Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MDT's > EKG > Flashcards

EKG Flashcards

1
Q

Where are your lead placements?

A 
V1 - 4th ics r sternal
V2 - 4th ics l sternal
V3 - between V2 and V4
V4 - 5th ics midclavicular
V5 - 5th ics anterior axillary
V6 - 5th ics midaxillary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the QT interval represent

A

Time between ventricular depolarization and repolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Time for QT interval?

A

.36 - .44 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PR interval normal time?

A

0.12 - 0.2 secs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

QRS complex time?

A

(Just smaller than P wave)

< 0.12 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does ST depression represent?

A

Myocardial ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does ST elevation represent?

A

Full Thickness Myocardial Infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does a T wave inversion that looks like a U (other than in V1) represent?

A

Ischemia (just remember if its below the line it’s ischemia - same as ST segment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What leads represent the lateral aspect of the heart?

A

I, aVL, V5-V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What leads represent the inferior aspect of the heart?

A

II
III
aVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What leads represent the anterior area of the heart?

A

V3

V4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is indicative of a left bundle branch block?

A

Wide QRS ( taking longer for signal to get to left ventricles for depolarization )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the gold standard for diagnosing cardiac arrythmias?

A

ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are your treatment options for cardiac arrythmias?

A

ABCs, IV, O2, Monitor (ALWAYS)

  • antiarrythmics
  • cardioversion
  • transcutaneous pacing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the complications of arrythmias?

A

Decreased cardiac perfusion

  • AMI
  • Syncope
  • Cardiac Arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the normal intrinsic rate for a Sinus rhythm?

A

60 - 100 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Textbook Sinus Brady symptoms?

A

Normal sinus rhythm but < 60bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Symptoms of severe bradycardia?

A

< 45 bpm

  • weakness
  • syncope
  • N/V
  • lightheaded
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

1st step to treating bradycardia?

A

Identify if stable or unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Signs of unstable arrythmias?

A
  • Change in mental status
  • Ischemic chest discomfort
  • Hypotension
  • Signs of shock
  • Acute heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you treat unstable brady?

A

Atropine 0.5mg IV, repeat q3-5 min max 3mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why would atropine not work for brady?

A

If the SA node is not actually being inhibited by vagal tone, then atropine will not have an effect. Atropine only inhibits vagal input

  • Heart transplant removes vagus nerve innervation with the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is Mydriasis a side effect of atropine?

A

Yup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What do you use if atropine is ineffective?

A 
Transcutaneous pacing
OR
Dopamine IV 2-10mcg/kg/min
OR
Epi IV 2-10mcg/min (1:10,000)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Issues with severe brady?

A

Poor cardiac output leading to issues that would result from that

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Tachycardia is what hr?

A

> 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Are there any abnormalities on the ECG for Sinus Tachy?

A

Nope just greater than 100 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

First treatment for Sinus Tachy?

A

Basics: ABCs, IV, O2, Monitor

Treat underlying cause

Determine stable vs unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What classifies an arrythmia as unstable?

A

MISHA is looking Ischemic

M - mental status
I - ischemic chest discomfort
S - shock
H - hypotension
A - acute heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

PSVT means?

A

Paroxysmal SVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does paroxysmal mean

A

comes and goes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

So supraventricular means?

A

From above the ventricles nerd

33
Q

What symptoms would you expect for a SVT?

A
  • Palpitations
  • SOB
  • Chest pain
  • SVT doesn’t typically last
34
Q

Whats the most common mechanism of PSVT?

A

Atreioventricular Nodal Reentry Tachy

35
Q

HR for PSVT?

A

150 - 240

36
Q

Unstable arrythmia symptoms?

A

MISHA is ischemic

M - mental status changes
I - ischemic chest discomfort
S - shock
H - hypotension
A - acute heart failure
37
Q

What are your ecg findings for PSVT?

A
  • HR 150-220
  • P wave somewhere in the QRS
  • Narrow QRS
  • Regular R-R interval (so it’s regular just super fast and a tiny qrs)
38
Q

First treatment for any arrythmia?

A

ABCs, Monitor, IV, O2

Determine Stable vs Unstable

40
Q

What can you do as a mechanical measure to reduce tachycardia?

A

Stimulate vagal nerve:

  • Valsalva
  • hold breathe
  • face in cold water
  • carotid sinus pressure 10-20 sec
41
Q

First line Drugs for PSVT unstable

A

3 Strikes and you’re out

  1. Adenosine 6mg IV with saline flush
  2. Repeat with 12mg
  3. Third time is it at 12mg but that’s it
42
Q

What does it mean when we say hemodynamically stable?

A

Blood pressure and HR are controlled, so when you see BP “crashing” this person is no longer hemodynamically stable

43
Q

Treatment for no longer hemodynamically stable with PSVT

A

Synchronized cardioversion 50-100J

44
Q

What is Wolf Parkinson White Syndrome?

