22.8.2013

Question 0

Electrical alternans

Answer 0

Beat to beat variation of QRS complexes by 1mm

Question 1

Tall waves,DD

Answer 1

Chamber enlargement
Young individuals
Thin,Emaciated individuals
Mastectomy pts

Question 2

Calculation of heart rate,boxes

Answer 2

100 use small boxes

Question 3

Causes of low voltage QRS complexes

Answer 3

Obesity
COPD
Pleural or pericardial effusion
Generalised Edema 
Hypothyroidism
Amyloidosis

Question 4

Causes of electrical alternans

Answer 4

Cardiac tamponade
Poor conduction in ventricles alternating with normal conduction
SVT
Severe myocardial ischemia

Question 5

Normal intrinsicoid deflection in V1 and V2

Answer 5

<0.03S

Question 6

Normal intrinsicoid deflection in V5 and V6

Answer 6

<0.05S

Question 7

Components of QRS

Answer 7

Ventricular activation time

Intrinsicoid deflection

Question 8

Sequence of ventricular activation

Answer 8

1. septum
2. free wall of both ventricles
3. posterobasal wall of septum and left ventricle

Question 9

Total duration of septal q wave should not exceed

Answer 9

0.03S

Question 10

Normal sinus rhythm is indicated by

Answer 10

Upright p wave in lead 2

Question 11

Measurements of inverted portion of p wave

Answer 11

Less than 1mm in depth and duration

Question 12

ECG of rt atrial enlargement

Answer 12

Tall(>2.5mm) peaked p waves in leads 2,3,avF
Axis of p wave shifted to right of 60’
P3>P1

Question 13

Normal p wave duration

Answer 13

<110ms

Question 14

Causes of rt atrial enlargement

Answer 14

Tricuspid or pulmonary valvular disease
Pulmonary hypertension
Acute pulmonary embolism
Right ventricular failure or hypertrophy

Question 15

Inverted p wave in V1

Answer 15

Lt atrial hypertrophy

Emphysema

Question 16

ECG changes of left atrial enlargement

Answer 16

P mitrale(duration>2.5boxes) in lead I,II,aVF,V5,V6
Axis of p wave is shifted to left,P1>P3
Inverted portion of P wave in lead V1 is more than 1mm vertically and horizontally

Question 17

LVH without increased voltage

Answer 17

Obesity
Anasarca
Peripheral Edema
Increased diameter of chest
Emphysema
Large breasts
Biventricular hypertrophy
Amyloidosis 
Pericardial effusion
Pleural effusion
Hypothyroidism

Question 18

Increased voltage not resulting from LVH

Answer 18

Lt Mastectomy
Adolescent boys
Anemia
Thin individuals

Question 19

Intrinsicoid deflection and ventricular hypertrophy

Answer 19

Delayed in V1 and V2 in RVH

Delayed in V5 and V6 in LVH

Question 20

ECG changes of LVH due to volume overload

Answer 20

Tall R waves
Prominent Q waves
Tall and upright T waves in V5 and V6

Question 21

Conduction defects associated with LVH

Answer 21

Incomplete BBB

LAFB

Question 22

Anti hypertensive medications not effective in reducing LVH

Answer 22

Hydralzine

Minoxidil

Question 23

ECG finding that is a must for RVH

Answer 23

Rt axis deviation

Question 24

Lead 1 sign

Answer 24

``` Seen in emphysema and chronic bronchitis where diaphragm is shifted downwards Small complexes in lead 1 and V6 Poor R wave progression Right axis deviation P pulmonale ```

Question 25

Most frequent ECG findings of pulmonary embolism

Answer 25

Sinus tachycardia | Incomplete RBBB

Question 26

ECG findings in RVH

Answer 26

``` Rt axis deviation qR in V1 R wave in V1 more than 7mm R wave taller than S wave in V1 Delayed onset of intrinsicoid deflection(V1>0.03) rS complex in V1-V6 with rt axis S1S2S3 pattern in adults ```

Question 27

ECG changes of acute pulmonary embolism

Answer 27

Sinus tachycardia,atrial flutter,atrial fibrillation Rt axis S1Q3T3 rSR' pattern in V1 of acute onset V1 shows QS,qR or R>S pattern Clockwise rotation with persistent S in V6 P pulmonale Ta wave exaggeration resulting in ST depression in inferior leads ST elevation in V1 T wave inversion in V1-V3

Question 28

ECG findings of biventricular hypertrophy

Answer 28

Katz wachtel phenomenon P pulmonale with LVH Voltage discordance

Question 29

ECG findings of RVH are more prominent in

Answer 29

TOF | congenital pulmonary stenosis

Question 30

Type A RVH is seen in

Answer 30

Primary pulmonary hypertension Severe pulmonic stenosis Mitral stenosis with severe pulmonary hypertension

Question 31

Type A RVH

Answer 31

Rt axis deviation of more than 120' Monophasic R waves in V1 Deep S waves in V5,V6

Question 32

Type B RVH causes

Answer 32

ASD | MS with mild to moderate pulmonary hypertension

Question 33

Type B RVH

Answer 33

R wave in V1 is slightly taller than S wave rsr' pattern in V1 Normal QRS in V5 and V6 Axis is at 90'

Question 34

Type C RVH causes

Answer 34

Pulmonary disease | Acute pulmonary embolism

Question 35

Type C RVH

Answer 35

Deep S wave in V1-V6 | Axis less than 90'

Question 36

QRS prolongation in RVH

Answer 36

Doesnot occur unless there is RBBB