cardiac, EKG, CXR videos Flashcards

Question

Medical Basics EKG for Beginners: which three leads are considered to determine of the axis is normal or abnormal?

Answer 1

I, II, aVR | P waves upright in I, II, inverted in aVR

Answer 2

P wave is inverted in aVR lead

Answer 3

LVH L anterior fascicular block inferior MI

Answer 4

RVH L posterior fascicular block lateral MI

Answer 5

I aVL V4-V6

Answer 6

III aVR V1-V3

Answer 7

II III aVF

Answer 8

I aVL V5 V6

Answer 9

>0.12 seconds = wide | but don't ignore .10 - .12 seconds

Answer 10

are P waves upright in leads I and II, and inverted in aVR? Is every P wave followed by a QRS? "yes" to both? good!

Answer 11

sinus tach 2:1 atrial flutter SVT

Answer 12

``` A Fib (MC) variable A flutter (variable block) MAT (multifocal atrial tachycardia) ```

Answer 13

VTach SVT w/ BBB sinus tach w/ BBB antidromic WPW

Answer 14

PMVT = PolyMorphic VTach AFib w/ WPW AFib w/ BBB

Answer 15

short positive deflection following the down stroke of the R wave producing a fish hook appearance this is helpful to differentiating benign early depolarization vs STEMI

Answer 16

STEMI pericarditis vasospasm PE LV aneurysm LV hypertrophy L BBB benign early repolarization

Answer 17

``` NSTEMI posterior MI L BBB LVH w/ strain reciprocal changes digoxin toxicity ```

Answer 18

benign early repolarization hypothermia hypercalcemia Brugada syndrome

Answer 19

downsloping horizontal upsloping horizontal ST depression can be harbinger of ischemia - don't send this pt home! (also, the upsloping in V1-V3 with peaked T waves can mean proximal LAD occlusion)

Answer 20

J point/ST segment at least 0.5 mm below isoelectric line in two contiguous leads

Answer 21

T-wave inversion hyperacute T wave biphasic T wave flat T wave

Answer 22

t-wave inversion by itself in aVL - this may be a sign of impending inferior wall MI...so keep getting serial EKGs

Answer 23

``` LVH strain increased ICP PE BBB ischemia ```

Answer 24

it's not abnormal to have T wave inversion in V1, V2, or lead III

Answer 25

vasospasm | early STEMI

Answer 26

ischemia | hyperkalemia

Answer 27

ischemia | hypOkalemia

Answer 28

BBB hyperkalemia ``` (also: VTach WPW paced rhythm meds (TCA)) ```

Answer 29

sign of proximal LAD occlusion | "Wellens-A criteria"

Answer 30

think HYPERKALEMIA, and check the potassium

Answer 31

hyperkalemia hypermagnesemia ischemia

Answer 32

De-Winters T-waves are signs of ischemia....they are STEMI equivalent, peaked T waves in V1 to V3 area, plus upsloping ST depression....get scared for proximal LAD occlusion

Answer 33

``` RIPE R = rotation I = inspiration P = projection E = exposure ``` (not the TB RIPE)

Answer 34

``` ABCDE A = airway B = breathing C = cardiology D = diaphragm E = everything else (bones, fxs, lytic lesions, etc.) ```

Answer 35

a depression that is at least 1mm or greater below the isoelectric line

Answer 36

``` pt name DOB date of XR where XR taken see if pt has any previous XRays ```

Answer 37

posterior: 9

Answer 38

anterior: 5-6

Answer 39

AP film will make heart look slightly larger than it is

Answer 40

pleural effusion LEFT pneumothorax RIGHT collapsed lung

Answer 41

sternal angle (angle of Louis)

Answer 42

apical upper middle lower

Answer 43

make sure the width of the heart is not more than 50% of the width of the thoracic window

Answer 44

yes, you may see air under the left side of the diaphragm b/c air is in the fundus of the stomach

Answer 45

``` confirm pt, DOB, date of XRay RIPE ABCDE say what you see review positive findings ```

Answer 46

1) >0.04 seconds ("very wide"), ORRRRR 2) >2 mm in depth (from isoelectric line), ORRRR 3) >25% of QRS complex height

Answer 47

V1-V2 --> deep big S wave (maybe even a little biphid shape) V5-V6 --> the 'M' shape

Answer 48

V1-V2 --> R-S-R' pattern V5-V6 --> super wide S wave, slurred even

Answer 49

V1-V3 seeing Q waves in V1-V3 = pathological Q waves

Answer 50

MI (old or new) PE LBBB LVH

Answer 51

pericardial effusion is the big concern (esp if there is increased HR and SOB) (think about reasons why the conduction is not getting through to the electrodes)

Answer 52

anterior MI | RVH with strain

Answer 53

it's a big R-wave in V1, V2, or V3 (R waves are supposed to be small in these leads, and definitely shouldn't be greater than the S waves!)

Answer 54

I'm most nervous for POSTERIOR MI, but make sure to r/o: RBBB and RVH

Answer 55

