Term
| Name leads which represent an lateral wall AMI? |
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Definition
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Term
| Name leads which represent an anterior AMI? |
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Definition
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Term
| Name leads which represent a septal AMI? |
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Definition
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Term
| Name leads which represent an inferior AMI? |
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Definition
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Term
| What does a finding of S1Q3T3 on a 12 lead EKG suggest? |
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Definition
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Term
| What do diffuse ST elevations on a 12 lead EKG suggest? |
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Definition
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Term
| What is the first line medication for a patient with SVT from WPW? |
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Definition
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Term
| What is the first line medication used in the treatment of Torsades? |
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Definition
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Term
| What arrhythmia is associated with the use of medications and sudden death? |
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Definition
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Term
| What do PVCs which increase in frequency with exertion represent? |
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Definition
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Term
| What is the treatment for LBBB or RBBB? |
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Definition
No treatment
- They are signs of an underlying condition |
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Term
Chest pain plus a new LBBB
(Left Bundle Branch Block) = ? |
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Definition
An acute heart attack until proven otherwise
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Term
| First line treatment for ventricular fibrillation? |
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Definition
Unsynchronized cardioversion
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Term
| First line treatment for ventricular tachycardia without a pulse? |
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Definition
Unsynchronized cardioversion
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Term
| First line treatment for ventricular tachycardia with a pulse? |
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Definition
Synchronized cardioversion
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Term
| For a patient with a stable SVT at 220 bpm what are the first and second line treatments? |
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Definition
Vagal maneuvers first
then adenosine if vagal fails |
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Term
| Untreated ventricular tachycardia progresses into what rhythm? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Which of the two 2nd degree heart blocks almost always becomes 3rd degree heart block? |
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Definition
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Term
| What is treatment for 2nd degree type 1 heart block? |
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Definition
Observation
(pacer only if symptomatic) |
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Term
| What is treatment for 3rd degree heart block? |
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Definition
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Term
| What heart block has no association of P waves and QRS complexes? |
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Definition
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Term
| What heart block has a long PR interval and never drops a QRS? |
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Definition
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Term
| What heart block gets longer and longer PR then drops a beat? |
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Definition
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Term
| What valvular disorder when combined with atrial fibrillation has highest risk of embolization? |
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Definition
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Term
| What conditions does a patient with atrial fibrillation have an increase risk of? |
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Definition
- Stroke
- ischemic limb
- ischemic bowel |
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Term
| What is the treatment for valvular heart disease + atrial fibrillation? |
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Definition
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Term
| What is the treatment for a patient with atrial fibrillation and a CHADS 2 score of a 0? |
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Definition
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Term
| What scoring system is used to determine anticoagulation in patients with atrial fibrillation? |
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Definition
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Term
| What is the treatment for symptomatic unstable SVT? |
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Definition
Synchronized cardioversion
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Term
| What duration is a normal QRS? |
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Definition
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Term
| What has a short less than 0.10 sec PRI and delta wave? |
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Definition
WPW
(Wolff-Parkinson-White Syndrome) |
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Term
| What is the PR interval over in first degree block? |
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Definition
Over 0.2 seconds
(Normal is 0.12 to 0.2 seconds) |
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Term
| What is the rate for sinus tachycardia? |
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Definition
Over 100 bpm
but less than 150 |
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Term
| What is the rate for normal sinus rhythm? |
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Definition
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Term
| What is the rate for bradycardia? |
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Definition
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Term
| What electrolyte abnormality is associated with flattening of the T waves? |
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Definition
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Term
| What electrolyte abnormality is associated with a prolonged PR interval and a widened QRS complex? |
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Definition
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Term
| What electrolyte abnormality is associated with long QT? |
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Definition
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Term
| A patient presents post URI with chest pain which is worse when he lays down. EKG shows diffuse ST elevations in all leads. What is your suspected diagnosis? |
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Definition
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Term
| A 69 year old male dialysis patient is found on 12 lead ECG to have peaked T waves in all leads. What is the most likely electrolyte abnormality? |
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Definition
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Term
| How does the pharmacological management of ventricular fibrillation and ventricular tachycardia differ from that of Torsades do Pointes? |
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Definition
In Torsades, magnesium is used first line before amiodarone or lidocaine
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Term
| Which antiarrhythmic medications can be used for a patient in ventricular tachycardia or ventricular fibrillation? |
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Definition
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Term
| A 54 year old in ventricular tachycardia, has a BP of 82/44 mmHg. What settings are appropriate for cardioversion of this patient? |
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Definition
Synchronized cardioversion
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Term
| What medication class may be used to prevent arrhythmic events in a patient who has non-acquired long QT syndrome? |
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Definition
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Term
| What counseling must be given to a patient once they are diagnosed with non-acquired long QT syndrome? |
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Definition
The patient's family must be screened for long QT as well
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Term
A 76 year old who was recently started on levofloxacin, suffers a cardiac arrest. What may likely be found on further evaluation of her ECG?
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Definition
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Term
| What is the most common accessory pathway in Wolff-Parkinson- White syndrome (WPW)? |
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Definition
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Term
| What medication is indicated for emergent treatment of tachyarrhythmia in a patient with diagnosed Wolff-Parkinson- White syndrome (WPW)? |
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Definition
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Term
| Direct thrombin inhibitors can not be used for anticoagulation of atrial fibrillation if the patient also has which disorder? |
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Definition
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Term
| A 69 year old male with a history of mitral regurgitation has developed atrial fibrillation. Should he be placed on anticoagulation? |
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Definition
All patients with valvular heart disease + atrial fibrillation need to be anticoagulated
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Term
| Should a solitary episode of atrial fibrillation in a healthy 34 year old require anticoagulation? |
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Definition
CHADS2 score is 0
- Patient is to be sent home on aspirin only
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Term
A stable 67 year old patient presents in atrial fibrillation but is unsure of any prior cardiac history.
Should you cardiovert this patient? |
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Definition
No.
1) Medical treatment before cardioversion in stable patients
2) Unknown time of atrial fibrillation would anticoagulate prior |
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Term
| What is the dosing protocol for adenosine and what must you ensure regarding the IV access prior to administering the adenosine? |
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Definition
Adenosine 6 mg,
if no change then 12mg,
if no change then second dose of 12mg
- Give through a large bore IV followed by rapid saline bolus
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Term
| What is the first line treatment for a stable patient who is in a supraventricular tachycardia? |
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Definition
Vagal maneuvers
(No carotid sinus massage in elderly) |
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Term
| A 48 year old patient has chest pain. Comparison of his 12 lead ECG to past tracings finds a new left bundle branch block. What is this finding consistent with? |
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Definition
New myocardial infarction
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Term
| Although right bundle branch blocks are not pathological in and of themselves, what underlying pathology may they represent? |
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Definition
- Pulmonary embolus
- ASD
- Heart attack |
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Term
| nurse notes that a patient is having frequent premature atrial contractions (PACs), but is asymptomatic. What is your next step? |
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Definition
Check O2 saturation and electrolytes
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Term
| Does second degree type I or type II more likely represent an significant underlying pathology? |
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Definition
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Term
| What is the recommended treatment for a patient in a second degree type I heart block with a blood pressure of 74/40 mmHg and chest pain? |
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Definition
Pacing
- Rule out acute underlying ischemic pathology |
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Term
Which of the following medications is the most likely to cause bradycardia?
Furosemide- Metoprolol - Amlodipine |
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Definition
Metoprolol
(beta blocker) |
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Term
An 83 year old has a blood pressure of 90/58 mmHg and a heart rate of 132 bpm fever and a + UA.
Should you use rate controlling medication? |
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Definition
No
- The patient's tachycardia is reactive from her urosepsis and fever |
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Term
| What is the most common cause of sinus tachycardia? |
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Definition
Underlying non-cardiac pathology
(sepsis, anemia, hyperthyroid state etc.) |
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Term
| You count 12 QRS complexes across the entire length of a 12 lead ECG. What is the approximate heart rate? |
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Definition
72 bpm - 10 seconds X 6 = 60 seconds/1 minute - 12 beats X 6 = 72 beats per minute
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Term
| How many seconds are represented across the entire length of a 12 lead ECG? |
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Definition
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Term
| While undergoing a stress test a patient's heart rate is 180 bpm and he is breathing heavily. What is the likely reason for his tachycardia? |
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Definition
Normal physiologic response to exercise
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Term
| A 45 year old marathon runner presents to the office with a resting heart rate of 42 bpm. He is stable. What is your recommendation? |
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Definition
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