Arrhythmias Originating in the Ventricles
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Questions and Answers

What is the typical morphology of a QRS complex in a Premature Ventricular Contraction (PVC)?

  • Less than 0.12 seconds and normal
  • Equal to 0.12 seconds and irregular
  • More than 0.12 seconds and bizarre (correct)
  • Variable and dependent on the underlying rhythm

    • Which of the following is a characteristic of a benign Premature Ventricular Contraction (PVC)?

  • More than six PVCs per minute
  • Multifocal PVCs
  • None of the above (correct)
  • Associated chest pain

    • What is the primary reason why frequent PVCs can reduce cardiac output?

  • Increased sympathetic tone
  • Myocardial ischemia
  • Decreased ventricular filling (correct)
  • Electrolyte imbalances

    • According to the Lown grading system, what is the highest grade of ectopy?

    <p>Grade 5: R on T phenomenon (D)</p> Signup and view all the answers

    What is the treatment of choice for perfusing ventricular tachycardia (VT) that is not accompanied by hypotension or signs of shock?

    <p>Adenosine administration (D)</p> Signup and view all the answers

    What is the typical rate of ventricular tachycardia (VT)?

    <p>100-250 beats per minute (C)</p> Signup and view all the answers

    What is the primary difference between monomorphic and polymorphic ventricular tachycardia?

    <p>Morphology of the QRS complex (C)</p> Signup and view all the answers

    Which of the following is a potential complication of ventricular tachycardia (VT)?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the primary goal of treatment for ventricular tachycardia (VT)?

    <p>Improving coronary artery perfusion (B)</p> Signup and view all the answers

    What is the typical PR interval in a Premature Ventricular Contraction (PVC)?

    <p>None, as there is no P wave (B)</p> Signup and view all the answers

    What is a characteristic of a ventricular escape rhythm?

    <p>It is usually regular unless the pacemaker site is low in the ventricular conductive system (C)</p> Signup and view all the answers

    What is the primary treatment for ventricular escape rhythm?

    <p>Treating the underlying cause, such as hypovolemia or hypoxia (A)</p> Signup and view all the answers

    What is an accelerated idioventricular rhythm (AIVR)?

    <p>A subtype of ventricular escape rhythm (A)</p> Signup and view all the answers

    What is the characteristic of a premature ventricular contraction (PVC)?

    <p>It occurs earlier than the next expected beat (C)</p> Signup and view all the answers

    What is the term for a pattern of group beating where every other beat is a PVC?

    <p>Bigeminy (A)</p> Signup and view all the answers

    What is the R on T phenomenon?

    <p>A PVC that occurs during the relative refractory period (C)</p> Signup and view all the answers

    What is a cause of PVCs?

    <p>Myocardial ischemia (C)</p> Signup and view all the answers

    What is the term for two consecutive PVCs without a normal complex between?

    <p>Couplets (B)</p> Signup and view all the answers

    What is the significance of a ventricular escape rhythm?

    <p>It is a safety mechanism that should not be suppressed (C)</p> Signup and view all the answers

    What is the treatment for a ventricular escape rhythm with signs of poor perfusion?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the most common cause of torsades de pointes?

    <p>The use of certain antiarrhythmic medications (A)</p> Signup and view all the answers

    What is the typical morphology of the QRS in torsades de pointes?

    <p>Wide and changing in size (C)</p> Signup and view all the answers

    What is the usual RR interval pattern in torsades de pointes?

    <p>Irregularly irregular (D)</p> Signup and view all the answers

    What is the most effective treatment for torsades de pointes?

    <p>1 to 2 g of magnesium sulfate (D)</p> Signup and view all the answers

    What is the usual outcome of ventricular fibrillation?

    <p>Cardiac arrest (A)</p> Signup and view all the answers

    What is the usual cause of asystole?

    <p>Massive MI, ischemia, and necrosis (A)</p> Signup and view all the answers

    What is the typical electrical activity pattern in asystole?

    <p>No electrical activity (C)</p> Signup and view all the answers

    What is the prognosis for resuscitation in asystole?

    <p>Poor (A)</p> Signup and view all the answers

    What is the typical rate of ventricular fibrillation?

    <p>No organized rhythm (A)</p> Signup and view all the answers

    What is the primary difference between primary and secondary asystole?

    <p>Presence or absence of P waves (B)</p> Signup and view all the answers

    What is the effect of hypercalcemia on the repolarization phase of the cardiac cycle?

    <p>Shortens it (B)</p> Signup and view all the answers

    What is the effect of digitalis on the PR interval?

    <p>Prolongs it (C)</p> Signup and view all the answers

    What is the characteristic ECG change associated with hypothermia?

    <p>Osborn wave or J wave (A)</p> Signup and view all the answers

    What is the effect of hypocalcemia on the QT interval?

    <p>Prolongs it (C)</p> Signup and view all the answers

    What is the effect of digitalis on the force of cardiac contraction?

    <p>Increases it (B)</p> Signup and view all the answers

    What is the concomitant effect of hypercalcemia and digitalis on the ECG?

    <p>Detrimental effects (A)</p> Signup and view all the answers

    What is the primary function of ventricular escape rhythms?

    <p>To prevent cardiac standstill (A)</p> Signup and view all the answers

    Which of the following is a characteristic of QRS complexes in arrhythmias originating in the ventricles?