A

Basically there is a bypass of the AV node and can cause reentry arrhythmias - leading to PSVT

45
Q

Second line drugs for PSVT?

A

Metoprolol - 5mg IV / 50mg PO (AMAL)

Diltiazem - .25mg/kg IV

46
Q

Symptoms of WPW?

A

Same as PSVT

  • SOB
  • Chest pain
  • Palpitations
47
Q

Basic first treatment of all arrhythmias?

A

ABCs, Monitor, IV, O2

Determine if stable vs unstable

Treat underlying causes

48
Q

Treatment for Unstable WPW

A

Immediate Cardioversion 50-150J

Adenosine 6mg, then 12, then 12

Metoprolol 5mg IV / 50mg PO

49
Q

What J do we always cardiovert at for arrythmias?

A

50 - 150 J

50
Q

Definitive treatment for WPW?

A

Cardiologist for catheter ablation

51
Q

What is the most common chronic arrythmia?

A

A FIB

52
Q

What is A FIB

A

Electrical storm in the atria just firing off causing it to fibrillate and not contract in an organized manner

53
Q

ECG findings for A-Fib

A

Just a wavy line (wavy baseline)

Irregularly Irregular R-R interval

54
Q

What diseases may increase occurence of A-Fib?

A 
HTN
Pericarditis
Holiday heart (alcohol)
Excess caffeine
Electrolyte abnormalities (potassium and magnesium)
55
Q

Is A-Fib life threatening?

A

Only when ventricular rate starts creating unstable conditions

56
Q

What does A-fib pre-dispose patients to?

A

Thromboembolic events

57
Q

What are increased risk factors for A-Fib and stroke?

A
  • HTN
  • Dyslipidemia
  • CHF
  • History of embolisms
58
Q

Any hallmarks for A-Fib?

A

Wavy baseline ECG

Dyspnea on exertion

59
Q

Why do you not cardivert for patients with A-Fib longer than 48 hours?

A

Pooling of blood in ventricles, so without anticoagulation therapy, pt may throw a clot

60
Q

What do you do for someone that has had A FIB for longer than 48h?

A

Anticoagulants for 3 weeks prior to cardioversion

61
Q

What is the goal of treatment for A FIB?

A

focus on ventricular rate control

62
Q

Treatment meds for arrythmia portion of AFIB?

A

Metoprolol 5mg IV / 50mg PO

Diltiazem .25mg IV

63
Q

Treatment meds for anticoagulation of A FIB?

A

Enoxaoarin 1mg/kg SC q 12h

weakens clot formation

64
Q

What is Atrial Flutter usually associated with?

A

Pulmonary disease

65
Q

What is the atrial rate in A FIb?

A

400 bpm

66
Q

What is the atrial rate in A Flutter?

A

250 - 350 bpm

67
Q

ECG presentation of Atrial Flutter?

A

A-Flutter has lots of P waves, but they are not always conducting a QRS - 2:1, 3:1, 4:1

Saw tooth flutter waves between QRS complexes

68
Q

Goal of treatment for A flutter?

A

Convert AF to sinus rhythm

Control ventricular rate
metoprolol and diltiazem

69
Q

Is A flutter ventricular rate easier or harder to control than A FIB?

A

It’s harder to control with Metoprolol or Diltiazem than A FIB

70
Q

Treatment for unstable A-Flutter?

A

Immediate cardioversion 100-200J

71
Q

What are the 3 types of V-Tach

A
  • Non-sustained - 3 or more premature beats lasting < 30 seconds and terminating
  • sustained
  • Pulseless
72
Q

What are the most common causes of V-Tach?

A
  • AMI
  • ischemic heart disease
  • electrolyte abnormalities
73
Q

EKG presentation of V-Tach?

A

Wide QRS (longer than .12)

No P waves

HR > 160 - 240

Moderate regular R-R interval

74
Q

Can you be asyptomatic with V-Tach?

A

Yes

75
Q

Basic treatment for VTach?

A

ABCs, Monitor, IV, O2

76
Q

Treatment for pulseless Vtach?

A

ACLS protocol

77
Q

Treatment for stable VTACH?

A

MEDAVICE and possibly antiarryhtmia drugs

78
Q

Treatment for unstable VTACH?

A

immediately perform synchronized cardioversion 100 - 200J

79
Q

Treatment meds for VTACH

A

Lidocaine .5mg/kg IV q5-10 min

Amiodarone 150mg IV over 10 min

Magnesium 2g IV (if low magnesium levels due to diuretics, alcoholism, diarrhea, or acute pancreatitis)

80
Q

Though WPW sydnrome can be associated with PSVT, what are the differences in the ECG?

A
  • Wide, slurred QRS with a delta wave

* Short PR interval (not hidden and < .12)

MDT's (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions