Ekg Exam Ii Mcphs

Front 1

What are five rhythms that originate on the SA node?

Back 1

Normal Sinus Rhythm

Sinus Bradycardia

Sinus Tachycardia

Sinus Dysrhythmia

Sinus Arrest

Front 2

What are two characteristics of sinus node rhythms/dysrhythmias?

Back 2

Normal P waves preceding each QRS

Each PR interval WNL (0.12-0.20 sec)

Front 3

This rhythm to which all other rhythms are compared to, this is the normal standard. The heart rate is 60-100 bpm, regular rhythm, normal P wave preceding each normal QRS, PR interval with normal duration and constant. Each QRS is followed by normal T wave.

Back 3

Normal Sinus Rhythm

Front 4

This is characterized by a HR < 60 bpm, this leads to longer R-R and P-P.

Back 4

Sinus Bradycardia

Front 5

What are two basic causes of Sinus bradycardia?

Back 5

1. May occur naturally, i.e. at rest (2/2 increased vagal stimulation and decreased sympathetic stimulation)

2. In conditioned athletes

Front 6

What cardiac d/o cause sinus bradycardia?

Back 6

Cardiac d/o: SA node dz, cardiomyopathy, myocarditis, ischemia, infarction, heart block

Front 7

What drugs can cause sinus bradycardia?

Back 7

Drugs - BB, Digoxin, CCB, Lithium, Amiodarone

Front 8

The following can cause what type of dysrythmia? Increased Vagal tone and decreased sympathetic stimulation - Carotid sinus massage, valsalva maneuver, deep relaxation, sleep

Back 8

Sinus Bradycardia

Front 9

What non cardiac d/o can cause sinus bradycardia?

Back 9

Non cardiac d/o: Hypothermia, hypoxia, increased potassium, increased intracranial pressure, hypothyroidism, glaucoma.

Front 10

What type of rhythm is this?

Back 10

Sinus Bradycardia

Front 11

This is a HR > 100 BPM with a shorter R-R and P-P intervals.

Back 11

Sinus Tachycardia

Front 12

This may occur naturally with exercise, pain, fear, anxiety secondary to increased sympathetic stimulation in response to need of increased 02 and nutrients.

Back 12

Sinus Tachycardia

Front 13

What are the cardiac d/o that cause sinus tachycardia?

Back 13

CHF, Cardiogenic shock, pericarditis

Front 14

What are the drugs that can cause sinus tachycardia?

Back 14

Epinephrine, isoproterenol, dopamine, dobutamine, atropine, EtOH, Caffieine, nicotine, amphetamines

Front 15

What can cause an increase in sympathetic stimulation, resulting in sinus tachycardia?

Back 15

Exercise, pain, stress, fever, fear, anxiety, respiratory distress, hypoxia, PE, anemia, sepsis, hyperthyroidism

Front 16

What type of rhythm is this?

Back 16

Sinus Tachycardia

Front 17

Sinus dysrhythmia is characterized by irregularly firing SA node which causes slowing, then speeding up, then slowing again, this is in response to what?

Back 17

In response to the respiratory cycle.

The HR increases during inspiration and decreases during expiration.

Front 18

In what instances can sinus dysrhythmia occur naturally?

Back 18

In athletes, children and older adults.

Front 19

What are the cardiac d/o that can cause sinus dysrhythmia?

Back 19

Heart dz, inferior wall MI

Front 20

What are the drugs that can cause sinus dysrhythmia?

Back 20

Digoxin, Morphine

Front 21

What are the non-cardiac d/o that can cause sinus dysrhythmia?

Back 21

Increase in intercranial pressure

Front 22

Usually no intervention is needed, but these may be associated with palpitations, dizziness, or syncope?

Back 22

Sinus dysrhythmia

Front 23

What type of rhythm is this?

Back 23

Sinus Dysrhythmia, AKA sinus arrhythmia.

Front 24

This is characterized by the SA node transiently not firing which leads to a pause until a lower level pacemaker initiates impulse or SA node resumes normal function.

Back 24

Sinus Arrest

Front 25

What are the causes of sinus arrest?

Back 25

Increased parasympathetic tone on SA node, hypoxia, ischemia

Front 26

These two things are classified as SA node diseases that cause sinus arrest?

Back 26

Fibrosis, idiopathic degeneration

Front 27

What are the cardiac d/o that cause sinus arrest?

Back 27

Chronic CAD, MI, acute myocarditis, cardiomyopathy, HTN

Front 28

What drugs cause sinus arrest?

Back 28

Digoxin, procainamide, quinidine, salicylates, excessive BB, CCB

Front 29

These three things cause sinus arrest and are causes for increased vagal tone.

Back 29

Valsalva maneuver, carotid sinus massage, vomiting.

Front 30

Increased potassium and hypoxia can cause what?

