Cardio Part 9

Front 1

escape rhythm ~~

Back 1

a *pacemaker cell* escaping overdrive suppression of the SA node

Front 2

escape rhythm occurs when:

Back 2

SA is damaged to the point of arrest

=> escape rhythm becomes failsafe to keep heart beating

Front 3

automaticity =

Back 3

non-pacemaker cell that gains ability to fire set the pace

Front 4

treatment for UA/NSTEMI:

(4)

Back 4

1. asp/nitrates

2. heparin

3. B-blockers

4. possibly ACEI's

Front 5

treatment of STEMI:

(3)

Back 5

1. heparin

2. PCI

3. fibrinolytics

Front 6

paroxysmal =

Back 6

sudden

Front 7

**3 features of ventricular tachycardia:**

Back 7

1. ~~ MI/CAD

2. WIDE QRS (duh)

3. ~~ *RAD*

Front 8

Torsades = twsiting ribbon outline; 2 features:

Back 8

1. a *ventricular* rhythm

2. brief episodes of >250 bpm

Front 9

atrial flutter ~~

Back 9

atrial automaticy

250-350 bpm

Front 10

ventricular flutter appearance =

Back 10

**sine waves**

Front 11

**narrow (normal) QRS excludes:**

Back 11

ventricular problem

Front 12

Fibrillations ~~ _____ bpm

Back 12

>350

Front 13

Always looks at lead ____ first

Back 13

lead II

Front 14

3 main features of A-fib:

Back 14

1. no discernible P wave

2. irregularly irregular

3. >350 bpm

Front 15

V-fib ~~

Back 15

complete chaos

- no discernible waves of any kind

Front 16

the accessory pathway of WPW is called:

Back 16

the Bundle of Kent

- found in right free wall

Front 17

3 features of WPW:

Back 17

1. pre-excitation of ventricle

2. => delta waves

3. dec. PR interval

Front 18

in a 3rd-degree block, conduction from atria to ventricles is:

Back 18

nonexistent

=> automaticity of ventricles

=> SLOW QRS rate (20-40)

=> syncope

Front 19

***to diagnose RBBB, look to leads:***

Back 19

v1, v2

Front 20

***to diagnose LBBB, look to leads:***

Back 20

v5, v6

Front 21

***a wide QRS indicates:***

(2)

Back 21

1. pacemaker activity below the AV node

2. BBB

Front 22

hyperkalemia ~~

Back 22

tent-shaped T-waves

Front 23

A-fib requires anticoagulants because:

Back 23

stroke is a common consequence

Front 24

both AVNRT and AVRT ~~

Back 24

*narrow* QRS

- originate in the atria

Front 25

aortic dissection ~~

Back 25

tearing pain to the back

Front 26

differential diagnosis of chest pain:

(6)

Back 26

1. MI/ACS/CAD)

2. PE

3. GERD

4. aortic dissection

5. pericarditis

6. gallbladder

Front 27

Digoxin is a _________________________ used to treat ____________

Back 27

positive inotrope

used to treat A-fib

(as well as HF)

Front 28

how does Digoxin work?

Back 28

it inhibits the Na+/K+ pumps of myocytes

=> inc. in myocyte Ca2+ concentration

=> inc. phase 4

=> decreased heart rate, increased contractility

Front 29

so how does Digoxin treat A-fib, a-flutter?

Back 29

it increases vagal activity in the AV node

=> chills it out

Front 30

apart from a long/getting longer PR, Mobitz type I also has:

Back 30

a dropped QRS

- just P without QRS after it

Front 31

to treat sinus tachy, treat:

Back 31

the UC

Front 32

just remember irregularly irregular means ________________________ and regularly irregular means that it's ______________________________________________________________________________

Back 32

no pattern (A-fib);

not completely steady but there's a pattern to the unsteadiness (atrial flutter, variable conductance)

Front 33

tiny box on EKG =

(2)

Back 33

1 mm x 1 mm,

0.04 sec = 40 ms

Front 34

how many tiny boxes is >450 ms?

