NP CARDIOLOGY REVIEW KATIE B PART 1 (AP Heavy)
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Questions and Answers

What is the result of counting the number of QRS complexes within a 3-second period and multiplying by 20?

  • This calculates the heart rate using the 3-second method. (correct)
  • This calculates the heart rate using the 6-second method.
  • This determines the presence of axis deviation.
  • This counts the total heartbeats in one minute.

    • In which scenario is the electrical impulse traveling toward the left side of the heart?

  • Normal axis condition.
  • Right axis deviation.
  • Extreme axis deviation.
  • Left axis deviation. (correct)

    • Which of the following quadrants corresponds to a negative Lead 1 and a positive aVF?

  • Normal Axis.
  • Right Axis Deviation. (correct)
  • Left Axis Deviation.
  • Extreme Axis Deviation.

    • What characteristic defines a positive QRS complex?

    <p>The R wave is taller than the S wave.</p> Signup and view all the answers

    Which EKG lead is primarily used to recognize rhythm patterns?

    <p>Lead 2</p> Signup and view all the answers

    What characterizes Mobitz Type 1 heart block?

    <p>Gradual lengthening of the P-R interval followed by a QRS drop.</p> Signup and view all the answers

    Which statement is true regarding Mobitz Type 2 heart block?

    <p>A pacemaker is required for treatment.</p> Signup and view all the answers

    What is a common treatment for Third-Degree Heart Block?

    <p>Placement of a pacemaker.</p> Signup and view all the answers

    Which of the following is NOT an etiological factor for Mobitz Type 1?

    <p>Myocardial infarction.</p> Signup and view all the answers

    What symptom is commonly associated with Third-Degree Heart Block?

    <p>Syncope.</p> Signup and view all the answers

    What is the correct pathway of deoxygenated blood through the heart?

    <p>Vena cava → Right atrium → Tricuspid valve → Right ventricle → Pulmonary artery</p> Signup and view all the answers

    Which lead is considered the strongest reflection of the electrical pathway of the heart?

    <p>Lead II</p> Signup and view all the answers

    What alteration in an EKG is indicative of hypokalemia?

    <p>U waves</p> Signup and view all the answers

    How does the AV node contribute to the heart's conduction system?

    <p>It connects the atria to the ventricles.</p> Signup and view all the answers

    Which artery supplies the interventricular septum and anterior wall of the left ventricle?

    <p>Left anterior descending (LAD)</p> Signup and view all the answers

    What is the normal firing rate of the SA node, the primary pacemaker of the heart?

    <p>60-100 beats per minute</p> Signup and view all the answers

    Which of the following correctly describes the QRS complex on an EKG?

    <p>Ventricular depolarization</p> Signup and view all the answers

    What is the function of the Purkinje fibers in the cardiac conduction system?

    <p>Conduct impulses rapidly to the ventricles</p> Signup and view all the answers

    What is the typical heart rate for normal sinus rhythm?

    <p>60-100 bpm</p> Signup and view all the answers

    What key feature distinguishes atrial fibrillation from other arrhythmias?

    <p>Irregularly irregular rhythm</p> Signup and view all the answers

    What is a common treatment for severe cases of sinus bradycardia?

    <p>Pacemaker</p> Signup and view all the answers

    Which arrhythmia is associated with a 'sawtooth' pattern on the ECG?

    <p>Atrial flutter</p> Signup and view all the answers

    What is the primary characteristic of multifocal atrial tachycardia (MAT)?

    <p>More than three morphologically distinct P waves</p> Signup and view all the answers

    What is a potential consequence of atrial fibrillation related to blood clots?

    <p>Blood clot formation due to quivering atria</p> Signup and view all the answers

    Which treatment is specifically indicated for Torsades de Pointes?

    <p>Magnesium sulfate</p> Signup and view all the answers

    Which of the following arrhythmias typically has no identifiable P waves?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What usually precedes a case of asystole?

    <p>Ventricular fibillation</p> Signup and view all the answers

    In what situation is a pacemaker indicated?

    <p>Second-degree Mobitz Type 2</p> Signup and view all the answers

    Which condition can lead to an increased risk of ventricular tachycardia?

    <p>Hypertension</p> Signup and view all the answers

    What is the hallmark finding of Wolff-Parkinson-White syndrome on an EKG?

    <p>Delta wave</p> Signup and view all the answers

    What is the primary cause of acute myocardial infarction?

    <p>Coronary artery disease</p> Signup and view all the answers

    Which type of heart block is characterized by a consistent P-R interval but some P waves are not followed by QRS complexes?

    <p>Mobitz Type 2</p> Signup and view all the answers

    What is the flow sequence of blood through the heart starting from the deoxygenated blood entering through the vena cava?

    <p>Right atrium → Tricuspid valve → Right ventricle → Pulmonary semilunar valve → Pulmonary artery</p> Signup and view all the answers

    Which EKG leads correspond to the views provided by the left main coronary artery?

    <p>1, AVL, V5, V6</p> Signup and view all the answers

    What mnemonic can assist in recalling the position of the tricuspid valve in relation to the heart?

    <p>Tricuspid before we buy cuspid</p> Signup and view all the answers

    Which artery is known as the 'widow maker' due to its association with high risks if blocked?

    <p>Left anterior descending artery</p> Signup and view all the answers

    What is the primary electrical function of Lead 2 on an EKG?

    <p>It provides the strongest reflection of the overall electrical activity of the heart.</p> Signup and view all the answers

    Which of the following vessels carries deoxygenated blood to the lungs?

