Drugs/Electrolyte Effects (Exam #2)

Question 1

What condition involves diffuse ST segment elevation?

Answer 1

Pericarditis

Question 2

With Acute Pericarditis, what two findings may be seen on EKG?

Answer 2

• Diffuse ST segment elevation

- T wave inversion

Question 3

What is seen on EKG with Pericarditis WITH Effusion?

Answer 3

Low voltage/amplitude in all leads

Question 4

What is Electrical Alternans, and what condition may it be seen with?

Answer 4

Amplitude of QRS alternates with every other beat

- Seen with Pericarditis

Question 5

What specific finding may be seen on EKG with a small PE? What if it’s a massive PE?

Answer 5

• Small PE: sinus tachycardia

- Massive PE: S1-Q3-(upside-down T)3 = deep S wave in lead I, deep Q wave in lead III, inverted T wave in lead III

Question 6

What condition involves S1-Q3-(upside T)3, and what does this mean?

Answer 6

Massive PE

• Deep S wave in lead I
• Deep Q wave in lead III
• Inverted T wave in lead III

Question 7

What rhythm finding is commonly seen with a PE?

Answer 7

Tachyarrhythmias

Question 8

What is QTc Interval? When is it considered prolonged for male vs. female?

Answer 8

QTcI = depolarization and repolarization corrected for HR

• Prolonged QTcI for MALES = 0.44+ seconds
• Prolonged QTcI for FEMALES = 0.46+ seconds

Question 9

What are you at increased risk of with QTc Interval of 0.50+ seconds?

Answer 9

TdP

Question 10

What is a visual hint for a normal QT interval?

Answer 10

Normal QTI is less than HALF the R-R interval

Question 11

What is a general rule for all HYPO- electrolyte abnormalities? What are you at increased risk for?

Answer 11

QTI prolongation

- Increased risk of VTach or TdP

Question 12

What three specific findings are seen on EKG with Hyperkalemia?

Answer 12

• Tall/peaked T waves
• “Sine waves” = S and T waves merge/indistinguishable
• Wide QRS

Question 13

What specific finding is seen on EKG with Hypokalemia?

Answer 13

U waves following flat T waves

Question 14

What are “sine waves”, and what condition are they seen with?

Answer 14

S and T waves merge/indistinguishable

- Seen with Hyperkalemia

Question 15

What condition involves U waves?

Answer 15

Hypokalemia

Question 16

What two abnormalities/drugs involve shortened QTI?

Answer 16

• Hypercalcemia

- Digoxin (therapeutic levels, worse if toxicity)

Question 17

What electrolyte abnormality involves shortened QTI, and why is this?

Answer 17

Hypercalcemia

- Shortened refractory period

Question 18

What specific finding is seen on EKG with Hypercalcemia?

Answer 18

Shortened QTI

Question 19

What specific finding is seen on EKG with Hypocalcemia?

Answer 19

Prolonged QTI

Question 20

What EKG finding is seen with general Digoxin use?

Answer 20

Shortened QTI

Question 21

What two EKG findings are seen with “Digoxin Effect”?

Answer 21

• Shortened QTI

- Gradual downward curve of ST segment

Question 22

What two EKG findings are seen with Digoxin toxicity?

Answer 22

• WORSE shortened QTI

- Tachydysrhythmia

Question 23

What is the most common tachydysrhythmia associated with Digoxin toxicity?

Answer 23

PAT with 2nd degree AV block (2:1)

Question 24

What abnormality makes Digoxin toxicity worse?

Answer 24

Hypokalemia

Question 25

What specific finding is seen on EKG with Hypothermia?

Answer 25

Osborn waves

Question 26

What are Osborn waves, and what condition are they associated with?

Answer 26

Hypothermia | - Osborn waves = ST segment elevation then abrupt ascent at J point then plunge back to baseline

Question 27

What three things are prolonged with Hypothermia?

Answer 27

- PRI - QRS - QTI

Question 28

What condition is associated with sudden cardiac death? What is its etiology?

Answer 28

Brugada Syndrome | - Autosomal Dominant disorder

Question 29

What EKG finding is seen with Brugada Syndrome?

Answer 29

Variable ST segment elevation abnormalities in V1-V3 (3 types)

Question 30

What condition involves variable ST segment elevation abnormalities in V1-V3?

Answer 30

Brugada Syndrome

Question 31

What five abnormalities/drugs involve prolonged QTI?

Answer 31

- Hypocalcemia - Antiarrhythmics - TCAs - Phenothiazines - Macrolides

Question 32

With QTI prolongation, what are you at increased risk for?

Answer 32

TdP