Cardiology

Question 1

How do you identify a Left Anterior Hemiblock on a 12-lead?

Answer 1

Normal QRS duration, left pathologic axis

(Lead 1 up
Lead 2 down or indeterminate
Lead 3 down)

Electricity -30 to -90

Question 2

How do you identify a left posterior fascicular block?

Answer 2

Normal QRS duration. Right axis deviation

Lead 1 down
Lead 2 and 3 up
90 to 180 electricity

Question 3

What is a bifascicular block?

Answer 3

Rbbb and a hemi-block

Question 4

How do you identify a bifascicular block (RBBB and LAFB)

Answer 4

Prolonged QRS interval
Upward S wave in V1

Left axis deviation (left anterior fascicular block) (pathological)

Question 5

How do you identify a bifascicular block (RBBB and LPFB)

Answer 5

Prolonged QRS duration
No evidence of RV
Rbbb present in V1

Right axis deviation

Question 6

What leads should normally be negative?

Answer 6

V1 and aVR

Question 7

How do you identify WPW syndrome?

Answer 7

Short PR interval
Lengthened QRS
“Delta” wave

Type A: QRS is primarily up V1 & V2
(Route LA to LV)

Type B: QRS is primarily down in V1 & V2
(Route RA to RV)

Question 8

What are the 12-lead characteristics of hypokalemia?

Answer 8

Flat T, prolonged QT and prominent U wave

Question 9

What are the 12-lead characteristics of hyperkalemia?

Answer 9

Peaked T waves
Flattened P waves
Prolonged PR interval
Widened QRS

Question 10

What are the 12-lead characteristics of hypocalcemia?

Answer 10

Prolonged QTc
May cause T wave inversion

Question 11

What are the 12-lead characteristics of hypercalcemia?

Answer 11

Shortened QTc
May cause sharply rise to a peak

Question 12

What are the 12-lead characteristics of hypomagnesemia?

Answer 12

May be associated with hypokalemia and/or hypocalcemia

Prolonged QTc may precipitate torsades

Question 13

Digitalis toxicity effects to heart

Answer 13

Bradycardia
AV blocks
Prolonged PR interval
Flattened T wave
Shortened QTc interval
Swooping ST segment (senor dali effect, mustache)

Question 14

Quinidine toxicity effects

Answer 14

T waves are depressed and widened
Later T waves are notched then inverted
Prominent U waves
Prolonged QTc
Widened QRS complex (late finding)

Question 15

TCA Tricyclic antidepressants OD

(Ending in pine or ine)

Answer 15

Prolonged QTc
Widened QRS-intervals
Ventricular arrhythmias
AV blacks/bundle branch blocks

Question 16

What are the inferior leads and what vessel supplies them?

Answer 16

II, III, aVF

RCA

(Recip changes in 1, aVL)

Question 17

What are the septal leads and what vessel supplies them?

Answer 17

V1, V2

LAD

Question 18

What are the anterior leads and what vessel supplies them?

Answer 18

V3, V4
LAD

(Recip changes in II, III, aVF)

Question 19

What are the lateral leads and what vessel supplies them?

Answer 19

I, aVL, V5, V6

Circumflex

(Recip changes in II, III, aVF)

Question 20

What are the posterior leads and what vessel supplies them?

Answer 20

V7, V8, V9
Reciprocal findings in V1-V4

RCA (in some circumflex)

Question 21

What are the right ventricular leads and what vessel supplies them?

Answer 21

V1R-V6R

RCA (and in some Circumflex)

Question 22

Describe diastolic HF

Answer 22

Ventricles are failing to fill adequately prior to systole (need to increase pre-load)