    <p>Right pulmonary artery</p> Signup and view all the answers

    What common knowledge is associated with the right main coronary artery?

    <p>It supplies the inferior wall along with the SA and AV nodes.</p> Signup and view all the answers

    What is the primary role of the EKG in the context of coronary artery disease?

    <p>To help localize areas of the heart affected by coronary artery disease.</p> Signup and view all the answers

    What duration is typically associated with severe retrosternal pressure during acute myocardial infarction (AMI)?

    <p>Longer than 30 minutes</p> Signup and view all the answers

    What does the presence of a persistent deep Q wave on an EKG indicate after an AMI?

    <p>Previous myocardial necrosis</p> Signup and view all the answers

    Which risk factor for AMI does NOT typically affect males and females equally?

    <p>Hormonal changes after menopause</p> Signup and view all the answers

    What is the correct definition of a STEMI based on EKG findings?

    <p>ST elevation &gt; 1mm in two contiguous leads or new Q wave</p> Signup and view all the answers

    What characterizes First-Degree Heart Block in terms of PR interval?

    <p>Fixed, prolonged PR interval (&gt;200 milliseconds)</p> Signup and view all the answers

    In Mobitz Type 1 heart block, what pattern is observed in the PR interval?

    <p>PR interval progressively lengthens until a QRS wave is dropped</p> Signup and view all the answers

    What is a typical treatment for Mobitz Type 2 heart block?

    <p>Pacemaker implantation</p> Signup and view all the answers

    What is a major consideration when treating a patient with suspected AMI?

    <p>Ensure door-to-drug or door-to-balloon within 90 minutes</p> Signup and view all the answers

    Which symptom is commonly associated with acute myocardial infarction?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What does a QRS complex without an associated P wave indicate?

    <p>Third-degree heart block</p> Signup and view all the answers

    Which of the following cardiac enzymes peaks quickly and normalizes within 2 to 3 days?

    <p>CK-MB</p> Signup and view all the answers

    What is the recommended response to a complete heart block?

    <p>Placement of a pacemaker</p> Signup and view all the answers

    Which EKG finding indicates myocardial necrosis in the context of AMI?

    <p>Deep Q waves</p> Signup and view all the answers

    What is the characteristic EKG finding in hyperkalemia?

    <p>Peaked T waves</p> Signup and view all the answers

    Which of the following rhythms represents Sinus Bradycardia?

    <p>Heart rate of less than 60 bpm</p> Signup and view all the answers

    What is the P:QRS ratio in Atrial Tachycardia?

    <p>1:1</p> Signup and view all the answers

    What defines Atrial Fibrillation?

    <p>Irregularly irregular rhythm with no P waves</p> Signup and view all the answers

    What is a common cause of Sick Sinus Syndrome?

    <p>Dysfunctional SA node</p> Signup and view all the answers

    How is the heart rate estimated using the 6-second method?

    <p>Count the QRS complexes in 2 hash marks and multiply by 10</p> Signup and view all the answers

    What describes Right Axis Deviation (RAD)?

    <p>Lead 1 negative, aVF positive</p> Signup and view all the answers

    In what situation might Atrial Flutter (AFL) occur?

    <p>AV conduction block associated with congenital heart disease</p> Signup and view all the answers

    Which of the following treatments could be used for Atrial Fibrillation?

    <p>Anticoagulation with warfarin</p> Signup and view all the answers

    What best describes the 'camel hump' appearance on an EKG?

    <p>T waves merging with P waves</p> Signup and view all the answers

    What is the most common arrhythmia associated with an increased risk of stroke?

    <p>Atrial Fibrillation</p> Signup and view all the answers

    What is a potential consequence of Paroxysmal Supraventricular Tachycardia (PSVT)?

    <p>Episodes of rapid heart rate</p> Signup and view all the answers

    What is a common characteristic of the heart rhythm in PSVT?

    <p>Rapid heart rate of 150-250 bpm</p> Signup and view all the answers

    What rhythm is produced by a dysfunctional SA node?

    <p>Sick Sinus Syndrome</p> Signup and view all the answers

    Which condition is most commonly associated with Multifocal Atrial Tachycardia (MAT)?

    <p>COPD</p> Signup and view all the answers

    What is the primary cause of Wolf-Parkinson-White Syndrome (WPW)?

    <p>Genetic accessory electrical pathways</p> Signup and view all the answers

    What EKG characteristic is typically observed in Ventricular Tachycardia (VT)?

    <p>Prolonged QRS complex</p> Signup and view all the answers

    Which of the following treatments is indicated for Torsades de Pointes?

    <p>Magnesium sulfate</p> Signup and view all the answers

    What is the primary consequence of Asystole?

    <p>Flat line EKG</p> Signup and view all the answers

    What distinguishes Premature Atrial Contractions (PACs) from Premature Ventricular Contractions (PVCs)?

    <p>Higher P wave with 1:1 P-QRS ratio</p> Signup and view all the answers

    What is the most common treatment approach for Ventricular Fibrillation (VF)?

    <p>Defibrillation</p> Signup and view all the answers

    Which of the following factors can trigger Torsades de Pointes?

    <p>Acute myocardial infarction</p> Signup and view all the answers

    Which findings indicate Left Bundle Branch Block (LBBB) on an EKG?

    <p>W in V1, M in V6</p> Signup and view all the answers

    What does the delta wave indicate in a patient with Wolf-Parkinson-White Syndrome?

