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107 Cards in this Set
- Front
- Back
5 dilations of the heart tube?
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sinus venosus, prim atrium, prim vent., bulbus cordis, truncus arteriosus
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what forms the smooth part of the right atrium?
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sinus venosus
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most common positional abnormality of the heart?
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dextrocardia (mirror image flip)
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critical first step in development of 4-heart chamber?
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endocardial cushions
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Most common congenital heart defect?
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(membranous) VSD
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Most common form of ASD?
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patent foramen ovale
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4 clinically significant types of ASD's?
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ostium secundum defect, endocardial cushion defect w/ ostium primum defect, sinus venosus defect, common atrium.... easy! ... what are those? it doesn't matter!
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vitelline veins eventually become what?
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hepatic sinusoids, hepatic veins (.... in the liver, duh), and a part of the IVC. and some other stuff
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Umbilical vein forms what eventually?
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left umbilical vein forms the venous shunt known as ductus venosus (umbilical vein to IVC)... remnant called ductus venosus
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What forms the SVC?
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right anterior and common cardinal veins
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equal division of truncus arteriosus w/ incomplete fusion of bulbar ridges distally leads to what?
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eisenmenger's syndrome
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4 criteria for tetralogy of fallot?
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pulmonary stenosis (RV outflow), VSD, overriding aorta, RVH
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What primitive aortic arch forms the real aortic arch?
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IV
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What forms the ductus arteriosus?
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the left VI aortic arch
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coronary arteries form from what?
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epicardium (mesodermal primordium)
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mom brings in a baby saying "they have labored breathing while they are feeding!" what you think?
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double aortic arch
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95% of coarctation of aorta cases are...?
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postductal
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What are the two types of futility?
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medical and physiological
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What are the 5 stages of death and dying?
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1. denial and isolation
2. anger 3. bargaining 4. depression 5. acceptance |
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What are the two types of depression in death and dying?
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reactive (to news of imminent death w/ regrets about goals), and preparatory (to imminent death)
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What is the minimum infectious dose for TB?
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10 cells
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What is the doubling time of M. tuberculosis?
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18 hours
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How does TB remain viable and replicate?
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infect and replicated intracellularly in alveolar macrophages
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What three areas is M. tuberculosis found in infected but asymptomatic individuals?
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primary lesions, lesion-free areas of the lung, and lymph nodes
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What is the major virulence factor of M. tuberculosis?
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Cell wall
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What is produced by virulent strains of TB?
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cord factor (mycolic acids connected by disaccharide trehalose)
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Two important cytokines in activation of macrophages?
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TNF-alpha and INF-gamma
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What cause weight loss in chronic TB infection?
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TNF-alpha toxicity
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How long can TB survive in fine aerosol particles?
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8 months
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What type of hypersensitivity response is characteristic of TB skin test?
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type IV
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Multiple discrete nodules throughout the lung = what cancer type?
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Metastatic carcinoma
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Are bronchial carcinoid tumors low-grade or aggressive?
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low grade cancer
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Bronchial carcinoid tumor arises from where?
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duh! a bronchus
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primary respiratory carcinoma least likely to find where?
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trachea
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lung carcinoma, hyperpcalcemia, think what?
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squamous cell
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what lung tumor arises from small peripheral airways?
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adenocarcinoma
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pulmonary tumor that is non-operable and baaad prognosis?
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small cell carcinoma
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what is bronchial carcinoid tumor growth like?
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intraluminal growth around site of origin
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most common endocrine site of metastasis from bronchiogenic carcinoma?
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adrenals
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Pts. w/ bronchiogenic carcinoma frequently present with (3 things)?
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bronchial obstruction, atelectasis, and pneumonia
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Where does squamous cell carcinoma normally originate?
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near the hilum
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What cell does small cell carcinoma come from?
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K-cells
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well-established risk factors for lung cancer?
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smoking, radiation, asbestos, certain metals (nickel), coal tar, etc.
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most common bronchiogenic carcinoma?
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all equally common
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squamous cell carcinoma commonly produces what substance?
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PTHrP
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most adenocarcinomas arise where?
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in the periphery beneath or near the pleura
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adenocarcinomas can arise near what causing "yokoo tumors"?
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scars
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what malignant tumor grows along alveolar septal framework?
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bronchio-alveolar carcinoma
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All major lung cancers usually stain for erbB except?
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small cell
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2 most commonly secreted substances of oat cell carcinoma?
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ACTH and hADH
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Eaton-lambert syndrome is associated with what lung tumor?
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oat cell
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What mesenchymal marker is famous in mesothelioma?
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vimentin
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Amplitude of P wave should not exceed what height and length?
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height: 2 or 3 mm in any lead
length: <0.11 sec |
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What things should you look for in a p wave (in various leads)?