Back 30

Sinus arrest

Front 31

What type of rhythm is this?

Back 31

Sinus Arrest

Front 32

These origionate outside the SA node in atrial tissue or in internodal pathway?

Back 32

Atrial Dysrhythmias

Front 33

This is a part of the atrial dysrhythmia mechanism, it is when the atrial cells spontaneously depolarize and initiate impulses before SA node generates impulse.

Back 33

Increased Automaticity

Front 34

What causes increased automaticity in atrial dysrhythmia mechanism?

Back 34

Secondary to ischemia, hypoxia, atrial dilation due to CHF, mitral valve dz.

Front 35

This is a part of the atrial dysrhythmia mechanism, it is when the injured cells only partially repolarize leading to repetitive ectopic firing also secondary to digoxin toxicity.

Back 35

Triggered activity after depolariztion

Front 36

This is a part of the atrial dysrhythmia mechanism, it is a slow pathway, secondary to CAD, cardiomyopathy or MI.

Back 36

Reentry

Front 37

This is when a premature SA impulse reaches AV node, and the fast pathway is refractory, the impulse goes down slow pathway, when it reaches Bundle of HIS, fast pathway is open, retrograde conduction back up to the atria and then back down slow pathway leading to continuous rapid flow of electrical impulses causing tachycardia.

Back 37

Reentry mechanism

Front 38

P waves look different from normal P waves and there is an abnormal PR interval, but the QRS is unchanged. These are characteristics of what?

Back 38

Atrial Dysrhythmias

Front 39

What are the 6 Atrial dysrhythmias?

Back 39

Wandering Atrial Pacemaker
Premature Atrial Complex (PAC)
Atrial Tachycardia
Multifocal Atrial Tachycardia (MAT)
Atrial Flutter
Atrial Fibrillations

Front 40

This is characterized by a 3 P wave morphology, with variable PR intervals.

Back 40

Wandering Atrial Pacemaker

Front 41

When are wandering atrial pacemakers normal?

Back 41

In children, elderly or athletes.

Front 42

What are the cardiac d/o that cause wandering atrial pacemaker?

Back 42

Coronary or valvular heart disease.

Front 43

What are the drugs that can cause wandering atrial pacemaker?

Back 43

Digitalis toxicity

Front 44

What is the Tx for wandering atrial pacemaker?

Back 44

Resolve/eliminate underlying trigger

Front 45

What type of rhythm is this?

Back 45

Wandering atrial pacemaker

Front 46

What type of rhythm is this?

Back 46

Wandering atrial pacemaker

Front 47

The key characteristics of this are early ectopic beat originating outside of SA node, and it can originate from one or several ectopic sites.

Back 47

Premature Atrial Complexes

Front 48

What are the cardiac causes of PAC?

Back 48

Coronary or valvular heart dz, pulmonary dz.

Front 49

What drugs cause PAC?

Back 49

digitalis

Front 50

Respiratory failure, hypoxia, electrolyte imbalances, infection, caffeine, tobacco or alcohol use, anxiety, fatigue or fever all can cause what dysrhythmia?

Back 50

PAC

Front 51

What is the tx for PAC?

Back 51

Resolve/eliminate underlying trigger

Front 52

What type of rhythm is this?

Back 52

PAC

Front 53

What type of rhythm is this?

Back 53

PAC

Front 54

This is characterized by regular rhythm, arises from one atrial pacemaker site, faster than SA node, P can be hard to see, HR 150-250.

Back 54

Atrial tachycardia

Front 55

Atrial tachycardia can occur at what age?

Back 55

It can occur at any age.

Front 56

What sinus node disease can cause atrial tachycardia?

Back 56

Sick sinus syndrome

Front 57

What cardiac d/o can cause atrial tachycardia?

Back 57

MI, cardiomyopathy, congenital anomalies, Wolff-Parkinson-White Syndrome, valvular heart dz, HTN, cor pulmonale

Front 58

What drugs can cause atrial tachycardia?

Back 58

Digitalis toxicity

Front 59

What is the most common cause of atrial tachycardia?

Back 59

Digitalis toxicity

Front 60

This is another cause other than cardiac d/o or drugs that can cause atrial tachycardia?

Back 60

Hyperthyroidism

Front 61

What type of rhythm is this?

Back 61

PAC

Front 62

What type of rhythm is this?

Back 62

Atrial tachycardia

Front 63

This is characterized by irregular rhythm, at least 3 different P wave configurations origionating from the SA node, atria and/or AV junction (can be as often as ever beat), HR 120-150.

Back 63

Multifocal Atrial Tachycardia

Front 64

What are the causes of multifocal atrial tachycardia?

Back 64

Advanced COPD, CHF, acute mitral regurgitation.

Advanced COPD = 99% of cases

Front 65

If HR is normal, and you see MAT, what does this mean?

Back 65

Wandering Pacemaker

Front 66

What is MAT sometimes mistaken as?

Back 66

Atrial Fib.

Front 67

What type of rhythm is this?

Back 67

Multifocal Atrial Tachycardia

Front 68

The key characteristics for this are an atrial rate 250-350, P waves blend together into saw tooth or picket fence pattern. Not every atrial impulse is conducted to ventricles.

Back 68

Atrial Flutter

Front 69

What is the mechanism for atrial flutter?

Back 69

Reentry and increased automaticity

Front 70

Enlarged atria, elevated atrial pressure post cardiac surgery, severe mitral valve dz, cardiomyopathy, pericarditis, myocarditis, CHF and AMI are all cardiac d/o that cause?

Back 70

Atrial Flutter

Front 71

COPD, hypoxia, digitalis toxicity, hyperthyroidism, infection, catecholamine release during exercise, in healthy person with excessive coffee, EtOH, tobacco use or person fatigued or under stress are all causes for what?

Back 71

Atrial Flutter

Front 72

This is characterized by atrial rate of over 350, chaotic asynchronous impulses from multiple areas in atria, atria quiver instead of contract, AV conducts impulses only sporadic and irregularly.

Back 72

Atrial Fibrillations

Front 73

Atrial quiver increases the risk of what?

Back 73

Thrombi

Front 74

This can lead to heart failure, angina or syncope.

Back 74

Increased ventricular rate

Front 75

This is the most common atrial tachycardia?

Back 75

Atrial fibrillations

Front 76

What cardiac d/o cause atrial fibrillations?

Back 76

CHF, CAD, AMI, pericarditis

Front 77

What are the non cardiac causes of atrial fibrillations?

Back 77

RA, chest trauma

Front 78

This can occur after exercise, excessive caffeine, EtOH or tobacco, fatigue, stress, digitalis toxicity.

Back 78

Atrial fibrillations

Front 79

What type of rhythm is this?

Back 79

Atrial Fibrillation

Front 80

These are rhythms that originate around the AV node and bundle of HIS. This is when an impuse is generated due to the SA node failing.

Back 80

Junctional dysrhythmias

Front 81

What are the common causes of junctional dysrhythmia?

Back 81

Hypoxia, ischemia, MI and drug toxicity

Front 82

Impulses from AV junction create retrograde depolarization of atria because of its location due to what three things?

Back 82

P wave is inverted with short PR interval

P wave not seen (buried in QRS)

Follows QRS complex

Front 83

In junctional dysrhythmias ventricles depolarize normally. QRS complexes are?

Back 83

Within normal limits .06-.12 seconds

Front 84

What are the four junctional dysrhythmias?

Back 84

Premature Junctional Complex

Junctional Escape Rhythm

Accelerated Junctional Rhythm

Junctional Tachycardia

Front 85

This is characterized by single early electrical impulse origionating in the AV junction, occurs before next AV impulse is fired.

Back 85

Premature Junctional Complex

Front 86

What is the mechanism of PJC?

Back 86

Enhanced automaticity and reentry

Front 87

These, digoxin toxicity, excessive caffeine, inferior MI, rheumatic heart dz, AV junction swelling post cardiac surgery, are causes of what?

Back 87

PJC's

Front 88

More than how many PJCs per minute indicate pending trouble?

Back 88

4-6

Front 89

What type of rhythm is this?

Back 89

PJC

Front 90

What type of rhythm is this?

Back 90

PJC

Front 91

What type of rhythm is this?

Back 91

PJC

Front 92

These are characterized by a slow HR 40-60, inverted P that precede, are lost or follow QRS; PR interval is shorter than 0.12 seconds.

Back 92

Junctional Escape Rhythms

Front 93

This is a protective mechanism when higher centers in the conduction system fail to fire.

Back 93

Escape rhythm

Front 94

What are the cardiac d/o that cause junctional escape rhythm?

Back 94

Increased vagal tone on SA node, sick sinus syndrome, inferior MI, rheumatic heart dz

Front 95

What drugs cause junctional escape rhythm?

Back 95

Digitalis, Quinidine, BB, CCB

Front 96

Post cardiac surgery and hypoxia cause what?

Back 96

Junctional Escape Rhythm

Front 97

What type of rhythm is this?

Back 97

Junctional Escape Rhythm

Front 98

This is characterized by HR 60-100, inverted P that precede, are lost or follow QRS; PR interval shorter than <0.12 seconds.

Back 98

Accelerated Junctional Rhythm

Front 99

What are the cardiac d/o that cause accelerated junctional rhythm?

Back 99

Inferior or posterior MI, rheumatic fever, post open heart surgery.

Front 100

What drugs cause accelerated junctional rhythm?

