Download ANCE Blueprint Cardiology - All Smarty PANCE cardiology sets combined + EKG (Latest 2026 / and more Exams Cardiology in PDF only on Docsity!
ANCE Blueprint Cardiology - All Smarty
PANCE cardiology sets combined + EKG
(Latest 2026 / 2027) Questions with
Answers 100% Correct {Grade A}
What are the three types of sinus arrhythmia?
1. Respiratory (phasic sinus arrhythmia) - Linked to the respiratory cycle - is a normal phenomenon; the term relates to the increase in heart rate with inspiration and decrease during expiration 2. Nonrespiratory (nonphasic sinus arrhythmia) - Not linked to the respiratory cycle. It is less common, typically occurs in elderly patients and is more likely to be pathological (e.g. due to heart disease or digoxin toxicity) 3. Nonrespiratory (ventriculophasic sinus arrhythmia) - Not linked to the respiratory cycle and characterized by intermittent differences in the PP intervals based upon their relationship to the QRS complex Diagnosis of sinus arrhythmia?
Diagnosis is by EKG - Sinus arrhythmia is considered present when there is a variation in the P-P interval by 0.12 seconds (120 milliseconds) and atrial activation is occurring via the sinus node. Characteristics ● Variation in the P-P interval of more than 120 ms (3 small boxes) ● The P-P interval gradually lengthens and shortens in a cyclical fashion , usually corresponding to the phases of the respiratory cycle. ● Normal sinus P waves with a constant morphology (i.e. no evidence of premature atrial contractions). ● Constant P-R interval (i.e. no evidence of Mobitz I AV block) Sinus Arrhythmia Atrial Fibrillation (A-Fib) - P waves are absent. They are replaced by lower case "f" waves. Premature atrial complexes - P wave is a different shape Wandering Atrial Pacemaker (WAP) - P-wave morphology varies, and this can be consistent with wandering atrial pacemaker. In Wandering Atrial Pacemaker, you must observe at least three different shaped P waves.
Name an antiemetic that can lead to torsades de pointes Ondansetron is an antiemetic that can lead to torsades de pointes What class of antibiotics can cause torsades de pointes as part of their cardiovascular adverse effect profile. Macrolide antibiotics can cause torsades de pointes as part of their cardiovascular adverse effect profile. Which class of antidepressants can cause torsades de pointes as part of their cardiovascular adverse effect profile. Tricyclic antidepressants are antidepressants that can cause torsades de pointes as part of their cardiovascular adverse effect profile. What class of antiarrhythmics can lead to torsade de pointes. Class IA and class III antiarrhythmics can lead to torsade de pointes Drug-induced long QT ( ABCDE )? Drug-induced long QT (ABCDE): ● AntiArrhythmics (class IA, III) ● AntiBiotics (eg, macrolides)
● Anti"C"ychotics (eg, haloperidol) ● AntiDepressants (eg, TCAs) ● AntiEmetics (eg, ondansetron) What two electrolyte disorders predispose to the development of torsades de pointes. Low levels of potassium and magnesium can lead to torsades de pointes. What is the best initial drug to administer in the management of torsade de pointes Magnesium sulfate is the best initial drug to administer in the management of torsade de pointes. Torsades de pointes is characterized by cyclic changes in what? Torsades de pointes is characterized by cyclic changes in the QRS complex morphology What condition is usually-fatal end-result of torsades de pointes. Ventricular fibrillation is the usually-fatal end-result of torsades de pointes. The ventricular rhythm in torsades de pointes is usually faster than how many beats per minute?
Ventricular fibrillation most commonly develops secondary to what myocardial abnormality? Ventricular fibrillation most commonly develops secondary to myocardial ischemia. Ischemia increases the excitability of the myocardium and thus predisposes to ventricular fibrillation. Patients with ventricular fibrillation are always hemodynamically ( stable/unstable )? Patients with ventricular fibrillation are always hemodynamically unstable. What is the initial management of ventricular fibrillation is cardiopulmonary resuscitation? The initial management of ventricular fibrillation is cardiopulmonary resuscitation What is the treatment of ventricular fibrillation? Treat with unsynchronized cardioversion using the following algorithm: ● Unsynchronized cardioversion => start CPR ● Give 3 sequential shocks (120, 150, 180); assess rhythm If VF persists --> do CPR and intubate
● Administer two doses amiodarone 2-4 min. Administer 1 mg IV bolus epi every 3 - 5 minutes (will ↑ myocardial blood flow and ↓ cerebral blood flow and ↓ defib threshold) An electric shock during a _______ wave can cause ventricular fibrillation? An electric shock during a T wave can cause ventricular fibrillation What's the difference between cardioversion and defibrillation? ● Cardioversion: shock is in synchrony with QRS complex ● Defibrillation: shock is NOT in synchrony with QRS complex (goal to convert dysrhythmia to NSR) What is used for the prevention of recurrent ventricular fibrillation in the predisposed patients? Implantable cardioverter-defibrillators are the devices used for the prevention of recurrent ventricular fibrillation in the predisposed patients. Name two illicit drugs that could cause ventricular fibrillation Two illicit drugs that could cause ventricular fibrillation are cocaine and methamphetamine
Monomorphic VT vs. Polymorphic VT? ● Monomorphic VT : Single abnormal focus or reentrant pathway and regular, identical- appearing QRS complexes ● Polymorphic VT : Several different foci or pathways and irregular, varying QRS complexes Describe the EKG findings of ventricular tachycardia? Wide, bizarre QRS complexes - Any wide QRS complex tachycardia (QRS ≥ 0. second) should be considered VT until proved otherwise. Monomorphic VT - has QRS complexes that are the same in shape, size, and direction Polymorphic VT - has varying QRS complexes Nonsustained VT vs Sustained VT? ● Nonsustained VT : Lasts < 30 seconds ● Sustained VT : Lasts ≥ 30 seconds or is terminated sooner because of hemodynamic collapse VT frequently deteriorates to _____________ and thus cardiac arrest? VT frequently deteriorates to ventricular fibrillation and thus cardiac arrest.
