EKG

Question 0

What are the leads associated with LCX?

Answer 0

Lead I and aVL

V5-6

Question 1

What does it mean if the rate is over 300?

Answer 1

It is artifact or non-mammalian.

Question 2

What leads are associated with RCA?

Answer 2

Lead II, III, aVF

V1-3

Question 3

What does a rate of 200 make you think?

Answer 3

Bypass tract

Question 4

What does a rate of 150 or close to 300 make you think?

Answer 4

A fib or a flutter

Question 5

What does a rate of 160+ make you think?

Answer 5

PSVT

Question 6

At what rate is it probably no longer sinus tachy?

Answer 6

140+

Question 7

What is the rate at which the AV node takes over?

Answer 7

50

Question 8

At what rate do the ventricles take over?

Answer 8

40

Question 9

Why is Lead I my friend?

Answer 9

Because all the waves should be positive in this lead and if they aren’t it means an abnormal heart

Question 10

What is a q wave?

Answer 10

A negative force before the R wave

Question 11

How can you kill someone with pericarditis?

Answer 11

By missing it and calling the cath lab. Can cause tamponade

Question 12

In what lead should all waves be negative?

Answer 12

AVR

Question 13

What should you do if there is isolated ST elevation in aVR?

Answer 13

Look for ST depression in other leads because this is an LAD or left main issue

Question 14

What else should you think of if you see positive waves in aVR?

Answer 14

TCA overdose

Question 15

How long should QT be?

Answer 15

No longer than 440 ms (11 boxes)

Question 16

What are Sgarbossa’s rules for reading a MI in the setting of a bundle branch block?

Answer 16

1. Concordat ST elevation
2. Discordant ST elevation over 5 mm
3. Concordat ST depression in V1-V3

Question 17

What does diffuse ST elevation mean?

Answer 17

Pericarditis

Question 18

What is first degree AV block?

Answer 18

Increased PR interval greater than .2

Question 19

What does an infarct in the widow maker look like?

Answer 19

ST elevation in I, aVL, V1-V4

ST depression in II, III, aVL

Question 20

What does a negative R wave with a large hump mean?

Answer 20

Ventricular aneurysm

Question 21

How can you kill someone with an ventricular aneurysm?

Answer 21

Giving thrombolytics because there could be a clot in the aneurysm

Question 22

What does an inferior wall MI look like?

Answer 22

ST elevation in II, III, aVF

ST depression in I, aVL, V5-6

Question 23

What does S1Q3T3 mean?

Answer 23

S1- negative deflection in lead 1 which indicates right heart strains
q3- shows a q wave in lead III
T3: means an inverted T wave in lead 3

pulmonary embolism

Question 24

What is a poor prognostic indicator in PE?

Answer 24

T wave inversions in v1-3

Question 25

What else might you see in right heart strain?

Answer 25

Big R waves

Question 26

What determining axis what is most important?

Answer 26

Look at lead I and aVF then lead II - area under the curve is what matters

Question 27

What does an inferoposterior wall MI look like?

Answer 27

ST elevations in II, III, aVF, V5-6 ST depression in I, aVL, V1-3 T wave inversion in V1-3

Question 28

What artery is blocked in inferoposterior wall MI?

Answer 28

Proximal RCA

Question 29

What are the five treatments of WCT?

Answer 29

``` Amiodarone Lidocaine Mg Procainamide Shock ```

Question 30

What points toward a right atrial abnormality?

Answer 30

Big p waves in the inferior leads | Rightward p axis

Question 31

What is unique about type I second degree heart block?

Answer 31

Regularly irregular | Increased PR interval and then a dropped beat

Question 32

What should wide QRS make you think of?

Answer 32

Heart block

Question 33

How can you tell which side the block is on?

Answer 33

The area under the curve in lead I will tell you Positive= left Neg= right

Question 34

Wide complex with p's connected =?

Answer 34

BBB

Question 35

What is the first EKG change you see in hyperkalemia?

Answer 35

Peaked t waves

Question 36

What is the order of changes in the EKG with hyperkalemia?

Answer 36

1. Peaked t waves 2. PR prolongation 3. P wave disappearance 4. Widened QRS

Question 37

What do you see in hypokalemia?

Answer 37

1. U waves (V4-6) 2. ST depression 3. Decreased amplitude of the T wave 4. QT prolongation (especially less than 3.0)

Question 38

St elevation in I, aVL, V1-V3 with reciprocal changes?

Answer 38

Anterolateral infarct (lesion in the LAD)

Question 39

What would right atrial abnormality look like?

Answer 39

Inverted p waves | P waves in lead II greater than 2.5 mm

Question 40

What would left atrial abnormality look like

Answer 40

P wave width greater than 3 boxes in lead II Negative deflection in V1 greater than 1 mm and 40 msec Notched p waves in lead II

Question 41

What is LVH?

Answer 41

Amplitude of S in V1 + R in V5 or V6 greater than 35 mm