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EKG Class > EKG Class > Flashcards

EKG Class Flashcards

1
Q
A

DeWinters

ST dep EVERYWHERE + upright Ts

Patient is having a heart attack get em to the cath lab

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2
Q

poor R wave progression

A

< 3 mm by V3

MALL COP (Myocarditis, Anterior MI/Amyloid, LVH, LBBB, COPD, Pneumothorax)

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3
Q
A

Schamroth’s sign = COPD

Lead I –> isoelectric + low voltage

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4
Q

normal PR interval

A

0.12 - 0.20 (< 1 big box)

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5
Q

normal QRS interval

A

0.08 - 0.09 sec (< 1/2 a big box)

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6
Q

normal QT

A

men 0.39 - 0.45, women 0.46 (< 2 big + 1 small box)

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7
Q

low voltage

A

limb leads < 1 big box (5mm)

precordial leads < 2 big boxes (10mm)

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8
Q

causes of low voltage

A

COPD, pericardial probs (effusion, itis), acute MI, hypothyroid, hypothermia, infections (Kawasaki, abscess), post-op fibrosis, obesity, meth

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9
Q

causes of sudden death in young athletes

A

HOCM, commotio cordis, arrhythmogenic right ventricular cardiomyopathy (ARVC, italians, epsilon wave in V1-3)

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10
Q

causes of long QT

A

congenital (Romano-Ward)

metabolic (hypo K, Mg, Ca)

sinus/AV nodes

Rx

…………………………………………………………………………..

3 ANTIs –> antiarrhythmics, anticholinergics AND organophosphate poisoning, antihistamines

6 you take when you’re SICK –> malaria, azoles, FQs, macrolides, HIV, metronidazole

cancer drugs, propofol, opioids, albuterol, zofran, haldol, TCAs, atomoxetine, cocaine

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11
Q

Draw a normal axis

A
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12
Q

Q1

A

normal

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13
Q

Q2

A

right axis deviation, left posterior fascicular block, RVH (pulm HTN)

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14
Q

Q3

A

no

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15
Q

Q4

A

left axis deviation after -30, left ANTERIOR fascicular block

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16
Q

inferior MI

A

II, III, AVF

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17
Q

posterior MI

A

ST dep V1-V2, upright T, large R

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18
Q

low lateral MI

A

V5-6 ST elev

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19
Q

high lateral MI

A

I, AVL ST elev

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20
Q

anterior MI

A

V3-4 = apical

V1-2 = septal

V1-4/5 = anterior

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21
Q

get right sided leads

A

pt with CP/diaphoresis, etc w/ a normal EKG, V4 most sensitive, no nitro, give esmolol

22
Q

serial changes of a STEMI (not reperfused)

A

1 h = ST elev

12 h = ST elev + inverted T

18 h+ = Qs + inverted Ts

23
Q

pathologic Q

A

> 25% R

wider than 0.03 s (1 small box)

24
Q

non-pathologic Q

A

isolated III or V1

small, narrow

25
Q

Q waves all over the place

A

HOCM

26
Q

ST elev w/ well developed Qs

A

LV dyskinesis / LV aneurysm

27
Q

R in V1 or 2, isoelectric ST, upright T

A

old posterior MI

28
Q

MI complications

A

3-8 days after CP

free wall rupture

pap muscle rupture, systolic decrescendo murmur, pulm edema

VSD, holosystolic murmur, thrill

29
Q

sounds of ischemia

A

S4

late systolic murmur (pap muscle)

30
Q

Q wave

A

atrial depol

< 3 mm width and height (~1/2 big box)

big Q = tricuspid stenosis, Ebstein’s anomaly

31
Q

heart rate

A

300, 150, 100, 75, 60, 50

32
Q
A

PR depression

pericarditis, early repolarization

33
Q

short PR

A

WPW, heart block, junctional rhythm (upside down Ps in II, III, AVF)

34
Q

long PR

A

elderly, Rx (heart drugs, propofol), ARF, SLE, AV endocarditis (abscess obstructs the bundle of his)

35
Q

QRS width 0.09 - 0.11 s (> 2 small boxes)

A

incomplete bundle branch block, IV conduction delay

36
Q

QRS width 0.12 - 0.16 s (> 3 small boxes)

A

bundle branch block, V tach

37
Q

REALLY wide QRS

A

hyper K, give Ca gluconate/Ca chloride

38
Q

normal T wave

A

< 1/2 R, same direction as QRS

39
Q

inverted T

A

amp < 5mm (big box), hyperventilation, pain

amp > 5mm, ischemia (+CP), CNS T waves, cocaine

Tokotsubo, pheochromocytoma)

40
Q

biphasic T

A

V1-4, Wellan’s warning LAD stenosis

41
Q

U wave

A

if the computer thinks it’s a ridiculous QT ~0.6 s think hypo K

42
Q

inverted P in AVL

A

COPD

43
Q

ST elev in V1

A

could be MI, but also think about acute R heart strain (PE)

44
Q

width of LV and RV free walls

A

1 cm, 2mm

45
Q

aneurysm v pseudoaneurysm

A

true = muscle, wide mouth, don’t rupture, embolis, VT reentry arrhythmia, CHF

pseudo = adventitia, narrow mouth, inferior wall infarcts, EMERGENCY

46
Q

acute posterior MI

A

V1/2 –> Tall R, ST dep, upright T

(old posterior = tall R, Ts may be up or down)

47
Q

RCA occlusion

A

inferior (PDA, II, III, AVF)

posterior (V1-3 R, ST dep, upright T)

lateral (V5-6)

48
Q

LAD occlusion

A

bifascicular block (before septal perforator) V1-6, I, AVL

after septal perforator before diagonal V1-4/5/6, I, AVL

after diagonal V1-4/5

apical V3-4

isolated diagonal I, AVL

49
Q

diffuse T wave inversions

A

cocaine, CNS, tokotsubo

50
Q

sinus arrhythmia

A

inspiration –> negative pressure –> BP drops –> HR increases

51
Q

II-III/VI systolic flow murmur + fixed split S2 @ 2nd L intercostal space

A

ASD

EKG Class (8 decks)

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