Atrial Rhythms

Question 1

DiGoxin

Answer 1

Decreases intrinsic firing in the SA node.
Decreases conduction in the AV node.
Increases automaticity, decreases refractory period in ventricles and His/perkinje

Question 2

Atrial Tach

Answer 2

common in peds

Question 3

PAC Etiology

Answer 3

1. Hypoxemia - early sign
2. Fatigue
3. Damaged atria
4. Frequent PAC - early CHF
5. CAD
6. Digoxin toxicity
7. Hypokalemia, hypomagnesemia
8. Stimulant abuse (Meth)

Question 4

20cc’s per KG

Answer 4

fluid bolus for peds

Question 5

Paroxysmal Atrial Tachycardia (PAT)

Answer 5

Starts and stops abruptly

Question 6

Atrial Tachycardia

Answer 6

1. Increased Sympathetic tone
2. Hypoxemia
3. Digitalis toxicity
4. Damaged Atria
5. CHF

Question 7

PAT Etiology

Answer 7

1. Common in young women
2. Sudden onset
3. Sudden termination
4. Mitral Valve Prolapse
5. Digitalis toxicity
6. Hypoxemia
7. Damaged Atrium
8. Caffeine/nicotine
9. Stimulant abuse

Question 8

Narrow regular QRS

SVT, ATAK

Answer 8

50, 75, 100, 200

Question 9

Narrow irregular

Afib, Aflutter

Answer 9

120-(150, 175)200

Question 10

Wide regular

VTAK

Answer 10

100, 150, 175, 200

Question 11

Wide and irregular

Vfib, torsades

Answer 11

200 biphasic

360 monophasic

Question 12

Adenosine additional action

Answer 12

Acts on sinus pacer cells and vagus nerve terminals

Question 13

WPW

Answer 13

Wolff Parkinson White (bundle of kent)

Question 14

Bundle of Kent (oral boards)

Answer 14

additional pathway (produces delta wave between pr)

Question 15

sick sinus syndrome

Answer 15

Sinus pause, sinus block

Question 16

A flutter

Answer 16

Saw tooth pattern and F wave

Question 17

Uncontrolled A-fib

Answer 17

> 100

Question 18

Controlled A-fib

Answer 18

<100

Question 19

Atrial flutter with 3:1 conduction

Answer 19

3 saw teeth with 1 qrs

Question 20

Atrial fib characteristics

Answer 20

no discernable P waves

grossly irregular

Question 21

Atrial fib rx

Answer 21

not treated unless above 180

Question 22

Holiday heart syndrome

Answer 22

tied to alcohol and stress

Question 23

Wandering atrial pace maker

Answer 23

WAP

Question 24

WAP

Answer 24

P wave may be: 3 different

		i. Upright
		ii. Diphasic
		iii. Inverted	
		iv. Behind QRS
		v. Lost

Question 25

3 rhythms classified as SVT

Answer 25

Afib Aflutter Sinus tach Atak

Question 26

Increase in automaticity

Answer 26

Causes increase in ventricular rate

Question 27

Paroxysmal SVT

Answer 27

?

Question 28

Lown-Ganang-Levine

Answer 28

"James" fibers that bypass the AV node and shorten the PRinterval

Question 29

Variable conduction

Answer 29

Irregular A flutter

Question 30

Types of PAC's

Answer 30

* Blocked (P wave in T wave, no time for ventricular response) * Paired (two complete complexes – early) * Isolated (one) * Runs (3 or more) * Bigeminal (Every other) * Trigeminal (Every third): normal, normal, early

Question 31

P wave of early beat differs from the sinus beat, it may be:

Answer 31

a. Notched b. Peaked c. Diphasic (+ & -) Lost in preceding T wave (you won’t know because it gets lost)

Question 32

Atrial Tachycardia

Answer 32

Rate is 150-250 beats per minute Rhythm is regular P-waves all alike (same as PAC). Usually different than “normal” p wave Usually triggered by a PAC, rest of P waves will now look like the trigger P wave