12 Lead

Question 1

Right axis deviation can indicate what five conditions?

Answer 1

1) Posterior hemiblock
2) Right ventricular hypertrophy
3) Cor pulmonal or right heart failure
4) Pulmonary embolism
5) Arrhythmias

Question 2

What two arteries supply the posterior hemifascicle?

Answer 2

Right coronary and the circumflex

Question 4

What vessel supplies blood to the anterior hemifascicle?

Answer 4

Left anterior descending (LAD)

Question 5

A left anterior hemiblock causes what kind of axis deviation?

Answer 5

Pathologic left axis

Question 6

What can an extreme right axis deviation indicate?

Answer 6

A rhythm ventricular in origin

Question 7

Right axis deviation indicates what kind of block?

Answer 7

Left posterior hemiblock

Question 9

Describe the positive/negative deflection of leads I, II, and III with normal axis deviation and the angle associated.

Answer 9

I - positive
II - positive
III - positive
0 to 90

Question 10

Describe the positive/negative deflection of leads I, II, and III with pathologic left axis deviation and the angle associated.

Answer 10

I - positive
II - negative
III - negative
-40 to -90

Question 11

Describe the positive/negative deflection of leads I, II, and III with physiological left axis deviation and the angle associated.

Answer 11

I - positive
II - positive or isoelectric
III - negative
0 to -40

Question 12

Describe the positive/negative deflection of leads I, II, and III with right axis deviation and the angle associated.

Answer 12

I - negative
II - any
III - positive
90 to 180

Question 13

An axis deviation of 0 to 90 indicates what type of deviation?

Answer 13

Normal

Question 14

An axis deviation of 0 to -40 indicates what type of deviation?

Answer 14

Physiological left

Question 15

An axis deviation of -40 to -90 indicates what type of deviation?

Answer 15

Pathological left

Question 16

An axis deviation of 90 to 180 indicates what type of deviation?

Answer 16

Right

Question 17

An axis deviation of >180 indicates what type of deviation?

Answer 17

Extreme right

Question 18

Describe the positive/negative deflection of leads I, II, and III with extreme right axis deviation and the angle associated.

Answer 18

I - negative
II - negative
III - negative
>180

Question 19

What is the main characteristic of a bundle branch block?

Answer 19

A QRS complex of at least 0.12 seconds or more.

36

Question 20

What are the three fascicles?

Answer 20

Right bundle branch
Left anterior hemifascicle
Left posterior hemifascicle

36

Question 21

What lead is used to diagnosed BBBs using the “turn signal criteria”?

Answer 21

V1

37

Question 22

Are BBB’s permanent, temporary, or either?

Answer 22

Either

39

Question 23

In the setting of an acute MI a BBB usually indicates what two problems?

Answer 23

1) Extensive coronary artery occlusion
2) Anterior wall damage

39

Question 24

Pts with occlusion to what coronary artery producing an anterior wall MI frequently develop complete heart blocks and sometimes V-fib?

Answer 24

Left anterior descending

39

Question 25

Why should lidocaine , procainamide, amiodarone, and morphine be used with caution when a bifascicular block exists?

Answer 25

That may result in a drug-induced complete heart block

39

Question 26

A QRS complex >170ms usually means an ejection fraction of ___%?

Answer 26

50

39

Question 27

Cardiac output = ____ X ____

Answer 27

Heart rate Stroke Volume 40

Question 28

Stroke volume is comprised of what three components?

Answer 28

Preload Afterload Contractile force 40

Question 29

Ejection fraction is one measure of what?

Answer 29

Left ventricular effectiveness 40

Question 30

What is normal ejection fraction?

Answer 30

60-75% 40

Question 31

What type of medication should be used with caution if Pt has a QRS wider than 170ms? Why?

Answer 31

Vasodilators Afterload is most likely a result of vasoconstriction compensating for other conditions. 40

Question 32

What is a bifascicular block?

Answer 32

A RBBB combined with a hemiblock or a LBBB 46 or A blockage of 2 of the 3 pathways to contract the ventricles. 49

Question 33

What is a hemiblock?

Answer 33

A block of one of the two fascicles of the left bundle branch 33

Question 34

What are the six severe degrees of heart block?

Answer 34

- 2nd degree type II - 3rd degree CHB - Bifascicular block - 1st degree + hemiblock - 1st degree + BBB - "block" said or implied twice during initial observation. 49

Question 35

When should vasodilators be used with extreme caution?

Answer 35

When the QRS is >170ms 40

Question 36

Until proven differently, wide complex bradycardia should be diagnosed as what?

Answer 36

Hyperkalemia Dr. Edminster February 2018 Medic Meeting

Question 37

What four things result in a wide QRS?

Answer 37

- Bundle Branch Block - Ventricular Beats - Hyperkalemia - Tricyclics Dr. Edminster February 2018 Medic Meeting

Question 38

What does a downward sloping PR interval indicate?

Answer 38

Pericarditis Dr. Edminster February 2018 Medic Meeting