``` antiarrythmics antibiotics antipsychotics antidepressants antiemetics ``` ischemia hypokalemia hypomagnesemia hypocalcemia

Answer 56

L BBB LVH inferior MI hyperkalemia

Answer 57

R BBB RVH anterior MI VTach

Answer 58

extreme RVH VTach severe obesity

Answer 59

1 mm of elevation from isoelectric line in any two contiguous leads except V2 or V3, where it's 2 mm of elevation

Answer 60

if the J point is >= 0.5 mm below isoelectric line in any two contiguous leads

Answer 61

benign early repolarization (add the proper leads to the question) (??)

Answer 62

benign early repolarization hypothermia hyperkalemia Brugada syndrome

Answer 63

V2/V3 biphasic T waves beginning with a positive deflection followed by a negative deflection don't know why it's important

Answer 64

progressively increasing amplitude of R waves from V1-V6

Answer 65

posterior MI RBBB RVH

Answer 66

Osborn wave

Answer 67

1) crooked pt? 2) ensure lung apices are visible above clavicles 3) ensure vertebral spinous processes bisect the distance b/w the medial ends of the clavicles

Answer 68

make sure 9-10 posterior ribs are visible

Answer 69

identify thoracic vertebrae

Answer 70

long volume appears falsely low lung markings are falsely prominent, giving false appearance of pulm edema cardiac silhouette/mediastinum appear falsely enlarged

Answer 71

costophrenic angles are not visible gastric air bubble, or intraperitoneal free air, not visible

Answer 72

density thickness duration of exposure

Answer 73

UNDERexposed, too bright

Answer 74

OVERexposed, too dark

Answer 75

duration of exposure energy of photons source-to-image distance

Answer 76

R Lung L Lung horizontal oblique oblique

Answer 77

nothing, it's normal

Answer 78

density and thickness

Answer 79

1 - the less-experienced clinicians need a system 2 - the system should include all aspects of a CXR 3 - the system should be logical and/or easy to remember 4 - always start with the eval of the CXR technical quality

Answer 80

ribs clavicles vertebral bodies sternum

Answer 81

RIGHT: ascending aorta R pulm artery R atrium ``` LEFT: aortic arch window L pulm artery L atrium L ventricle descending aorta ```

Answer 82

``` A = airways B = bones & soft tissue C = cardiac silhouette and mediastinum D = diaphragm & gastric bubble E = effusions (i.e. pleural) F = fields (lung) and findings (lines, tubes, devices) ```

Answer 83

a very pronounced costophrenic angle/sulcus

Answer 84

``` subcutaneous = tissue beneath skin emphysema = "trapped air" ``` air that leaks from chest cavity, often found in chest, neck, face; it travels along the fascia

Answer 85

blunting of posterior costophrenic angle on lateral view fluid may track up the pleura

Answer 86

fluid accumulation b/w lung base and diaphragm which does not track up the pleura, does not blunt costophrenic angle

Answer 87

1 - diaphragm appears to peak more lateral than normal 2 - diaphragm appears more horizontal than normal 3 - on L: abnormally large distance b/w gastric bubble and lung base 4 - on R: abnormally high horizontal fissure

Answer 88

the R ventricle fills the retrosternal space

Answer 89

enlarged L atrium stretching over the R atrium

Answer 90

lymphadenopathy

Answer 91

COPD barrel chest

Answer 92

water bottle sign | oreo cookie sign

Answer 93

technical errors, sign of a suboptimal CXR three of them are: rotation poor inspiratory effort AP view

Answer 94

technical errors, sign of a suboptimal CXR three of them are: rotation poor inspiratory effort AP view

Answer 95

maliignancy infection other

Answer 96

anterior superior middle posterior

Answer 97

pleural effusion large mass pneumothorax

Answer 98

collapsed lung (atelectasis) lobectomy/pneumonectomy fibrosis

Answer 99

an extra rib that arises from the 7th cervical vertebrae

Answer 100

cervical ribs can cause thoracic outlet syndrome

Answer 101

found in unusual locations that defy gravity won't shift when pt lays in lat decubitus position

Answer 102

if pulmonary vessels are visible THROUGH a mass, then the mass is not in the hilum (a hilar mass would obscure the pulmonary vessels)

Answer 103

poor inspiratory effort suboptimal timed exposure restrictive lung disease subpulmonic effusions

Answer 104

``` alveolar opacities (aka "airspace opacities") interstitial opacities ```

Answer 105

any cause of congestive heart failure

Answer 106

acute lung injury (ALI) acute resp distress syndrome (ARDS)

Answer 107

multilobar pneumonia diffuse alveolar hemorrhage

Answer 108

reticular nodular reticulonodular

cardiac, EKG, CXR videos Flashcards

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