ECG

Question 1

U have no Pot no T just a long PR & QT

mnemonic for?

Answer 1

Hypokalemia (no pot)
U waves
absent T waves
Prolonged PR & QT

Question 2

Jesus Quist it’s Bloody Freezing

mnemonic for?

Answer 2

Hypothermia
J waves
prolonged QT
Bradycardia
First degree heart block

Question 3

ECG: digoxin

long QT interval

Answer 3

false

short

Question 4

ECG: digoxin

raised T waves

Answer 4

false

flattened or inverted

Question 5

ECG: digoxin ST wave features?

Answer 5

down-sloping ST depression (‘reverse tick’, ‘scooped out’)

Question 6

ECG: digoxin arrhythmias?

Answer 6

AV block, bradycardia

Question 7

ECG: hyperkalaemia Peaked or ‘tall-tented’ T waves occurs first

Answer 7

true

Question 8

ECG: hyperkalaemia which waves absent?

Answer 8

P waves

Question 9

ECG: hyperkalaemia narrow/broad QRS

Answer 9

broad

Question 10

ECG: hyperkalaemia can lead to VF

Answer 10

true

Question 11

ECG: hyperkalaemia characteristic wave pattern

Answer 11

sinusoidal

Question 12

WiLLiaM MaRRoW looks at changes in which leads

Answer 12

V1 & V6

Question 13

in LBBB there is a ‘?’ in V1 and a ‘?’ in V6

Answer 13

in LBBB there is a ‘W’ in V1 and a ‘M’ in V6

Question 14

in RBBB there is a ‘?’ in V1 and a ‘?’ in V6

Answer 14

in RBBB there is a ‘M’ in V1 and a ‘W’ in V6

Question 15

Bifascicular block features RBBB/LBBB

Answer 15

RBBB

Question 16

Bifascicular block features RBBB alongside right/left hemiblock

Answer 16

left anterior or posterior hemiblock

e.g. RBBB with left axis deviation

Question 17

Trifascicular block includes

features of bifascicular and

Answer 17

1st-degree heart block

Question 18

Posterior STEMI features which ECG changes

Answer 18

Tall R waves V1-2

Question 19

STEMI areas and coronary artery affected

Answer 19

Anteroseptal V1-V4 Left anterior descending

Inferior II, III, aVF Right coronary

Anterolateral V4-6, I, aVL Left anterior descending or left circumflex

Lateral I, aVL +/- V5-6 Left circumflex

Posterior Tall R waves V1-2 Usually left circumflex, also right coronary

Question 20

LBBB/RBBB may point towards a diagnosis of acute coronary syndrome.

Answer 20

LBBB

Question 21

Acute myocardial infarction (MI) T wave changes in first few minutes are T waves typically become inverted

Answer 21

false

hyperacute T waves are often the first sign of MI but often only persists for a few minutes

Question 22

Acute myocardial infarction (MI) T wave changes in first 24 hours

Answer 22

T waves typically become inverted within the first 24 hours

Question 23

Acute myocardial infarction (MI) inversion of the T waves can last for 48 hours

Answer 23

false

days to months

Question 24

Acute myocardial infarction (MI) pathological Q waves develop after several hours to days

Answer 24

true

Question 25

Acute myocardial infarction (MI) pathological Q waves persists infinitely

Answer 25

true

Question 26

clinical symptoms consistent with ACS (generally of ≥ 20 minutes duration) with persistent (> 20 minutes) ECG features in ≥ 2 contiguous leads

Answer 26

true

Question 27

A posterior MI causes ST depression not elevation on a 12-lead ECG.

Answer 27

true

Question 28

ECG features STEMI | in men under 40 years

Answer 28

2.5 mm (i.e ≥ 2.5 small squares) ST elevation in leads V2-3

Question 29

ECG features STEMI | in men over 40 years

Answer 29

≥ 2.0 mm (i.e ≥ 2 small squares) ST elevation in leads V2-3

Question 30

ECG features STEMI in women

Answer 30

1.5 mm ST elevation

Question 31

new LBBB/RBBB is ECG feature of STEMI

Answer 31

new LBBB

Question 32

ECG features STEMI 1 mm ST elevation in other leads (not V2/V3)

Answer 32

true

Question 33

Causes of RBBB

Answer 33

``` right ventricular hypertrophy chronically increased right ventricular pressure - e.g. cor pulmonale pulmonary embolism myocardial infarction atrial septal defect (ostium secundum) cardiomyopathy or myocarditis ```

Question 34

RBBB is a normal variant - more common with increasing age

Answer 34

True

Question 35

Causes peaked T waves includes hyperkalaemia & myocardial ischaemia

Answer 35

True

Question 36

Inverted T waves causes

Answer 36

``` myocardial ischaemia digoxin toxicity subarachnoid haemorrhage arrhythmogenic right ventricular cardiomyopathy pulmonary embolism ('S1Q3T3') Brugada syndrome ```

Question 37

Increased P wave amplitude is a feature of

Answer 37

cor pulmonale

Question 38

Broad, notched (bifid) P waves a sign of left atrial enlargement, classically due to

Answer 38

mitral stenosis | often most pronounced in lead II

Question 39

In atrial fibrillation, there is an absence of P waves.

Answer 39

true

Question 40

Causes of ST depression

Answer 40

``` secondary to abnormal QRS (LVH, LBBB, RBBB) ischaemia digoxin hypokalaemia syndrome X ```

Question 41

A prolonged PR interval may also be seen in athletes

Answer 41

true

Question 42

Causes of a prolonged PR interval

Answer 42

``` idiopathic ischaemic heart disease digoxin toxicity hypokalaemia* rheumatic fever aortic root pathology e.g. abscess secondary to endocarditis Lyme disease sarcoidosis myotonic dystrophy ```

Question 43

A prolonged PR interval may also be seen in WPW

Answer 43

false | short PR

Question 44

Causes of left axis deviation (LAD)

Answer 44

left anterior hemiblock left bundle branch block inferior myocardial infarction Wolff-Parkinson-White syndrome* - right-sided accessory pathway hyperkalaemia congenital: ostium primum ASD, tricuspid atresia minor LAD in obese people

Question 45

Causes of right axis deviation (RAD)

Answer 45

``` right ventricular hypertrophy left posterior hemiblock lateral myocardial infarction chronic lung disease → cor pulmonale pulmonary embolism ostium secundum ASD Wolff-Parkinson-White syndrome* - left-sided accessory pathway normal in infant < 1 years old minor RAD in tall people ```

Question 46

The following ECG changes are considered normal variants in an athlete

Answer 46

sinus bradycardia junctional rhythm first degree heart block Wenckebach phenomenon

Question 47

Causes of ST elevation include

Answer 47

``` myocardial infarction pericarditis/myocarditis normal variant - 'high take-off' left ventricular aneurysm Prinzmetal's angina (coronary artery spasm) Takotsubo cardiomyopathy ```

Question 48

ECG changes WPW

Answer 48

short PR interval wide QRS complexes with a slurred upstroke - 'delta wave' left axis deviation if right-sided accessory pathway* right axis deviation if left-sided accessory pathway*