    <p>Accessory pathway activation</p> Signup and view all the answers

    What aspect is crucial for the proper diagnosis of a myocardial infarction (MI)?

    <p>Presence of ST-segment elevation</p> Signup and view all the answers

    What is a potential reversible cause of Asystole?

    <p>Hyperkalemia</p> Signup and view all the answers

    Which arrhythmia is characterized by a prolonged QT interval?

    <p>Torsades de Pointes</p> Signup and view all the answers

    What is the primary role of the SA node in the cardiac conduction system?

    <p>Initiates heartbeat at a rate of 60-100 bpm</p> Signup and view all the answers

    How can one detect hypokalemia via an EKG?

    <p>Presence of U waves</p> Signup and view all the answers

    Which axis deviation indicates that the electrical impulse is directed towards the right side of the heart?

    <p>Right axis deviation</p> Signup and view all the answers

    Which component of a normal EKG reflects the repolarization of the ventricles?

    <p>T wave</p> Signup and view all the answers

    What method is typically used to estimate heart rate for regular rhythms on an EKG?

    <p>Distance between R waves</p> Signup and view all the answers

    What is a characteristic feature of Mobitz Type 1 heart block?

    <p>Gradually lengthening PR interval followed by a dropped QRS complex</p> Signup and view all the answers

    Which treatment is typically necessary for Mobitz Type 2 heart block?

    <p>Pacemaker implantation</p> Signup and view all the answers

    In third-degree heart block, what is the relationship between atrial and ventricular activity?

    <p>P waves are independent of QRS complexes</p> Signup and view all the answers

    Which type of heart block can progress to third-degree heart block?

    <p>Mobitz Type 2</p> Signup and view all the answers

    What is often a common cause of both Mobitz Type 1 and Mobitz Type 2 heart blocks?

    <p>Infections</p> Signup and view all the answers

    Which characteristic distinguishes Mobitz Type 2 from Mobitz Type 1 heart block?

    <p>Dropping of QRS complexes occurs randomly</p> Signup and view all the answers

    What symptom is likely associated with third-degree heart block?

    <p>Syncope</p> Signup and view all the answers

    What typically characterizes the PR interval in Mobitz Type 1 heart block?

    <p>It gradually increases in length until a QRS is dropped</p> Signup and view all the answers

    What color represents oxygenated blood in the circulatory system?

    <p>Red</p> Signup and view all the answers

    Which of the following arteries is only responsible for carrying deoxygenated blood?

    <p>Pulmonary artery</p> Signup and view all the answers

    Which EKG lead is most commonly used for monitoring rhythm strips?

    <p>Lead 2</p> Signup and view all the answers

    What structure in the heart follows the right atrium in the blood flow sequence?

    <p>Tricuspid AV valve</p> Signup and view all the answers

    Which coronary artery supplies blood to the septal wall of the heart?

    <p>Left Anterior Descending (LAD)</p> Signup and view all the answers

    How are leads 1, aVL, and aVR positioned for EKG readings?

    <p>Anterior view</p> Signup and view all the answers

    Which valve is located between the left atrium and the left ventricle?

    <p>Bicuspid (Mitral) valve</p> Signup and view all the answers

    What percentage of gas exchange occurs in the capillaries?

    <p>100%</p> Signup and view all the answers

    What indicates left axis deviation in an EKG?

    <p>Lead 1 (+) &amp; aVF (-)</p> Signup and view all the answers

    What is the typical heart rate range for normal sinus rhythm?

    <p>60-100 bpm</p> Signup and view all the answers

    Which reversible cause listed is specifically associated with Tension Pneumothorax?

    <p>Hypoxia</p> Signup and view all the answers

    Which condition is characterized by a 'Slow-Fast-Slow-Fast' rhythm?

    <p>Sick Sinus Syndrome</p> Signup and view all the answers

    What is a common cause of atrial tachycardia?

    <p>Caffeine</p> Signup and view all the answers

    What is the proper first treatment for Asystole according to ACLS guidelines?

    <p>CPR</p> Signup and view all the answers

    What is a key characteristic of atrial fibrillation?

    <p>Irregularly irregular rhythm</p> Signup and view all the answers

    What characterizes a Premature Atrial Contraction (PAC)?

    <p>One-to-one P to QRS relationship</p> Signup and view all the answers

    Which treatment is most commonly indicated for Torsades de Pointes?

    <p>Magnesium sulfate</p> Signup and view all the answers

    Which EKG finding is characteristic of a Left Bundle Branch Block (LBBB)?

    <p>V6: M shape</p> Signup and view all the answers

    What symptom is most commonly associated with an ST-Elevation Myocardial Infarction (STEMI)?

    <p>Diaphoresis</p> Signup and view all the answers

    When is synchronized cardioversion indicated?

    <p>Patient with a pulse in ventricular tachycardia</p> Signup and view all the answers

    Which of the following is a characteristic of Premature Ventricular Contractions (PVCs)?

    <p>Prolonged QRS interval</p> Signup and view all the answers

    Which feature is commonly associated with ventricular tachycardia?

    <p>Rate over 100 bpm</p> Signup and view all the answers

    Which phase of Acute Myocardial Infarction (AMI) involves T wave inversion on EKG?

    <p>24 hours post AMI</p> Signup and view all the answers

    What defines the treatment for atrial flutter lasting more than 48 hours?

    <p>Immediate cardioversion and anticoagulation</p> Signup and view all the answers

    What is a common treatment for cardiac conditions characterized by bundle branch block?

    <p>Pacemaker</p> Signup and view all the answers

    How is a Second Degree Heart Block Mobitz Type 2 typically identified?

    <p>Consistent PR interval with intermittent dropped QRS</p> Signup and view all the answers

    What is the hallmark finding on an EKG for Wolff-Parkinson-White syndrome?

    <p>Delta wave</p> Signup and view all the answers

    Which of the following is NOT a reversible cause of cardiac arrest?

    <p>Atherosclerosis</p> Signup and view all the answers

    What can cause the irregular rhythm in multifocal atrial tachycardia?

    <p>Competing atrial pacemaker sites</p> Signup and view all the answers

    What is the most serious complication associated with atrial fibrillation?

    <p>Blood clots leading to stroke</p> Signup and view all the answers

    What is a hallmark finding in the EKG of a patient with anterior wall AMI?

    <p>ST elevation in leads V3-V4</p> Signup and view all the answers

    What rhythm indicates right axis deviation in an EKG?

    <p>Lead 1 (-) &amp; aVF (+)</p> Signup and view all the answers

    What treatment is prioritized for patients with suspected STEMI?

    <p>Fibrinolytics</p> Signup and view all the answers

    Which condition is most likely to cause T wave changes on an EKG post AMI?

    <p>Successful reperfusion therapy</p> Signup and view all the answers

    What is the defining characteristic of Wolff-Parkinson-White syndrome on an electrocardiogram (EKG)?

    <p>Delta wave after the P wave</p> Signup and view all the answers

    What does the P-R interval on an ECG represent?

    <p>Time from SA node to ventricles</p> Signup and view all the answers

    Which of the following treatments is standard for addressing accessory electrical pathways diagnosed via EKG?

    <p>Radio frequency ablation</p> Signup and view all the answers

    During which segment of the ECG does ventricular repolarization occur?

    <p>T wave</p> Signup and view all the answers

    Which of the following describes the QRS complex in an ECG?

    <p>Represents ventricular depolarization</p> Signup and view all the answers

    What structure controls the flow of blood from the right atrium to the right ventricle?

    <p>Tricuspid valve</p> Signup and view all the answers

    Which EKG lead provides the strongest impulse from the heart's electrical pathway?

    <p>Lead 2</p> Signup and view all the answers

    What is the role of the Bundle of His in the heart's conduction system?

    <p>Conducts the impulse to the ventricles</p> Signup and view all the answers

    What is the only artery in the body that carries deoxygenated blood?

    <p>Pulmonary artery</p> Signup and view all the answers

    Which electrolyte disturbance is associated with the presence of peaked T waves on an EKG?

    <p>Hyperkalemia</p> Signup and view all the answers

    Which leads reflect the inferior wall of the heart and include views of the right atrium and ventricle?

    <p>Leads 2, 3, and AVF</p> Signup and view all the answers

    What is the primary function of the SA node in the cardiac conduction system?

    <p>Regulate heart rate at 60-100 bpm</p> Signup and view all the answers

    Which of the following EKG leads reflects the anterior wall of the heart?

    <p>Leads V2, V3, and V4</p> Signup and view all the answers

    What characterizes a first-degree heart block?

    <p>Prolonged PR interval greater than 200 milliseconds</p> Signup and view all the answers

    What distinguishes second-degree Mobitz Type 1 (Wenckebach) from Mobitz Type 2?

    <p>Incremental prolongation of PR interval before a drop</p> Signup and view all the answers

    In which situation does a patient experience a complete dissociation between P waves and QRS complexes?

    <p>Third-degree heart block</p> Signup and view all the answers

    What treatment is commonly required for Mobitz Type 2 heart block?

    <p>Pacemaker implantation</p> Signup and view all the answers

    What risk is associated with second-degree heart block, Mobitz Type 2?

    <p>Progression to complete heart block</p> Signup and view all the answers

    Which characteristic describes the conduction in a third-degree heart block?

    <p>Independent beating of atria and ventricles</p> Signup and view all the answers

    What is the typical P-to-P distance observation in Mobitz Type 2 heart block?

    <p>Constant with occasional drops</p> Signup and view all the answers

    Which of the following is a common cause of heart block?

    <p>Electrolyte abnormalities</p> Signup and view all the answers

    What should be monitored in a patient with complete heart block?

    <p>Signs of syncope and respiratory distress</p> Signup and view all the answers

    Which symptom might indicate a need for treatment in Mobitz Type 1 heart block?

    <p>Symptoms causing patient distress</p> Signup and view all the answers

    What heart rate categorizes sinus bradycardia?

    <p>Less than 60 bpm</p> Signup and view all the answers

    Which waveform on an EKG represents the depolarization of the atria?

    <p>P wave</p> Signup and view all the answers

    What is the characteristic heart rate range for atrial tachycardia?

    <p>120 to 250 bpm</p> Signup and view all the answers

    In normal sinus rhythm, what is the P:QRS ratio?

    <p>1:1</p> Signup and view all the answers

    Which method is used for estimating heart rate in irregular rhythms?

    <p>Six-second method</p> Signup and view all the answers

    What is true about atrial fibrillation?

    <p>The heart rate is typically 110 to 140 bpm.</p> Signup and view all the answers

    Which condition is characterized by a negative Lead 1 and a positive aVF?

    <p>Right axis deviation</p> Signup and view all the answers

    What type of treatment is common for atrial flutter?

    <p>Synchronized cardioversion</p> Signup and view all the answers

    Which condition is associated with multifocal atrial tachycardia (MAT)?

    <p>Cor pulmonale</p> Signup and view all the answers

    What is the rate typically observed in paroxysmal supraventricular tachycardia (PSVT)?

    <p>150 to 250 bpm</p> Signup and view all the answers

    Which of the following is a common cause of atrial fibrillation?

    <p>Coronary artery disease</p> Signup and view all the answers

    What condition features a negative sawtooth pattern on an EKG?

    <p>Atrial flutter</p> Signup and view all the answers

    Which arrhythmia is characterized by alternating slow and fast heartbeats?

    <p>Sick sinus syndrome</p> Signup and view all the answers

    In which scenario might sinus bradycardia be considered normal?

    <p>During sleep</p> Signup and view all the answers

    What is a common cause of Ventricular Tachycardia?

    <p>Electrolyte abnormalities</p> Signup and view all the answers

    What notable feature distinguishes Torsades de Pointes on an ECG?

    <p>ECG appears to spin around the baseline</p> Signup and view all the answers

    Which treatment is NOT indicated for Ventricular Fibrillation?

    <p>Synchronized cardioversion</p> Signup and view all the answers

    What rhythm feature is associated with Asystole?

    <p>Flat line on ECG</p> Signup and view all the answers

    What is the characteristic of Premature Ventricular Contractions (PVCs)?

    <p>Compensatory pause after contraction</p> Signup and view all the answers

    What type of Bundle Branch Block is generally considered more serious?

    <p>Left Bundle Branch Block (LBBB)</p> Signup and view all the answers

    What is a primary risk factor for Acute Myocardial Infarction?

    <p>Sedentary lifestyle</p> Signup and view all the answers

    Which statement best describes the characteristic ECG changes after an ST-Elevation Myocardial Infarction (STEMI)?

    <p>ST elevation observed in contiguous leads.</p> Signup and view all the answers

    How is Torsades de Pointes treated?

    <p>Magnesium sulfate administration</p> Signup and view all the answers

    What common feature observed on an ECG indicates Ventricular Fibrillation?

    <p>Very fast rhythm with irregular intervals</p> Signup and view all the answers

    Which of the following is a common treatment for both Ventricular Tachycardia and Ventricular Fibrillation?

    <p>Defibrillation</p> Signup and view all the answers

    What defines the QT interval length associated with Torsades de Pointes?

    <p>Greater than 600 milliseconds</p> Signup and view all the answers

    Which part of the treatment for Acute Myocardial Infarction focuses on reducing cardiac stress long-term?

    <p>Beta blockers</p> Signup and view all the answers

    What irregularity is characterized by more than three morphologically different P waves?

    <p>Multifocal Atrial Tachycardia</p> Signup and view all the answers

    Which treatment option is specifically used for Wolff-Parkinson-White Syndrome?

    <p>Radiofrequency ablation</p> Signup and view all the answers

    Which condition is most commonly associated with Multifocal Atrial Tachycardia?

    <p>Cor pulmonale</p> Signup and view all the answers

    What is a recognized feature of diagnosis for Wolff-Parkinson-White Syndrome?

    <p>Presence of a delta wave on ECG during normal activity</p> Signup and view all the answers

    What temporary treatment resets the heart in cases of acute arrhythmias?

    <p>Adenosine</p> Signup and view all the answers

    What structure is responsible for pumping deoxygenated blood into the pulmonary artery?

    <p>Right ventricle</p> Signup and view all the answers

    Which valve allows blood to flow from the left atrium to the left ventricle?

    <p>Mitral (bicuspid) valve</p> Signup and view all the answers

    What does the T wave on an EKG represent?

    <p>Ventricular repolarization</p> Signup and view all the answers

    Which component of the cardiac conduction system is responsible for generating impulses at the highest rate?

    <p>SA node</p> Signup and view all the answers

    What is the primary role of the pulmonary artery?

    <p>Carry deoxygenated blood to the lungs</p> Signup and view all the answers

    Which of the following conditions can lead to peaked T waves on the EKG?

    <p>Hyperkalemia</p> Signup and view all the answers

    What effect does the AV node have on heart impulses?

    <p>Slows the impulse rate</p> Signup and view all the answers

    Which of the following is true about the aorta?

    <p>It carries oxygenated blood from the left ventricle</p> Signup and view all the answers

    What distinguishes Mobitz Type 2 heart block from Mobitz Type 1 heart block?

    <p>The PR interval is constant.</p> Signup and view all the answers

    Which treatment is appropriate for Third Degree Heart Block?

    <p>Pacemaker</p> Signup and view all the answers

    What is a common ECG characteristic of Mobitz Type 1 heart block?

    <p>Gradually lengthening PR interval</p> Signup and view all the answers

    What characterizes Third Degree Heart Block in terms of P wave and QRS complex behavior?

    <p>P waves and QRS complexes have regular intervals but no correlation.</p> Signup and view all the answers

    What is a significant risk associated with Mobitz Type 2 heart block?

    <p>It can progress to third-degree heart block.</p> Signup and view all the answers

    Which of these is NOT a common cause of heart block?

    <p>Excessive exercise</p> Signup and view all the answers

    How can Mobitz Type 1 heart block be recognized in terms of its cyclical nature?

    <p>It often occurs in cycles of three, four, or five beats.</p> Signup and view all the answers

    What treatment option is generally recommended for Mobitz Type 1 heart block?

    <p>Observation</p> Signup and view all the answers

    What is the heart rate classification for a regular rhythm with three lines between QRS complexes?

