to TB.
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What is cardiac tamponade?
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Pericarditis with an excessive amount of fluid, hemorrhagic or purulent. There is so much fluid that the heart decreases it's ability to fill. Causes in increase in HR, failure signs increase and causes pulsus paradoxus.
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What is pulsus paradoxus?
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The patients heart rate goes up with in inhalation and the patients heart rate goes down with exhalation.
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What is constrictive pericarditis?
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When the pericardial sac gets tight around the heart. There is inflammation and scarring over time. It can be treated by cutting a hole in the sac.
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What is Adhesive mediastinopericarditis?
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It is post scar tissue. This can happen after surgery, the heart is sticking to the scar tissue or the pericardium which is sticking to the rib cage or the sternum. It decreases the ability of the heart to pump well. If untreated can cause heart failure. Anti-scar tissue drugs can be used after surgery.
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What are congenital heart deformities?
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Deformities of the heart that occur during gestation. There are two kinds cyanotic and acyanotic.
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What are the acyanotic congenital heart deformities?
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There are three caused from abnormal shunts. The patent foramen ovale, the patent ductus arteriosus and the ventricular septal defect.
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What is the patent foramen ovale?
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A congenital heart defect where the foramen ovale fails to close after birth. It is an opening between the two atria during gestation and should close after birth.
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What is patent ductus arteriosus?
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A congenital heart defect where the ductus arteriosus fails to close after birth. It is a vessel between the aorta and the pulmonary artery that typically becomes a ligament after birth. If patent, 10% of the blood may skip the lungs so it typically does not cause the baby to turn blue.
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What is this a picture of?
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Cardiac Tamponade.
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What is this a picture of?
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Patent ductus arteriosus.
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What is this a picture of?
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Patent foramen ovale.
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Describe the ventricular septal defect.
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A congenital heart defect where this is an opening between the two ventricles. If the blood flows from the left to the right, then it is mostly okay, but if blood flows from the right to the left, it will cause the baby to become cyanotic, or turn blue.
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What is this a picture of? Is it okay or will it cause the baby to become cyanotic?
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Ventricular septal defect. The photo shows the blood flowing from left to right, so it will not cause the baby to turn blue.
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What are the cyanotic congenital heart deformities?
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1. Tetralogy of Fallot
2. Transposition of the big arteries (aorta & pulmonary trunk) 3. Truncus arteriosus. |
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What is tetralogy of Fallot?
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A combination of congenital heart deformities consisting of ventricular septal defect, the aorta opens over the ventricular septal defect, the pulmonary artery is undersized (stenosis) and the right ventricle is oversized.
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Can you tell what's wrong with this heart?
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Tetralogy of Fallot. There is a Ventricular septal defect, the aorta opens over it and the pulmonary trunk is narrow.
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If there is a transposition of the aorta and pulmonary trunk, what does it do?
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It is fatal at birth unless there is a VSD. The opening of the VSD will aid in getting oxygenated blood to the body.
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What's going to save this baby?
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The ventricular septal defect.
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Describe truncus arteriosus.
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A cyanotic congenital heart defect where the heart has two atria, one ventricle and one big artery (like a frog heart) .
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What are the SA node arrhythmias?
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1. Sinus tackycardia
2. Sinus Bradycaria 3. Sinus arrhythmia 4. Sick sinus syndrome 5. Asystole 6. Premature atrial contaction |
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Describe sinus tackycardia.
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- 100 BPM or higher (not an infant)
- from the sympathetic NS (epinephrine) - stress - pain - low BP - low oxygen - hyperthyroid can be caused by a caffeine IV or asthma meds |
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Describe bradycardia.
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- Less than 60 BPM (other than endurance athletes)
- from the parasympathetic NS pain meds may cause this, sleep, or seriously cold water. |
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Describe sinus arrhythmia.
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No normal rhythm. Typical for children.
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Describe sick sinus syndrome.
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Alternating between tackycardia and bradycardia.
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Describe asystole.
