EKG

Question 1

Rate

Answer 1

300, 150, 100, 75, 60, 50

Question 2

Rhythm

Answer 2

II - upright P wave
distance between P & QRS > 0.2 = 1st degree block
PR extended
QRS wide vs narrow

Question 3

Axis (QRS)

Answer 3

+ I, + aVF = Normal
+ I, - aVF = LAD - LVH, LBBB, LAHB
- I, + aVF = RAD - RVH, RBBB, LAHB
- I, - aVF = extreme RAD

Question 4

Hypertrophy

Answer 4

RVH - V1: R >S, RAD - neg QRS in I due to pulmonary disease, CHD
LVH - V1/2 (S) + V5/6 (r) > 35 mm

Question 5

Ischemia

Answer 5

T wave inversion

Question 6

Injury

Answer 6

ST elevation/depression

Question 7

Infarct

Answer 7

Q wave > 0.04, > 1/3 height QRS in 2 leads

Question 8

Angina

Answer 8

ST depression, Twave squiggle

Question 9

STEMI

Answer 9

ST-segment elevations > 1 mm in two or more contiguous leads, new LBBB, or true posterior infarction on electrocardiography

Question 10

Localization of Acute MI

Answer 10

Inferior - elevation in II, III, aVF
Anteroseptal - elevation in V1 - V2
Lateral and apical - elevation in V4-V6, possible elevations in I and aVL
Posterior wall - depression tall R waves in V1 - V3
Right ventricle - elevation V4R, tall R waves in V1 - V3

Question 11

NSTEMI

Answer 11

elevated cardiac enzymes without ST-segment elevation, often associated with ST segment depression

Question 12

Bundle branch blocks

Answer 12

RBBB - RSR’ in V1/2
LBBB - deep S waves in V5/6, I, aVL - ischemic/degenerative
- monophasic R waves in I, V5, V6

Question 13

Flutter, fib, Torsades

Answer 13

Flutter - sawtooth
A fib - noisy baseline, 0 P, irregular QRS
Torsades - prolonged QT intervals
- hypocalcemia, hypokalemia, hypomagnesium
- amiodarone, flecanide, phenothiazines, TCA’s

Question 14

Alternans

Answer 14

Variation in height of QRS - Pericardial tamponade