EKG 2

Question 1

p waves always upright

Answer 1

lead I, II

Question 2

left axis deviation

Answer 2

-30 to -90

Question 3

normal axis

Answer 3

-30 to +90

Question 4

right axis deviation

Answer 4

+90 to +180

Question 5

extreme right axis deviation

Answer 5

-90 to -180

Question 6

axis - biphasic lead

Answer 6

0 or +/-90

Question 7

axis- biphasic lead aVF

Answer 7

0 or +/-180

Question 8

axis-biphasic lead II/ III

Answer 8

+/-30 or +/-150

Question 9

axis-biphasic lead aVR/ aVL

Answer 9

+/-60, +/-120

Question 10

fine tuning axis

Answer 10

biphasic more + - add +10 degrees
biphasic more -
add -10 degrees

Question 11

LAE

Answer 11

wide notched p in lead II
biphasic in V1 with terminal portion larger than 1 box
shift of p wave axis right

Question 12

RAE

Answer 12

tall, peaked p in lead II
biphasic in V1 with initial segment greater than 2 boxes
shift of p wave axis left

Question 13

biatrial enlargement

Answer 13

biphasic p wave with terminal component greater than 1 box in height and length
p wave in lead II greater than 3 boxes

Question 14

left BBB

Answer 14

bunny ears

V5, V6

Question 15

right BBB

Answer 15

RSR’

V1, V2

Question 16

prolonged QT

Answer 16

CHF, MI
low Ca, K, Mg
quinidine
procainamide

Question 17

short QT

Answer 17

high K, Ca

digitalis use

Question 18

J point

Answer 18

btwn QRS and ST segment

Question 19

ST elevation

Answer 19

injury, ins\tense ischemia
coronary vasospasm
ventricular aneurysm
diffuse - pericarditis with appropriate hx

Question 20

ST depression

Answer 20

angina attack
subendocardial infarct
positive exercise or chemical stress test
digitalis

Question 21

Wellens syndrome

Answer 21

T wave inversion in V2, V3

stenosis of LAD

Question 22

flat t wave

Answer 22

hypokalemia

Question 23

broad, peaked t wave

Answer 23

hyperkalemia or acute ischemia

Question 24

u waves

Answer 24

hypokalemia
bradycardia
digitalis
amiodarone
once > 2 mm, high potential for lethal arrhthmias like Torsades de Pointes

Question 25

inverted u wave

Answer 25

ischemia, HTN, Av valvular disease, RVH

Question 26

lateral wall

Answer 26

aVL, I, V5, V6

left circumflex

Question 27

inferior wall

Answer 27

II, II, aVF

usually RCA, sometimes LAD

Question 28

septal wall

Answer 28

V1, V2

Question 29

anterior wall

Answer 29

V3, V4

LAD

Question 30

anteroseptal wall

Answer 30

V1, V2, V3, V4

Question 31

high lateral wall

Answer 31

I, aVL

Question 32

low lateral wall

Answer 32

V5, V6

Question 33

apical wall

Answer 33

II, III, aVL, V1, V2, V3, V4

Question 34

true posterior wall

Answer 34

tall R in V1, V2
ST depression in V1, V2
RCA

Question 35

STEMI ECG evolution

Answer 35

t wave inversion
t wave peaked and upright
ST elevation, depression
Q waves develop (cell death)
t wave inversion

Question 36

LVH

Answer 36

left ventricular hypertropy

• prominent voltage:
  1. aVL > 11 mm
  2. S in V1 plus the R in V5 or V6 > 35 mm
  3. Any R plus any S of the precordial (V1-V6 leads) > 45 mm

Question 37

RVH

Answer 37

right ventricular hypertrophy

1. V1 - R wave > S wave or R wave > 7 mm ( make sure to consider RBB and TPWMI as well)
2. RV strain - ST depression in V1-V3

Question 38

LAFB

Answer 38

Left axis deviation

S wave > R wave in II, II, aVF w/o MI

Question 39

LPFB

Answer 39

R axis shift
right axis deviation
normal QRS and no RVH

Question 40

Afib atrial rate

Answer 40

350-450 / min

Question 41

delta wave

Answer 41

slurring of ARX in upstroke - 45 degrees, slow

Wolf-Parkinson-White syndrome where SVT is present too