Back 100

Digoxin

Front 101

Decreased K and COPD can cause what?

Back 101

Accelerated junctional rhythm

Front 102

What type of rhythm is this?

Back 102

Accelerated Junctional Rhythm

Front 103

This is characterized by HR 100-180, inverted P that precede, are lost or follow QRS, PR Interval shorter than <0.12 seconds.

Back 103

Junctional Tachycardia

Front 104

With HR > 150 it is hard to distinguish junctional tachycardia from what?

Back 104

atrial tachycardia

Front 105

What are the cardiac d/o causes of junctional tachycardia?

Back 105

Inferior or posterior MI, rheumatic fever, post open heart surgery

Front 106

What drugs cause junctional tachycardia?

Back 106

Digoxin, particularly in presence of decreased K.

Front 107

Excessive catecholamine administration, anxiety, hypoxia, electrolyte imbalance, espescially decreased Potassium, are causes of what?

Back 107

Junctional Tachycardia

Front 108

What type of rhythm is this?

Back 108

Junctional Tachycardia

Front 109

These originate in the ventricle below the bundle of HIS. It may be benign or life threatening. Occurs when both the atria and AV junctional pacemakers are unable to initiate an electrical impulse.

Back 109

Ventricular Dysrhythmias

Front 110

What are the four types of ventricular dysrhythmias?

Back 110

Premature ventricular complexes

Ventricular tachycardia

Ventricular fibrillation

Asystole

Front 111

This is characterized by early ectopic beat originating from an irritable focus in ventricle, usually benign.

Back 111

Premature Ventricular Complexes

Front 112

What is the mechanism for PVC?

Back 112

Enhanced automaticity or reentry

Front 113

What are the cardiac d/o that cause PVC?

Back 113

MI, enlarged ventricles, CHF, myocarditis

Front 114

Cocaine, amphetamines, tricyclic antidepressants, EtOH, caffeine, tobacco, PCP, epinephrine, isoproterenol cause what?

Back 114

Drugs that can cause PVC

Front 115

Hypoxia, electrolyte imbalance (decreased K, increased K, decreased Mg, decreased Ca), metabolic acidosis, increased sympathetic stimulation all cause what?

Back 115

PVC

Front 116

When is Tx needed for PVC?

Back 116

Intervention needed if >3 consecutive PVCs

Front 117

What type of rhythm is this?

Back 117

PVC

Front 118

What type of rhythm is this?

Back 118

PVC

Front 119

This is the distance between the normal beats before and after the premature ventricular contraction is equal to twice the normal cycle length.

Back 119

Full compensatory pause.

Front 120

What is this?

Back 120

Full compensatory pause

Front 121

The characteristics of this are HR 100-250, made up of more than 3 PVCs, often precedes ventricular fibrillation and sudden death.

Back 121

Ventricular Tachycardia

Front 122

What are the cardiac d/o that cause V tach?

Back 122

MI, CAD, valvular heart dz, CHF, cardiomyopathy

Front 123

Digitalis, triglyceride antidepressants, cocaine amphetamines cause what?

Back 123

V tach

Front 124

Electrolyte imbalance (decreased K), acid base imbalance, trauma, EtOH, caffeine and tobacco can cause what?

Back 124

V tach

Front 125

What type of rhythm is this?

Back 125

V Tach

Front 126

This is known as "twisting of the points", it is a unique variant of polymorphic ventricular tachycardia. The QRS complexes gradually alternate between upright and downward deflection.

Back 126

Torsades de pointes

Front 127

What is the Tx for Torsades de pointes?

Back 127

Magnesium Sulfate, if pt is in cardiac arrest the pt needs immediate defibrillation.

Front 128

Torsades de pointes is considered a _____ rhythm?

Back 128

regular

Front 129

What type of rhythm is this?

Back 129

Torsades de pointes

Front 130

This is characterized by HR 300-500, chaotic firing in ventricles, ventricles quiver (bag of worms), no effective muscular contraction, no cardiac output leads to death if not defibrillation.

Back 130

V Fib

Front 131

What are the cardiac d/o that cause V fib?

Back 131

MI, untreated ventricular tachycardia, underlying heart dz

Front 132

Acid base imbalance, electric shock, severe hypothermia, electrolyte imbalance (decrease K, increase K, increase Ca) can cause what?

Back 132

V Fib

Front 133

What is this?

Back 133

V Fib

Front 134

This is characterized by an absence of cardiac activity, no cardiac output.

Back 134

Asystole

Front 135

This can be caused by MI, underlying heart dz.

Back 135

Asystole

Front 136

Severe uncontrolled acid base imbalance, electrical shock, electrolyte imbalance esp increased K, massive PE, prolonged hypoxemia, drug intoxication (ie cocaine overdose) can cause?

Back 136

Asystole