Diagnosis of ventricular tachycardia? Diagnosis is by electrocardiography (EKG) What Blueprint topic is considered a form of rapid polymorphic ventricular tachycardia with long QT? Torsades de pointes Treatment of Pulseless VT? Pulseless VT requires defibrillation with ≥100 joules. Treatment of stable sustained VT? Stable sustained VT can be treated with synchronized direct-current cardioversion with ≥100 joules or with IV class I or class III antiarrhythmic drugs Treatment of nonsustained VT? Nonsustained VT does not require immediate treatment unless the runs are frequent or long enough to cause symptoms. In such cases, antiarrhythmics are used as for sustained VT. long-term treatment of VT?
What murmur has a left parasternal lift pulmonic area ejection murmur and fixed splitting of S2? ASD (Atrial Septal Defect) What cardiac abnormality is associated with a bicuspid aortic valve? Coarctation of aorta What murmur has a continuous machinery quality? Patent ductus arteriosus Dyspnea with feeding and poor growth during infancy associated with a harsh ; holosystolic murmur heard best at the left sternal border with wide radiation and a fixed, split S Ventricular septal defect Higher blood pressures in the arms than in the legs and pulses are bounding in the arms but decreased in the legs Coarctation of aorta Crescendo-decrescendo, holosystolic murmur at LSB radiating to the back. Baby with cyanosis and LOC with crying
Tetralogy of Fallot Four features of Tetralogy of Fallot Four features: PROVe P ulmonary Stenosis R ight ventricular hypertrophy O verriding aorta V entricular septal defect An atrial septal defect is defined as a defect in the _______ that divides what part of the heart? An atrial septal defect is defined as a defect in the septum that divides the atria An atrial septal defect initially presents with what type of shunt? An atrial septal defect initially presents with a left-to-right shunt What are the symptoms and signs of ASD? Complete atrioventricular septal defect with a large left-to-right shunt causes signs of heart failure (eg, tachypnea, dyspnea during feeding, poor weight gain, diaphoresis) by age 4 to 6 weeks. Partial AV septal defects do not usually cause symptoms during
Atrial septal defect presents with a loud first heart sound. How will an atrial septal defect affect the oxygen saturation in the right side of the heart? An atrial septal defect will cause increased oxygen saturation in the right side of the heart. How does ASD affect the second heart sound? Atrial septal defect is a congenital heart disorder that is associated with wide fixed splitting of the second heart sound What is the best diagnostic tool for diagnosing atrial septal defect? Echocardiography is the best diagnostic tool for diagnosing atrial septal defect. Treatment of ASD? Most ASD lesions will close spontaneously , but lesions causing symptoms or CHF require surgical repair What is coarctation of the aorta? Coarctation of the aorta is a congenital heart defect defined as a narrowing of a segment of the aorta
Infantile coarctation of the aorta is associated with what two abnormalities? Infantile coarctation of the aorta is associated with both patent ductus arteriosus and (chromosomal anomaly) Turner syndrome What is the the classic clinical sign of coarctation of the aorta? The classic clinical sign of coarctation of the aorta is higher blood pressure in the arms than in the legs and pulses that are bounding in the arms but decreased in the legs What is the best diagnostic tool to confirm aortic coarctation and to rule out associated cardiac anomalies? Transthoracic echocardiography is the best diagnostic tool to confirm aortic coarctation and to rule out associated cardiac anomalies. What should be administered to neonates with aortic coarctation to keep the ductus arteriosus open? Prostaglandin E1 should be administered to neonates with aortic coarctation to keep the ductus arteriosus open.
In adults, aortic coarctation most commonly presents as hypertension Treatment of coarctation of the aorta? Treatment is balloon angioplasty with stent placement, or surgical correction What is patent ductus arteriosus? PDA is failure of the fetal ductus arterioles (artery connecting the aorta and the pulmonary artery) to close within the first weeks of life What is the congenital infection associated with patent ductus arteriosus? Congenital rubella is the congenital infection associated with patent ductus arteriosus. Patent ductus arteriosus causes what type of shunt? Patent ductus arteriosus causes left to right shunt What is the murmur associated with PDA? A continuous "machinery murmur" at the upper left sternal border is common What is used for confirming the diagnosis of patent ductus arteriosus? Echocardiography is used for confirming the diagnosis of patent ductus arteriosus. What is the treatment for patent ductus arteriosus?
Indomethacin is the treatment for patent ductus arteriosus, because it decreases prostaglandin E1/E2 production. How are neonates with patent ductus arteriosus who weigh less than five kilograms are best managed? Neonates with patent ductus arteriosus who weigh less than five kilograms are best managed medically If the connection persists what is the next best course of action? If the connection persists, surgical or catheter-based correction is indicated What are the four features of tetralogy of Fallot? The four features of tetralogy of Fallot can be remembered using the mnemonic " PROV e": ● P ulmonary infundibular stenosis (most important determinant for prognosis) ● R ight ventricular hypertrophy (RVH)— boot-shaped heart on CXR ● O verriding aorta ● V entricular septal defect Symptoms of tetralogy of Fallot?