    <p>75 beats per minute</p> Signup and view all the answers

    Which method is used for calculating heart rate in an irregular rhythm without a consistent pattern?

    <p>Count QRS complexes in a 3-second segment and multiply by 20</p> Signup and view all the answers

    What does negative lead 1 and positive aVF indicate in terms of heart axis deviation?

    <p>Right axis deviation</p> Signup and view all the answers

    What is a major characteristic of normal sinus rhythm?

    <p>PR interval between 0.12 and 0.20 seconds</p> Signup and view all the answers

    Which of the following can contribute to sinus bradycardia?

    <p>Hyperthyroidism</p> Signup and view all the answers

    Which condition is primarily treated with a pacemaker for rhythm stabilization?

    <p>Tachy-brady syndrome</p> Signup and view all the answers

    What heart rate range characterizes atrial tachycardia?

    <p>120 to 250 beats per minute</p> Signup and view all the answers

    Atrial fibrillation is most associated with which significant risk?

    <p>Leading cause of cerebrovascular accidents</p> Signup and view all the answers

    What is the characteristic wave pattern seen in atrial flutter?

    <p>Sawtooth pattern with flutter waves</p> Signup and view all the answers

    Which of the following treatments is essential before and after cardioversion in atrial fibrillation?

    <p>Anticoagulation</p> Signup and view all the answers

    What heart rate condition is typical for paroxysmal supraventricular tachycardia (PSVT)?

    <p>Rapid, regular rhythm between 150 to 250 beats per minute</p> Signup and view all the answers

    What describes the primary focus of atrial fibrillation?

    <p>Uncontrolled SA node activity</p> Signup and view all the answers

    Which is a common cause of atrial fibrillation?

    <p>Congestive heart failure</p> Signup and view all the answers

    What signifies an extreme axis deviation on an ECG?

    <p>Negative lead 1 and negative aVF</p> Signup and view all the answers

    Which of the following is a characteristic sign of Torsades de Pointes on an ECG?

    <p>Prolonged QT interval</p> Signup and view all the answers

    What is the initial treatment recommended for a patient experiencing Ventricular Fibrillation?

    <p>Defibrillation</p> Signup and view all the answers

    Which condition is commonly associated with a history of sudden cardiac death?

    <p>Ventricular Fibrillation</p> Signup and view all the answers

    When treating a patient for acute myocardial infarction (AMI), which medication is contraindicated in cases of right ventricular infarction?

    <p>Nitroglycerine</p> Signup and view all the answers

    What is a common cause of Premature Ventricular Contractions (PVCs)?

    <p>Electrolyte imbalance</p> Signup and view all the answers

    Which of the following ECG characteristics is typical of Left Bundle Branch Block (LBBB)?

    <p>V1 shows an M pattern</p> Signup and view all the answers

    Which is a primary difference between STEMI and NSTEMI in terms of ECG findings?

    <p>ST elevation in STEMI</p> Signup and view all the answers

    What is the most immediate treatment for a patient presenting with asystole?

    <p>CPR</p> Signup and view all the answers

    In what situation is magnesium sulfate specifically indicated?

    <p>Torsades de Pointes</p> Signup and view all the answers

    Which arrhythmia is typically characterized by the absence of P waves on an ECG?

    <p>Ventricular Tachycardia</p> Signup and view all the answers

    Which symptom is frequently associated with acute myocardial infarction (AMI)?

    <p>Chest pain lasting over 30 minutes</p> Signup and view all the answers

    What defines the typical treatment approach for Ventricular Tachycardia in a pulseless patient?

    <p>Defibrillation</p> Signup and view all the answers

    What are the typical ECG features for Premature Atrial Contractions (PACs)?

    <p>One-to-one P to QRS ratio with abnormal P wave</p> Signup and view all the answers

    What is the primary role of the left anterior descending artery?

    <p>It supplies the intraventricular septum and anterior wall of the left ventricle.</p> Signup and view all the answers

    Which EKG lead provides the strongest reflection of the heart's electrical pathway?

    <p>Lead II</p> Signup and view all the answers

    What characteristic of hyperkalemia can be observed on an EKG?

    <p>Peaked T waves</p> Signup and view all the answers

    Which of these statements accurately describes the function of the SA node?

    <p>It is the primary pacemaker that sets the heart rate at 60-100 bpm.</p> Signup and view all the answers

    During which phase of the cardiac cycle does the QRS complex occur?

    <p>Ventricular depolarization</p> Signup and view all the answers

    Which of the following leads reflects the lateral wall of the heart supplied by the circumflex artery?

    <p>Leads 1, aVL, V5, and V6</p> Signup and view all the answers

    What electrical impulse initiation and conduction process occurs after the SA node?

    <p>The impulse passes through the Bundle of His.</p> Signup and view all the answers

    Which statement correctly describes the pulmonary arteries?

    <p>They are responsible for transporting deoxygenated blood to the lungs.</p> Signup and view all the answers

    What is a significant EKG finding for Torsades de Pointes?

    <p>Twisting pattern around the baseline</p> Signup and view all the answers

    Which treatment is most suitable for symptomatic premature ventricular contractions (PVCs)?

    <p>Beta-blocker</p> Signup and view all the answers

    Which arrhythmia is characterized by the absence of P waves and a prolonged QRS complex?

    <p>Ventricular tachycardia</p> Signup and view all the answers

    What major condition can lead to the development of ventricular fibrillation?

    <p>Electrolyte imbalances</p> Signup and view all the answers

    Which of the following symptoms is often associated with acute myocardial infarction?