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Nothing coming from the SA node or anywhere else. "Flatline". Can be caused by electrolyte disorders, pH disorder or an MI.
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Describe premature atrial contraction.
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A varied distance between the P waves, one is too close then the next is delayed. Will feel like a skipped beat. It is okay for an abnormal heart rhythm, not really a risk sign.
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What is this a slide of?
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Cardiomyopathy. Hypertrophic tissue.
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What are we looking at?
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Splinter hemorrhages, possible endocarditis.
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What could this baby have?
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Tetralogy of fallot
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What is wrong with this heart?
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Fibrinous percarditis, post MI
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What's wrong with this heart?
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Purulent pericarditis.
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What are we looking at?
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Endocarditis vegetations.
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What is this a slide of?
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Dilated cardiomyopathy.
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What is an atrial flutter?
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Abnormal heart rhythm in the atria. It still contracts, it's just not the most effective.
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What kind of ECG are we looking at?
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Atrial flutter
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What is atrial fibrillation?
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The atria is quivering and not really pumping. There is a high risk for embolis here because the blood sits in the atria and doesn't really go anywhere. The patient should take blood thinners.
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What is the treatment for an atrial flutter or an atrial fibrillation?
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To cauterize the secondary pace maker, which creates scar tissue that blocks the signal from where the flutter or fibrillation signal is coming from.
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What is this ECG showing?
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An atrial fibrillation.
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What is an escape rhythm?
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A temporary takeover of the heartbeat from another area, then returns to normal.
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What is a junctional escape rhythm?
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AV node takes over, runs things for a bit then returns to normal. The heart rate may be normal, then be 40 to 60 BPM then go back to normal. The patient may feel a drop in energy at that time.
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What is a ventricular escape rhythm?
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The ventricle cells take over, run things for a bit then returns to normal. The heart rate may be normal, then 15 to 40 BPM, then back to normal again. The patient may get light-headed or faint during that time.
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What kind of escape rhythm is this?
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Junctional (atrial)
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What kind of escape rhythm is this?
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Ventricular.
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Name three ventricular arrhythmias, not escape.
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Premature Ventricular Contraction (PVC), Ventricular tackycardia, Ventricular fibrillation.
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Describe premature ventricular contraction.
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A ventricular arrhythmia initiated by the purkinje fibers instead of the SA node. Can be caused by electrolyte problems, coronary disease, pH disorders, or medications.
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What is this a picture of?
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An ECG of a PVC, premature ventricular contraction.
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Describe ventricular tackycardia.
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A ventricular arrhythmia of a fast heartbeat that starts in the ventricles. There is poor filling, increased risk of MI, exhaustion. Can die if it is not stopped. Can be caused by MI, stress, electrolyte issues, pH issues, etc.
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What is this a picture of?
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An ECG of ventricular tachycardia.
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Describe ventricular fibrillation.
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The heart is quivering like jello and not really pumping and it will go into circulatory shock. Can be caused by MI, stress, electrolyte or pH issues or meds.
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What is this a picture of?
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An ECG of ventricular fibrillation.
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What is a heart block?
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Scar tissue in the septum of the ventricles. There are four kinds. First, second, third degrees and bundle branch block.
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What is a first degree heart block?
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Sufficient scarring in the septum of the ventricles of the heart to slow the signal getting to the ventricles. P waves will trigger a contraction but timing will vary. Pulse will be uneven in rhythm.
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What is this an ECG of?
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First degree heart block.
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Describe the second degree heart block.
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Sufficient scarring in the septum of the ventricles of the heart where not every signal gets through.
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What is this an ECG of?
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Second degree heart block.
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Describe third degree (or total) heart block.
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The atria and the ventricles are not talking.
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What is this an ECG of?
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Third degree heart block.
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Describe bundle branch block.
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Sufficient scarring in the septum of the ventricles of the heart where one side of septum is scarred but not the other side , so there's a delay for one ventricle.
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What is this an ECG of?
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Bundle branch block.
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