3

Question 1

Septal lead locations

Answer 1

V1 and V2

Question 2

Abnormal Cardiac Stress Test responses

Answer 2

Shortness of breath, pain on lower body, fatigue in early stages, fall in blood pressure

Question 3

Cardiac Stress Test patient prep

Answer 3

No solid food for 3-6 hours before test, no fluids besides water, no caffeine 24 hours before test, restrict medications that alter heart rate

Question 4

Antero lead locations

Answer 4

V3 and V4

Question 5

Findings that indicate Cardiac Stress Test should not be administered

Answer 5

AF with RVR, short bursts of V-tach, within 2 days myocardial infarction/heart attack

Question 6

Target heart rate for Cardiac Stress Test formula

Answer 6

(220 - age of patient) x 0.85

Question 7

Pseudonormalization

Answer 7

Pseudonormalization is described as baseline T wave inversion that converts to normal, upright T waves. This is specific to patients with previous myocardial infarction/heart attacks.

Question 8

Lateral lead locations

Answer 8

lead I, aVL, V5 and V6

Question 9

Wolf-Parkinson-White (WPW) syndrome

Answer 9

WPW syndrome is characterized by presence of delta wave, short PRI, and Bundle of Kent; can lead to VF

Question 10

Lown-Ganong-Levine (LVL) syndrome

Answer 10

LVL syndrome is characterized by no delta wave and short PRI; anatomically caused by James fibers

Question 11

Inferior lead locations

Answer 11

lead II, lead III, and aVF

Question 12

Midclavicular line location

Answer 12

V4

Question 13

Pacemaker malfunctions

Answer 13

1. Failure to capture (indicated by missing QRS) 2. Undersensing (indicated by unorderly pacemaker spikes) 3. Competition (indicated by crazy pacemaker spikes all over waveform) 4. Runaway pacemaker 5. Battery failure

Question 14

Twiddler’s syndrome

Answer 14

Twiddler’s syndrome occurs when a pacemaker rotates and slowly pulls lead wire around itself; can cause sudden cardiac arrest.

Question 15

Hyperkalemia versus hypokalemia

Answer 15

HYPERKALEMIA: characterized by peaked T wave and widening of QRS. HYPOKALEMIA: characterized by the blunting of T wave and appearance of U wave.

Question 16

Anterior axillary line location

Answer 16

V5

Question 17

Pericarditis

Answer 17

characterized by ST-segment elevation in aVR and V1 and PR-segment depression in other leads

Question 18

Hypothermia

Answer 18

characterized by Osborn wave/”camel-hump” and slow rate

Question 19

Hypercalcemia versus hypocalcemia

Answer 19

HYPERCALCEMIA: characterized by inverse and short QT. HYPOCALCEMIA: characterized by normal and long QT.

Question 20

Mid-axillary line location

Answer 20

V6