EKG

Question 1

Normal P-wave duration

Answer 1

2-2.5 boxes (80-100 msec)

Question 2

Normal PR interval

Answer 2

3-5 boxes (120-200 msec)

Question 3

Normal QT interval

Answer 3

5-10 boxes (200-400 msec)

Question 4

What EKG finding indicates NSR?

Answer 4

P-wave is upside down in aVR

OR there is a p-wave preceding every QRS in aVR

Question 5

What EKG finding indicates L axis deviation, and what causes it?

Answer 5

QRS is up in Lead I, down in aVF

Caused by LV hypertrophy

Question 6

What EKG finding indicates R axis deviation, and what causes it?

Answer 6

QRS is up in aVF, down in Lead I

Caused by emphysema or “vertical heart”

Question 7

What EKG finding indicates infarct and what does this mean?

Answer 7

ST segment elevation

Indicates chronic, non-reversible ischemia

Question 8

What EKG finding indicates injury and what does this mean?

Answer 8

ST segment depression
Indicates acute, reversible ischemia (exercise induced)

(T-wave inversion is a less reliable indicator of this)

Question 9

What EKG finding indicates hypertrophy?

Answer 9

QRS amplitude >7 big boxes

QRS duration >3 small boxes

Question 10

Atrial rate for atrial flutter

Answer 10

250-350 bpm

Question 11

Atrial rate for atrial fibrillation

Answer 11

> 400 bpm

Question 12

Ventricular rate during a-flutter/ a-fib?

Answer 12

Normal (AV node acts as filter so ventricle maintains normal rate)

Question 13

Sxs of a-flutter/fib

Answer 13

rapid HR, syncope, CO < 20% b/c ventricle not filling, risk of clotting

Question 14

What EKG finding indicates 1st degree AV node block?

Answer 14

PR interval >5 boxes (200 msec)

Question 15

What EKG finding indicates 2nd degree AV block (Mobitz type I/ Wenckebach)?

Answer 15

Progressively increasing PR interval with periodic dropped QRS…then resets and repeats

Question 16

What EKG finding indicates 2nd degree AV block (Mobitz type II)?

Answer 16

Fixed number of dropped QRS between p waves

Question 17

What EKG finding indicates 3rd degree AV node block?

Answer 17

Completed QRS block with no association between P and QRS
Normal, consistent p-wave, unmarried to QRS
Time between p wave and QRS is variable

Question 18

What EKG finding indicates Bundle Branch Block?

Answer 18

WRS widening and/or RR’

Question 19

What EKG finding indicates PVC?

Answer 19

Additional ventricular contractions w/o p-wave (QRS looks very different than the others)

Question 20

Ratio of normal QRS:PVC

Answer 20

Bigeminy 1:1
Trigeminy 2:1
Quadrigeminy 3:1

Question 21

PVC in pairs

Answer 21

Ventricular couplet

Question 22

When is a PVC benign/ not?

Answer 22

Benign: <30 seconds
Abnormal: >6 PVCs/min

Question 23

What EKG finding indicates ventricular tachycardia?

Answer 23

> 3 ventricular beats faster than 100bpm
No associated p-waves
Rhythmic and consistent QRS shape

Life threatening b/c can lead to v-fib

Question 24

What EKG finding indicates ventricular fibrillation?

Answer 24

Little to no organization or waves –> no functional ventricular systole
Pulselessness
Immediate defib required

Question 25

Pacer Rhythm

Answer 25

Impulse spike

Wide QRS

Question 26

What EKG finding indicates AV node issue in general?

Answer 26

Dropped QRS