Back 34

between 11 and 12

Front 35

what do Class IV anti-arr's (Diltiazem, Verapamil) do?

Back 35

block L-type Ca2+ channels

=> don't let Ca2+ in

=> dec. conduction through SA and AV nodes,
dec. HR,
dec. contractility
dilate arteries/arteriols (for HTN)

Front 36

Premature Atrial Contraction ~~

(2)

Back 36

1. weird P's of different shapes

2. sometimes, no QRS => "pauses"

Front 37

be careful - when first looking at an EKG, remember to differentiate between:

Back 37

A-fib and

atrial flutter of variable conduction

Front 38

"irregularly irregular" specifically refers to the __________________________ of A-fib

Back 38

QRS activity

Front 39

2 main findings of hypercalcemia =

Back 39

1. shortened QT interval

2. Osborne wave (notch on the way down of QRS)


(hypocalcemia thus has longer QT interval)

Front 40

P wave before each QRS + 1:1 ratio of P to QRS rules out;

Back 40

ventricular problems

=> problem with AV node or above

Front 41

trick to see if P waves are buried:

Back 41

measure rate of QRS complexes

- find an obvious P wave

- use that rate to find next P wave

(don't ignore ventricular overdrive though)

Front 42

S3 is normal in:

Back 42

children

Front 43

S4 is never present in:

Back 43

A-fib

Front 44

benign arteriosclerosis =

Back 44

adaptation in which wall thickens, with inc. in *elastin* and *collagen*

Front 45

remember that ACEI's/ARB's, by combating the effects of AII, lower:

Back 45

SNS/catecholamines

Front 46

***2 major goals of treatment of ADHF = ***

Back 46

1. relieve congestion (i.e. optimize preload)

2. assure adequate tissue perfusion

Front 47

2 drugs with reflex tachycardia:

Back 47

1. Hydralazine/Minoxidil

2. Nitroprusside

Front 48

in DCM, prophylaxis is NOT indicated for:

Back 48

thrombo-embolisms

Front 49

SAM => obstruction =>

Back 49

regurgitation

=> dec. SV => dec. CO

Front 50

3 drugs that raise the curve, giving you a greater SV/CO at the same preload:

Back 50

1. B-blockers

2. Inotropes

3. Hydralazine

Front 51

venous dilation =>

Back 51

*decreased* preload

Front 52

is DCM a disease of systolic or diastolic dysfunction?

Back 52

SYSTOLIC

DCM ~~ SYSTOLIC dysfunction

Front 53

why AI causes a decreased DP:

Back 53

less blood to system = less pressure of DP

Front 54

difference between Digoxin and Diltiazem/Verapamil (wrt effects on the heart):

Back 54

Digoxin dec. HR but increases Contractility,

while Diltiazem/Verapamil decrease both HR *and* Contractility

Front 55

normal visceral pericardium has lots of:

Back 55

fat

Front 56

pericarditis ~~

Back 56

yellow purulent exudate

(in excess of normal yellow adipose)

Front 57

constrictive pericarditis =

Back 57

heart covered in white scar

(~~ severe fibrosis)

Front 58

2 most common causes of acute pericarditis =

Back 58

1. viral

2. idiopathic

Front 59

best treatment for acute pericarditis =

Back 59

NSAIDs like ibuprofen

Front 60

in constrictive pericarditis, rapid early filling =>

Back 60

prominent y-wave descent

(y is the latter half of the v wave)

Front 61

symptoms of constrictive pericarditis =

Back 61

symptoms of RHF

Front 62

Beck's Triad of cardiac tamponade:

Back 62

1. JVD

2. muffled heart sounds

3. hypotension

Front 63

atrial feature of cardiac tamponade:

Back 63

blunted y, barely a descent

Front 64

S1 is best heard at:

Back 64

the apex

Front 65

both S3 and S4 are considered:

Back 65

gallops

Front 66

splitting of S2 occurs when:

(5)

Back 66

closure of A3 and P3 are not synchronized,

as in inspiration, AS, HCM, LBBB, and atrial septal defect