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PHCY310 Quiz am L44,45,46 Dysrhythmias, erstellt von Mer Scott am 20/05/2019.

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L44,45,46 Dysrhythmias

Frage 1 von 13

1

Choose the incorrect statement.

Wähle eine der folgenden:

  • 2% of all people over age 65 in New Zealand have Afib.

  • People with dysrythmias have a higher risk of mortality from MI, stroke, HF and dementia.

  • Ventricular arrhythmias are less common than atrial fibrillation.

Erklärung

Frage 2 von 13

1

The mechanism of arrhythmia can be due to abnormal firing or abnormal . Abnormal impulse firing can be increased (where cells SA node start firing spontaneously) or activity (where cells contract despite only being activated once).

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    impulse
    conduction
    automaticity
    outside
    triggered
    twice

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Frage 3 von 13

1

Bradyarrhythmias:
1. Sinus Bradycardia - Slow heart rate < bpm(elderly, athletes).
• Increased vagal tone or stimulation, vomiting, myocardial ischemia or MI, thyroid, hypo, increased pressure. Can be caused by drugs: Beta blockers (slow ) and/or non-dihydropyridine calcium channel blockers (slow ).
2. Sick Sinus Syndrome -
• A of bradycardia and tachycardia
• Sinus dysfunction
• Associated with episodes of tachyarrhythias
3. Atrio-Ventricular Block - impulses generated in atria are conducted to ventricles or partially/totally.

2 and 3 can be caused by

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    60
    intracranial
    hypo
    thermia
    impulse firing
    conduction
    combination
    node
    atrial
    slowly
    blocked
    BBs, CCBs, or digoxin

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Frage 4 von 13

1

Tachyarrhythmias:
1. Atrial flutter - Rapid, atrial depolarization. Atrial rate: 250-350 bpm. If atrial impulses are conducted to the , it can result in ventricular tachycardia. Since atrial rate is high, AV may occur to protect ventricles...
2. Atrial fibrillation - Most common sustained arrhythmia. mpulses conduct across the atria – leading to fibrillation. Atrial rate bpm. AV node irregularly filters (blocks) atrial impulses, irregular increased rate occurs. Concern is atrial thrombus formation due to stasis. Clinical Features: Fatigue, palpitation, syncope, worsening .
3. Ventricular Tachycardia - Rate bpm. ' VT' if tachycardia lasts >30 seconds. ECG: wide and rapid complexes (: All QRS complexes are similar, or : QRS complexes change in morphology, amplitude, polarity).
4. Torsades de Pointes (TdP) - Variance of polymorphic VT. Drug causes: Anti-arrhythmics (Class Ia, Class III), phenothiazines, erythromycin. Electrolyte causes: , hypomagnesemia.
5. Ventricular Fibrillation - Chaotic () ventricular arrhythmia. Rate 250-500 bpm. Follows ischemic event, most frequent cause of sudden .
6. Wolf-Parkinson-White Syndrome - Early ventricular depolarization. Congenital defect.

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    regular
    ventricle
    block
    irregularly
    350-600
    ventricular
    heart failure
    100-250
    Sustained
    QRS
    monomorphic
    polymorphic
    hypokalemia
    irregular
    death

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Frage 5 von 13

1

Atrial Fibrillation - Classification:
=Only one diagnosed episode
= Recurrent episodes that stop on their own in <7 days
= Recurrent episodes that last >7 days
= Ongoing long-term episode

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    First detected
    Paroxysmal
    Persistent
    Permanent

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Frage 6 von 13

1

Select all the options which could be clinical presentations of arrhythmia.

Wähle eine oder mehr der folgenden:

  • Cardiac arrest

  • Loss of consciousness/syncope

  • Shortness of breath

  • Anxiety

  • Palpitations

  • Asymptomatic/no symptoms

  • Constipation

  • Dry cough

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Frage 7 von 13

1

Vaughan Williams Classification of Anti-arrythmics:
• Class I -
• Class Ia: Quinidine, Procainamide, Disopyramide (intermediate block)
• Class Ib: Lidocaine, Mexilitine (fast block)
• Class Ic: Flecainide, Propafenone, Moricizine (slow block)
• Class II -
• Class III -
- Amiodarone, Dronedarone, Sotalol, Ibutilide, Dofetilide
• Class IV -
- Diltiazem, Verapamil

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    Sodium channel blockers
    Beta adrenergic blockers
    Potassium channel blockers
    Calcium channel blockers

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Frage 8 von 13

1

Choose the incorrect statement.

Wähle eine der folgenden:

  • All sodium channel blockers (Class I) decrease conduction velocity and automaticity, but have different affects on the refractory period.

  • Beta blockers reduce conduction velocity and automaticity, and increase the refractory period.

  • Potassium channel blockers only affect refractory period, by increasing it.

  • Calcium channel blockers reduce conduction velocity and automaticity, and increase the refractory period.

Erklärung

Frage 9 von 13

1

Diltiazem in patients post-MI with heart failure and flecainide post-MI to suppress ventricular ectopy both decrease mortality.

Wähle eins der folgenden:

  • WAHR
  • FALSCH

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Frage 10 von 13

1

Choose the incorrect statement about lidocaine.

Wähle eine der folgenden:

  • It is Class Ib.

  • It decreases depolarization, automaticity, and excitability of the ventricles during systole.

  • It's onset of action occurs within 30-90 seconds.

  • It can cause hypotension, arrhythmias, and heart block.

  • It can cause sedation, dizzy, vision changes, seizures, parasthesia.

Erklärung

Frage 11 von 13

1

Which cardiac-related drugs are greatly affected by coadministration with Amiodarone?

Wähle eine der folgenden:

  • Digoxin, Statins, Warfarin, Dabigatran

  • Digoxin, ACEis, Warfarin, Rivaroxiban

  • SSRIs, Dabigatran, Phenytoin

  • Sulphonylureas and beta blockers

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Frage 12 von 13

1

Treating ventricular arrhythmias:
Non sustained VT, no structural disease -
blockers, CCB, Class 1( blockers)
• Catheter

VF or TdP (idiopathic) -

Structural disease present -
• Treat cause
• Catheter ablation or ICD
when above fails
• Do not give

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    Beta
    Na+
    ablation
    ICD
    underlying
    Amiodarone
    CCBs

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Frage 13 von 13

1

Select all the drug classes that target rhythm control instead of rate.

Wähle eine oder mehr der folgenden:

  • Class IV agents/Calcium Channel Blockers

  • Class II agents/Beta blockers

  • Amiodarone

  • Digoxin

  • Class I agents/Sodium channel blockers

  • Class III agents/Potassium channel blockers

Erklärung