PANCE PREP PEARLS UPDATED FINAL EXAMS
QUESTIONS AND ANSWERS SURE A+
✔✔what is normal sinus rate - ✔✔60-100 bpm
✔✔sinus arrest w/ alterations of paroxysms of atrial tachy and bradyarrhythmias,
caused by sinoatrial node disease is called ________________. how is it treated -
✔✔sick sinus syndrome aka brady-tachy syndrome
permanent pacemaker
✔✔EKG: prolonged PR-interval is criteria for _______________ - ✔✔first degree AV
block
PR interval > 0.20 sec
✔✔describe second degree AV block (mobitz I) - ✔✔aka wenckebach
increased lengthnening of PR interval with dropped QRS
✔✔describe second degree AV block (mobitz II) - ✔✔constant/prolonged PR interval w/
dropped beat
✔✔P waves are not related to QRS in what type of AV block? what is the treatment for
this - ✔✔third degree AV block
,permanent pacemaker
✔✔what is the atrial flutter rate and how does it look on EKG - ✔✔250-350 bpm
note: sawtooth pattern
✔✔irregularly irregular rhythm defines ______________. What is the treatment -
✔✔atrial fibrillation
rate vs rhythm control...
rate
-vagal
-CCB
-BB
rhythm
-DC cardioversion
-DCC may also be done after 3-4 weeks of anticoagulation or TEE showing no atrial
thrombi
✔✔pts w/ atrial fibrillation are on warfarin or aspirin for prophylaxis for ____ based on
____ score - ✔✔stroke
CHADS2 = CHF, HTN, age > 75 yo, DM, Stroke/TIA
note:
high risk (score > 2)-on warfarin (INR 2.0-3.0)
moderate risk (score 1) -on warfarin or aspirin
low risk (score 0)- none or aspirin
✔✔describe wandering atrial pacemaker - ✔✔> 3 P wave morphologies w/ rate under
100
✔✔multifocal atrial tachycardia (MAT) is associated with severe ______ - ✔✔COPD
✔✔definitive tx for paroxysmal supraventricular tachycardia (PSVT) is
_______________ - ✔✔radiofrequency catheter ablation
✔✔delta wave (slurred QRS upstroke) and a short PR interval is present in
______________. What is the accessory pathway called - ✔✔wolff-parkinson white
kent bundle
, ✔✔why must we avoid A-V nodal blocking agents in wolff-parkinson white? Sooo then
what is the tx - ✔✔may cause preferential conduction through accessory pathway
vagal maneuvers
antiarrhythmics (ex: procainamide, amiodarone)
radiofrequency ablation *definitive tx
✔✔most common rhythm seen with digitalis toxcity - ✔✔AV junctional dysrhythmia
✔✔what is the junctional rhythm rate - ✔✔40-60 bpm
✔✔wide, bizarre QRS occurring earlier than expected, usually the T wave is in the
opposite direction of the R, associated with compensatory pause. this describes what? -
✔✔premature ventricular complexes
✔✔describe ventricular tachycardia - ✔✔> 3 consecutive PVCs at a rate of > 100 bpm
✔✔electrolyte status with torsades - ✔✔hypomagnesium
hypokalemia
✔✔what is tx for stable sustained VT - ✔✔anti-arrhythmics (Amiodarone*, lidocaine,
procainamide)
✔✔what is treatment for unstable VT with a pulse - ✔✔synchronized (direct current)
cardioversion (DCC)
✔✔what is tx for VT withOUT a pulse - ✔✔defibrillation/CPR (tx as ventricular
fibrillation)
✔✔tx for torsades de pointes is ____________ - ✔✔IV magnesium
✔✔electrical activity that is not coupled with mechanical contraction is called
____________ - ✔✔pulseless electrical activity
note: no mechanical contraction aka no pulse
✔✔asystole rhythm (ventricular standstill) Tx - ✔✔CPR
epinephrine
checks for shockable rhythm q 2 mins
✔✔______ leads and _____ (vessel)
II, III, aVF - ✔✔inferior
right coronary artery
QUESTIONS AND ANSWERS SURE A+
✔✔what is normal sinus rate - ✔✔60-100 bpm
✔✔sinus arrest w/ alterations of paroxysms of atrial tachy and bradyarrhythmias,
caused by sinoatrial node disease is called ________________. how is it treated -
✔✔sick sinus syndrome aka brady-tachy syndrome
permanent pacemaker
✔✔EKG: prolonged PR-interval is criteria for _______________ - ✔✔first degree AV
block
PR interval > 0.20 sec
✔✔describe second degree AV block (mobitz I) - ✔✔aka wenckebach
increased lengthnening of PR interval with dropped QRS
✔✔describe second degree AV block (mobitz II) - ✔✔constant/prolonged PR interval w/
dropped beat
✔✔P waves are not related to QRS in what type of AV block? what is the treatment for
this - ✔✔third degree AV block
,permanent pacemaker
✔✔what is the atrial flutter rate and how does it look on EKG - ✔✔250-350 bpm
note: sawtooth pattern
✔✔irregularly irregular rhythm defines ______________. What is the treatment -
✔✔atrial fibrillation
rate vs rhythm control...
