2024 RELIAS ASSESSMENTS
ASSISTANCE MATERIAL
DYSRHYTHMIAS EXAM WITH
CORRECT ANSWERS
EKG interpretation - CORRECT-ANSWERSOne of the most useful and
commonly used diagnostic tools is electrocardiography (EKG) which
measures the heart's electrical activity as waveforms. An EKG uses
electrodes attached to the skin to detect electric current moving through the
heart. These signals are transmitted to produce a record of cardiac activity.
Arrhythmia or dysrhythmia are disturbances in the normal cardiac rhythm of
the heart which occurs as a result of alterations within the conduction of
electrical impulses. These impulses stimulate and coordinate atrial and
ventricular myocardial contractions that provide cardiac output.
Premature Junctional Contraction - CORRECT-ANSWERSPremature Junctional
Contraction (PJC) occurs when some regions of the heart becomes excitable
than normal. It has the following characteristics.
PR interval less than 0.12 seconds if P wave precedes QRS complex
QRS complex configuration and duration is normal
P wave is inverted
Atrial and ventricular rhythms irregular
Causes of PJC may include myocardial infarction or ischemia, digoxin toxicity,
excessive caffeine or amphetamine use. Management includes correction of
underlying cause, discontinuation of digoxin if appropriate.
Atrioventricular Blocks - CORRECT-ANSWERSAV blocks are conduction
defects within the AV junction that impairs conduction of atrial impulses to
ventricular pathways. The three types are first degree, second degree and
third degree.
First Degree AV Block - CORRECT-ANSWERSRate is usually 60 to 100 bpm
PR intervals are prolonged for usually 0.20 seconds
QRS complex is usually normal
Rhythm is regular
First degree AV block is asymptomatic and may be caused by inferior wall MI
or ischemia, hyperkalemia, hypokalemia, digoxin toxicity, calcium channel
blockers, amiodarone and use of antidysrhythmics. Management includes
, correction of underlying cause. Administer atropine if PR interval exceeds
0.26 second or symptomatic bradycardia develops.
Second Degree AV Block Mobitz I (Wenckebach) - CORRECT-ANSWERSAtrial
rhythm is regular
Ventricular rhythm is irregular
Atrial rate exceeds ventricular rate
PR interval progressively but only slightly, longer with each cycle until QRS
complex disappears (dropped beat)
PR Interval shorter after dropped beat.
Clinical manifestations include vertigo, weakness, and an irregular pulse.
This may be caused by Inferior wall MI, cardiac surgery, acute rheumatic
fever, vagal stimulation. Treatment includes correction of underlying cause,
atropine or temporary pacemaker for symptomatic bradycardia and
discontinuation of digoxin if appropriate.
Second Degree AV Block Mobitz II - CORRECT-ANSWERSAtrial rhythm is
regular
Ventricular rhythm maybe regular or irregular depending on the degree of
block
P-P interval constant
QRS complex periodically absent or disappears
Clinical manifestations same as Mobitz I. Causes includes: severe coronary
artery diseases, anterior wall MI, acute myocarditis and digoxin toxicity.
Treatment includes: atropine, epinephrine, and dopamine for symptomatic
bradycardia. Discontinuation of digoxin if appropriate. Installation of
pacemaker.
Third Degree AV Block (Complete Heart Block) - CORRECT-ANSWERSAtrial
rhythm regular
Ventricular rhythm regular and rate slower than atrial rate
No relation between P waves and QRS complexes
NO constant PR interval
QRS interval normal or wide and bizarre
Manifestations include: hypotension, angina and heart failure. This may be
caused by congenital abnormalities, rheumatic fever, hypoxia, MI, LEv's
disease, Lenegre's disease and digoxin toxicity. Management includes
atropine, epinephrine, and dopamine for bradycardia. Installation of
pacemaker may also be considered.
Premature Ventricular Contractions (PVC) - CORRECT-ANSWERSEarly or
premature ventricular contractions are caused by increased automaticity of
ventricular muscle cells. PVCs usually are not considered harmful but are of
concern if more than six occur in 1 minute, if they occur in pairs or triplets if
they are multifocal or if they occur or near a T wave.
Atrial rhythm is regular
ASSISTANCE MATERIAL
DYSRHYTHMIAS EXAM WITH
CORRECT ANSWERS
EKG interpretation - CORRECT-ANSWERSOne of the most useful and
commonly used diagnostic tools is electrocardiography (EKG) which
measures the heart's electrical activity as waveforms. An EKG uses
electrodes attached to the skin to detect electric current moving through the
heart. These signals are transmitted to produce a record of cardiac activity.
Arrhythmia or dysrhythmia are disturbances in the normal cardiac rhythm of
the heart which occurs as a result of alterations within the conduction of
electrical impulses. These impulses stimulate and coordinate atrial and
ventricular myocardial contractions that provide cardiac output.
Premature Junctional Contraction - CORRECT-ANSWERSPremature Junctional
Contraction (PJC) occurs when some regions of the heart becomes excitable
than normal. It has the following characteristics.
PR interval less than 0.12 seconds if P wave precedes QRS complex
QRS complex configuration and duration is normal
P wave is inverted
Atrial and ventricular rhythms irregular
Causes of PJC may include myocardial infarction or ischemia, digoxin toxicity,
excessive caffeine or amphetamine use. Management includes correction of
underlying cause, discontinuation of digoxin if appropriate.
Atrioventricular Blocks - CORRECT-ANSWERSAV blocks are conduction
defects within the AV junction that impairs conduction of atrial impulses to
ventricular pathways. The three types are first degree, second degree and
third degree.
First Degree AV Block - CORRECT-ANSWERSRate is usually 60 to 100 bpm
PR intervals are prolonged for usually 0.20 seconds
QRS complex is usually normal
Rhythm is regular
First degree AV block is asymptomatic and may be caused by inferior wall MI
or ischemia, hyperkalemia, hypokalemia, digoxin toxicity, calcium channel
blockers, amiodarone and use of antidysrhythmics. Management includes
, correction of underlying cause. Administer atropine if PR interval exceeds
0.26 second or symptomatic bradycardia develops.
Second Degree AV Block Mobitz I (Wenckebach) - CORRECT-ANSWERSAtrial
rhythm is regular
Ventricular rhythm is irregular
Atrial rate exceeds ventricular rate
PR interval progressively but only slightly, longer with each cycle until QRS
complex disappears (dropped beat)
PR Interval shorter after dropped beat.
Clinical manifestations include vertigo, weakness, and an irregular pulse.
This may be caused by Inferior wall MI, cardiac surgery, acute rheumatic
fever, vagal stimulation. Treatment includes correction of underlying cause,
atropine or temporary pacemaker for symptomatic bradycardia and
discontinuation of digoxin if appropriate.
Second Degree AV Block Mobitz II - CORRECT-ANSWERSAtrial rhythm is
regular
Ventricular rhythm maybe regular or irregular depending on the degree of
block
P-P interval constant
QRS complex periodically absent or disappears
Clinical manifestations same as Mobitz I. Causes includes: severe coronary
artery diseases, anterior wall MI, acute myocarditis and digoxin toxicity.
Treatment includes: atropine, epinephrine, and dopamine for symptomatic
bradycardia. Discontinuation of digoxin if appropriate. Installation of
pacemaker.
Third Degree AV Block (Complete Heart Block) - CORRECT-ANSWERSAtrial
rhythm regular
Ventricular rhythm regular and rate slower than atrial rate
No relation between P waves and QRS complexes
NO constant PR interval
QRS interval normal or wide and bizarre
Manifestations include: hypotension, angina and heart failure. This may be
caused by congenital abnormalities, rheumatic fever, hypoxia, MI, LEv's
disease, Lenegre's disease and digoxin toxicity. Management includes
atropine, epinephrine, and dopamine for bradycardia. Installation of
pacemaker may also be considered.
Premature Ventricular Contractions (PVC) - CORRECT-ANSWERSEarly or
premature ventricular contractions are caused by increased automaticity of
ventricular muscle cells. PVCs usually are not considered harmful but are of
concern if more than six occur in 1 minute, if they occur in pairs or triplets if
they are multifocal or if they occur or near a T wave.
Atrial rhythm is regular