    <p>Duration of 0.12 seconds or more (C)</p> Signup and view all the answers

    What is the typical discharge rate of ventricular pacemakers?

    <p>15-40 beats per minute (D)</p> Signup and view all the answers

    Which of the following is NOT a cause of ventricular arrhythmias?

    <p>Cardiac structure abnormalities (C)</p> Signup and view all the answers

    What is the rate of a ventricular escape rhythm?

    <p>15-40 beats per minute (D)</p> Signup and view all the answers

    What is the significance of ventricular escape complexes in lead II monitoring?

    <p>They are frequently seen following successful defibrillation (C)</p> Signup and view all the answers

    What is the primary purpose of interrogating a pacemaker?

    <p>To adjust the power level and other essential parameters (D)</p> Signup and view all the answers

    What is the effect of applying a magnet over the pulse generator of a pacemaker?

    <p>It inhibits all sensing and sets the pacemaker to a predetermined rate (C)</p> Signup and view all the answers

    What is the primary cause of pulseless electrical activity (PEA)?

    <p>Any of the above (C)</p> Signup and view all the answers

    What is the typical treatment for pulseless electrical activity (PEA)?

    <p>Administer epinephrine 1 mg every 3 to 5 minutes (A)</p> Signup and view all the answers

    What is the term for a single supraventricular beat conducted through the ventricles in a delayed manner?

    <p>Aberrant conduction (C)</p> Signup and view all the answers

    What is the characteristic of a complete bundle branch block on an ECG?

    <p>A QRS complex longer than 0.12 second (A)</p> Signup and view all the answers

    What is the term for a disorder in which all supraventricular beats are conducted through the ventricles in a delayed manner?

    <p>Bundle branch block (B)</p> Signup and view all the answers

    What is the effect of a premature atrial contraction on the bundle branch?

    <p>It blocks conduction through the bundle branch (D)</p> Signup and view all the answers

    What is the typical outcome of pulseless electrical activity (PEA)?

    <p>Poor (B)</p> Signup and view all the answers

    What is the purpose of a card carried by a pacemaker patient?

    <p>To provide the pacemaker's manufacturer and model information (D)</p> Signup and view all the answers

    What is the primary function of a demand pacemaker?

    <p>To fire only when the natural heart rate drops below a set rate (D)</p> Signup and view all the answers

    What is the characteristic of the QRS complexes associated with pacemaker rhythms?

    <p>They are longer than 0.12 seconds and have a bizarre morphology (D)</p> Signup and view all the answers

    What is the term for the artifact created each time the pacemaker fires?

    <p>Pacemaker spike (A)</p> Signup and view all the answers

    What is the benefit of dual-chambered pacemakers in patients with marginal cardiac output?

    <p>They provide an extra atrial kick to maintain cardiac output (A)</p> Signup and view all the answers

    What is the problem that can occur when a pacemaker battery fails?

    <p>The pacemaker stops firing and the patient's underlying rhythm returns (B)</p> Signup and view all the answers

    What is the condition that results in a rapid discharge rate, often seen when the battery runs low?

    <p>Pacemaker runaway (B)</p> Signup and view all the answers

    What is the term for the situation where a paced beat falls in the absolute or relative refractory period, precipitating ventricular fibrillation?

    <p>R-on-T phenomenon (D)</p> Signup and view all the answers

    What should be done when treating a patient with ventricular fibrillation from pacemaker failure?

    <p>Treat the patient as any other patient with ventricular fibrillation (D)</p> Signup and view all the answers

    What is the characteristic of a ventricular pacemaker rhythm?

    <p>It resembles an idioventricular rhythm (C)</p> Signup and view all the answers

    Why is it important to examine an unconscious patient for a pacemaker?

    <p>To identify the presence of a pacemaker and adjust management accordingly (A)</p> Signup and view all the answers

    What is the primary characteristic of QRS morphology in ventricular conduction disturbances?

    <p>A notched or slurred QRS complex (B)</p> Signup and view all the answers

    What is the indication of a ventricular origin of the arrhythmia?

    <p>AV dissociation (C)</p> Signup and view all the answers

    What is the characteristic of the PR interval in Wolff-Parkinson-White (WPW) syndrome?

    <p>A PR interval less than 0.12 seconds (A)</p> Signup and view all the answers

    What is the effect of low potassium levels on the action potential?

    <p>A decrease in Phase 3 repolarization (D)</p> Signup and view all the answers

    What is the typical serum potassium level in which the T wave begins to merge with the QRS forming a very wide QRS complex?

    <p>8.0 mEq/L (B)</p> Signup and view all the answers

    What is the primary reason for treating patients as if they have ventricular tachycardia (VT)?

    <p>Because VT is more lethal than supraventricular tachycardia (A)</p> Signup and view all the answers

    What is the conduction pathway that bypasses the AV node in Wolff-Parkinson-White (WPW) syndrome?

    <p>The bundle of Kent (B)</p> Signup and view all the answers

    What is the typical ECG change associated with hyperkalemia as potassium levels approach 7.0 mEq/L?

    <p>A peaked T wave (C)</p> Signup and view all the answers

    What is the condition associated with a high incidence of tachyarrhythmias in Wolff-Parkinson-White (WPW) syndrome?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the treatment of choice for unstable patients with wide complex tachycardias?

    <p>Cardioversion (B)</p> Signup and view all the answers

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