rate
-vagal
-CCB
-BB
rhythm
-DC cardioversion
-DCC may also be done after 3-4 weeks of anticoagulation or TEE showing no atrial
thrombi
✔✔pts w/ atrial fibrillation are on warfarin or aspirin for prophylaxis for ____ based on
____ score - ✔✔stroke
CHADS2 = CHF, HTN, age > 75 yo, DM, Stroke/TIA
note:
high risk (score > 2)-on warfarin (INR 2.0-3.0)
moderate risk (score 1) -on warfarin or aspirin
low risk (score 0)- none or aspirin
✔✔describe wandering atrial pacemaker - ✔✔> 3 P wave morphologies w/ rate under
100
✔✔multifocal atrial tachycardia (MAT) is associated with severe ______ - ✔✔COPD
✔✔definitive tx for paroxysmal supraventricular tachycardia (PSVT) is
_______________ - ✔✔radiofrequency catheter ablation
✔✔delta wave (slurred QRS upstroke) and a short PR interval is present in
______________. What is the accessory pathway called - ✔✔wolff-parkinson white
kent bundle
, ✔✔why must we avoid A-V nodal blocking agents in wolff-parkinson white? Sooo then
what is the tx - ✔✔may cause preferential conduction through accessory pathway
vagal maneuvers
antiarrhythmics (ex: procainamide, amiodarone)
radiofrequency ablation *definitive tx
✔✔most common rhythm seen with digitalis toxcity - ✔✔AV junctional dysrhythmia
✔✔what is the junctional rhythm rate - ✔✔40-60 bpm
✔✔wide, bizarre QRS occurring earlier than expected, usually the T wave is in the
opposite direction of the R, associated with compensatory pause. this describes what? -
✔✔premature ventricular complexes
✔✔describe ventricular tachycardia - ✔✔> 3 consecutive PVCs at a rate of > 100 bpm
✔✔electrolyte status with torsades - ✔✔hypomagnesium
hypokalemia
✔✔what is tx for stable sustained VT - ✔✔anti-arrhythmics (Amiodarone*, lidocaine,
procainamide)
✔✔what is treatment for unstable VT with a pulse - ✔✔synchronized (direct current)
cardioversion (DCC)
✔✔what is tx for VT withOUT a pulse - ✔✔defibrillation/CPR (tx as ventricular
fibrillation)
✔✔tx for torsades de pointes is ____________ - ✔✔IV magnesium
✔✔electrical activity that is not coupled with mechanical contraction is called
____________ - ✔✔pulseless electrical activity
note: no mechanical contraction aka no pulse
✔✔asystole rhythm (ventricular standstill) Tx - ✔✔CPR
epinephrine
checks for shockable rhythm q 2 mins
✔✔______ leads and _____ (vessel)
II, III, aVF - ✔✔inferior
right coronary artery