    <p>Clutching of the chest</p> Signup and view all the answers

    What is the recommended treatment for asystole?

    <p>CPR and epinephrine</p> Signup and view all the answers

    Which EKG change occurs 24 hours after the onset of an acute myocardial infarction?

    <p>T wave inversion</p> Signup and view all the answers

    What is the hallmark finding of left bundle branch block (LBBB) on an EKG?

    <p>W pattern in V1 and M in V6</p> Signup and view all the answers

    Which of the following can cause Torsades de Pointes?

    <p>Antiarrhythmic medications</p> Signup and view all the answers

    What symptom commonly accompanies jugular vein distension in ventricular tachycardia?

    <p>Cannon a waves</p> Signup and view all the answers

    What is the recommended treatment strategy for a patient experiencing severe chest pain and hypotension?

    <p>Administering morphine</p> Signup and view all the answers

    Which cardiac biomarker is known to peak quickly and is used for evaluating new myocardial infarction (MI)?

    <p>CKMB</p> Signup and view all the answers

    In which situation is a pacemaker typically required for patients with heart blocks?

    <p>Mobitz Type 2 heart block</p> Signup and view all the answers

    What is the optimal goal for door-to-drug/balloon time to enhance patient outcomes in myocardial infarction?

    <p>90 minutes</p> Signup and view all the answers

    Which EKG leads correspond to Inferior MI?

    <p>Leads II, III, aVF</p> Signup and view all the answers

    What differentiates Mobitz Type 1 from Mobitz Type 2 heart block regarding the P-R interval?

    <p>Mobitz Type 1 exhibits gradual lengthening of the P-R interval</p> Signup and view all the answers

    Which medication is contraindicated in patients with hypotension or bradycardia during chest pain management?

    <p>Nitroglycerin</p> Signup and view all the answers

    Which type of heart block shows independent atrial and ventricular rhythms, with no consistent relation between P waves and QRS complexes?

    <p>Third-degree heart block</p> Signup and view all the answers

    What is a primary purpose of long-term medications such as ACE inhibitors or beta blockers after an MI?

    <p>To reduce stress on the heart and recurrence of events</p> Signup and view all the answers

    Which arrhythmia is characterized by randomly dropped QRS complexes and a fixed P-to-R interval?

    <p>Mobitz Type 2 block</p> Signup and view all the answers

    What indicates a negative lead 1 and a positive aVF on an EKG?

    <p>Right axis deviation</p> Signup and view all the answers

    In atrial tachycardia, what heart rate range is considered normal?

    <p>120 to 250 bpm</p> Signup and view all the answers

    What is a common treatment for atrial fibrillation?

    <p>Amiodarone</p> Signup and view all the answers

    Which characteristic best describes sinus bradycardia?

    <p>P to QRS ratio of 1:1</p> Signup and view all the answers

    What does the treatment for severe bradycardia typically involve?

    <p>Atropine</p> Signup and view all the answers

    What distinguishes multifocal atrial tachycardia (MAT) from other tachycardias?

    <p>Irregular rhythm with multiple P wave morphologies</p> Signup and view all the answers

    Which of the following is a symptom of atrial flutter?

    <p>Rales or crackles</p> Signup and view all the answers

    What term describes the rapid electrical impulses due to accessory pathways in Wolf-Parkinson-White syndrome?

    <p>Reentry</p> Signup and view all the answers

    Which rhythm demonstrates a heart rate of 110-140 bpm without identifiable P waves?

    <p>Atrial fibrillation</p> Signup and view all the answers

    What causes paroxysmal supraventricular tachycardia (PSVT)?

    <p>AV node reentrant pathways or accessory pathways</p> Signup and view all the answers

    What is a characteristic finding of atrial fibrillation on an EKG?

    <p>No identifiable P waves</p> Signup and view all the answers

    How is axis deviation determined using leads 1 and aVF?

    <p>By combining QRS orientation from both leads as x and y coordinates</p> Signup and view all the answers

    What should be multiplied when counting QRS complexes over a 6-second interval to calculate heart rate?

    <p>10</p> Signup and view all the answers

    Study Notes

    Cardiology Objectives

    • Cardiology is the most heavily weighted unit on the PANCE and PANRE exams.
    • EKGs are a critical component of cardiology and frequently tested on exams.
    • "Dubin's EKG" is a recommended resource for EKG learning.

    Blood Flow Through the Heart

    • Deoxygenated blood enters the heart via the vena cava, reaching the right atrium.
    • Tricuspid valve regulates blood flow from the right atrium to the right ventricle.
    • Pulmonary semilunar valve facilitates blood exit from the right ventricle, into the pulmonary artery.
    • The pulmonary artery uniquely carries deoxygenated blood to the lungs.
    • Oxygenated blood returns to the heart through pulmonary veins, entering the left atrium.
    • Bicuspid (mitral) valve directs blood from the left atrium into the left ventricle.
    • Aortic semilunar valve allows blood to leave the left ventricle, entering the aorta.
    • Oxygenated blood from the aorta travels to the body via arteries, arterioles, and capillaries.

    EKG Leads and Coronary Arteries

    • 12-lead EKGs visually represent the heart's electrical activity.
    • Lead 2 reflects the heart's electrical pathway most strongly.
    • Lead 1 and aVL depict the left lateral wall activity.
    • V5 and V6 show left lateral wall activity.
    • V1 and V2 reflect activity of the interventricular septum.
    • V2, V3, and V4 display anterior wall activity.
    • Leads 2, 3, and aVF represent the inferior wall (right atria, ventricle, SA and AV nodes, and posterior right side of the heart).

    Electrolyte Abnormalities

    • Hyperkalemia (high potassium) produces peaked T waves on an EKG.
    • Hypokalemia (low potassium) shows U waves on an EKG.

    Cardiac Conduction System

    • The sinoatrial (SA) node, the heart's natural pacemaker, sets a rhythm of 60-100 bpm.
    • The atrioventricular (AV) node slows the impulse to 45-60 bpm, allowing ventricular filling.
    • The impulse progresses through the Bundle of His, bundle branches, and Purkinje fibers.

    EKG Waveforms

    • P wave: Atrial depolarization.
    • QRS complex: Ventricular depolarization (atrial repolarization masked).
    • T wave: Ventricular repolarization.

    EKG Rate Interpretation

    • Regular rhythms: Count large boxes between two consecutive R waves (300, 150, 100, 75, 60, 50 bpm).
    • Irregular rhythms: Use 3-second (20x count) or 6-second (10x count) method to calculate rate.

    Axis Deviation

    • Normal axis: -30° to +90°.
    • Right axis deviation (RAD): +90° to +180°.
    • Left axis deviation (LAD): -30° to -90°.
    • Extreme axis deviation: -90° to +180°.
    • Determine axis using lead 1 and aVF as xy-coordinates.

    Normal Sinus Rhythm (NSR)

    • Originates from the SA node, 60-100 bpm.
    • Regular rhythm; 1:1 P-to-QRS ratio.
    • P, QRS, T waves have similar direction. PR interval: 0.12-0.2 seconds; QRS <0.12 seconds.

    Sinus Bradycardia

    • Heart rate < 60 bpm.
    • Normal in trained athletes; caused by medications, hypothermia, hypothyroidism, or hypoglycemia.
    • Severe cases require atropine or pacemaker.

    Sick Sinus Syndrome (SSS/Tachy-Brady Syndrome)

    • Dysfunctional SA node leading to irregular atrial conduction (varying rhythm).
    • Treatment: Pacemaker.

    Atrial Tachycardia

    • Fast SA node conduction.
    • Normal with exertion, fever, dehydration; caused by stimulants, hypoxia.
    • 120-250 bpm, regular rhythm, 1:1 P-to-QRS ratio.

    Atrial Fibrillation (AFib)

    • Most common arrhythmia and stroke risk factor.
    • Irregular, irregular rhythm.
    • Anticoagulation critical for at least 3 weeks prior and 4 weeks after cardioversion.

    Atrial Flutter

    • Less common than atrial fibrillation.
    • Saw-tooth pattern (flutter or F waves).

    Paroxysmal Supraventricular Tachycardia (PSVT)

    • Episodic, fast rhythm (150 to 250 bpm), regular rhythm; 1:1 P-to-QRS ratio.

    Multifocal Atrial Tachycardia (MAT)

    • Irregular; more than three different types of P waves.
    • Associated with cor pulmonale (COPD).

    Wolf-Parkinson-White Syndrome

    • Rare; genetic accessory pathway (delta waves).

    Ventricular Tachycardia

    • Fast rhythm, over 100 beats per minute; no P waves; wide QRS in leads V1-V6, associated with various causes like electrolytes, cardiac surgical scars, meds.

    Torsades de Pointes

    • Polymorphic ventricular tachycardia with twisting pattern around baseline.

    Ventricular Fibrillation

    • Irregular, rapid rhythm; usually preceded by VTach

    Asystole

    • Flat line on EKG in at least two leads; causes include hypovolemia, hypoxia, acidosis, hyperkalemia, hypothermia, and more.

    Premature Atrial Contractions (PACs)

    • Early atrial contraction.

    Premature Ventricular Contractions (PVCs)

    • Early ventricular contraction.

    Bundle Branch Block

    • Block in bundle branch, LBBB more serious, often associated with cardiac issues, RBBB more common.

    Acute Myocardial Infarction (MI)

    • STEMI (ST-elevation MI): ST elevation > 1 mm in two contiguous leads, new Q wave.
    • NSTEMI (Non-ST elevation MI): ST segment depression; no Q wave.
    • Findings vary over time, initially tall positive T waves, then ST elevation, Q wave enlargement, R wave decrease, T wave inversion.

    Heart Block Algorithm

    • First-degree: P-to-R interval prolonged (> 200ms)
    • Second-degree Mobitz type I (Wenckebach): Gradual PR lengthening leading to dropped QRS.
    • Second-degree Mobitz type II: Fixed PR interval, but intermittently dropped QRS.
    • Third-degree (complete): No P-QRS relationship.

    Mobitz Type 1 (Wenckebach)

    • Gradual lengthening of PR interval leading to a dropped QRS .
    • Not a constant P to R ratio.

    Mobitz Type 2

    • Constant P to R ratio, randomly dropped QRS complexes, often requiring pacemaker

    Third-Degree Heart Block

    • No association between P waves and QRS complexes; atrial and ventricular rhythms are completely independent.

    Key Differences

    • Mobitz type 2 is closer to third-degree block than Mobitz type 1.
    • Mobitz type 1 is not a constant P-R ratio, while Mobitz type 2 is.
    • Third-degree block has no association between P and QRS.

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    Description

    Test your knowledge on the cardiovascular system, focusing on blood flow through the heart and EKGs. This quiz emphasizes key concepts crucial for PA exams and provides insights from the book 'Dubin'. Challenge yourself and reinforce your understanding of cardiology.

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