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inversion, increased amplitude, increased width, diphasicity, notching, peaking, absence
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What are the 7 features to inspect for the QRS complex?
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duration, amplitude, absence of q wave, axis, transition zone, intrinsicoid depletion, slurring or notching
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QRS should not exceed what duration?
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duration: 0.12 sec or > indicates problem
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A Q wave, if present, should not exceed what depth and duration?
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height: 1 or 2 mm fine.
duration: shoudn't be more than 0.03 sec |
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What is the exception to the isoelectric ST segment rule?
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young, healthy black men (due to early repol.)
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Displacement of ST segment is hallmark of what?
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MI or myocardial injury
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ST depression in precordial leads =?
ST elevation = ? |
dep= subendocardial
elevation= subepicardial injury or ischemia |
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Sharply pointed and symmetrical t wave. suspect ?
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MI
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T wave heights should not exceed ?
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std leads: 5 mm; chest leads: 10 mm
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What is the most common cause of LVH?
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hypertension
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What do you use the Ronhilt-Este's scoring system for?
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diagnosing LVH; 4 points = probable LVH, 5 points= LVH
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What are some causes of RVH?
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COPD, mitral stenosis, tricuspid regurg, something congenital
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What is a major thing to examine for determing RVH?
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R:S ratio greater than 1 in V1
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What are two good leads for determining atrial enlargement?
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V1 and LII
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p-pulmonale peaked p wave w/ 3 mm amplitude in lead II. think ?
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RAE
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Key causes of LAE?
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MS & MR
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p-mitrale w/ p wave suration of .11 sec. think ?
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LAE
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Septum is depolarized in what direction?
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L to R
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What is intrinsicoid deflection? What is normal?
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1. time lapse from beg of QRS to the peak of the R wave = time when impulse reaches the epicardial surface of the ventricle
2. V1- .02 sec. V6- .04 sec |
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2 common features of BBB?
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1. wide QRS (> .12 sec)
2. ST seg: T wave slopes off in opposite direction to QRS |
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RsR' in V1 = ?
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RBBB
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QS (rS) in V1, monophasic R . think?
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LBBB
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T wave polarity is opposite QRS direction. think ?
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BBB
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3 features of LAH?
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LAD, normal QRS duration, Q1S3
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3 features of LPH?
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RAD (120+), Q3R1, normal QRS duration
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fixed PR interval > .2 sec. no dropped beats. diagnosis?
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first degree block
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#1 etiology of first degree block?
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ischemic heart disease
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progressivel prolonged PR-interval w/ dropped beats.... could be "grouped beats"... what is it?
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second degree block: Mobitz 1
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most common cause of mobitz I?
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inferior MI
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uniform PR interval w/ dropped beats. what is it?
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second degree block: mobitz II
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Where does a mobitz II block occur?
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bundle of HIS or below
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common cause of mobitz II?
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LAD ischemia
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AV dissociation. QRS occurs as either junctional or ventricular rhythm. what is it?
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third degree block
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rate <60/min = ?
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bradycardia
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Where is the SA node located?
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junction of SVC & RA
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inferior wall MI leads to brady or tachy?
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brady (usually)
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anterior wall MI leads to brady or tachy?
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tachy (usually)
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2 drugs and 1 electrolyte imbalance associated w/ bradycardia?
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digitalis, quinidine, hyperkalemia..... also beta blockers
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DOC for bradycardia? if that doesn't work?
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atropine.... then pacemaker
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3 classifications of SVT?
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paroxysmal, sustained (> 30sec), and repetitive
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DOC for sinus tach?
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treat the underlying cause!
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combination of A-fib and RAD = ?
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mitral stenosis
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irregular rhythym irregular baseline... what is it?
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a-fib
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Saw tooth pattern on baseline, normal QRS in 8:1 - 2:1 ratio... what is it?
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atrial flutter
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flutter waves occur at what rate range?
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250-350 /min
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irregular rhythm, P-R interval varies, 3 or more P wave morphologies. what is it?
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multifocal atrial tach
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MAT is associated w/ what?
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lung disease! (and theophylline, catecholamines. etc)
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DOC for MAT?
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magnesium sulfate
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What often follows a PVC?
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full compensatory pause
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What is it called when a PVC occurs w/ no pause in between beats?
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interpolated
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at least 3 consecutive bizarre QRS complexes rate at 120-200. what is it?
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v-tach
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ventricular arrhythmia associated w/ prolonged QT?
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torsades de pointes
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How do you treat torsade de pointes?
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magnesium sulfate
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no evidence of p waves. extremely wide and bizarre QRS w/ a rate at 75. what is it (likely)?
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accelerated idioventricular rhythm. LEAVE IT ALONE (seen post-thrombolysis tx)
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