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Flashcards in Meds and Metabolic Derangements Deck (16):
1

Digitalis/Digoxin causes what?

a scooped ST depression in therapeutic doses

2

Symtpoms of Digoxin toxicity:
GI? 4
Visual? 3
CVS? 3
CNS? 4

GI: Nausea, vomiting, anorexia, diarrhea

Visual: Blurred vision, yellow/green discoloration, haloes

CVS: Palpitations, syncope, dyspnea

CNS: Confusion, dizziness, delirium, fatigue

3

How does digoxin affect automaticity and the AV node and how does it do that?

Increased automaticity (increased intracellular calcium) and decreased AV conduction (increased vagal effects at the AV node)

4

The classic dysrhythmia associated with digoxin toxicity is the combination of what?

a supraventricular tachycardia (due to increased automaticity) with a slow ventricular response (due to decreased AV conduction), e.g. ’atrial tachycardia with block’
(looks like a slow Aflutter)

5

4 rhythms that are caused by too much digoxin?
8

1. Atrial and junctional premature beats
2. PAT with block
3. Sinus block
4. AV blocks
5. Atrial and junctional tachyarrhythmias
6. PVCs
7. VT
8. VF

6

Characteristic changes of hyperkalemia on an EKG?
3

1. Classic change is that of peaked T waves
2. P wave can also flatten and widen
3. QRS complex can widen

7

Characteristic changes of hypokalemia on an EKG?
3

1. Classic changes are the presence of U waves
2. T waves can flatten out and possibly invert
3. Causes irritation of ventricular foci which can lead to Torsades, VT, VF

8

Characteristics of hypercalcemia on an EKG? 2

1. Short QT interval
2. J waves

9

Characteristic of hypocalcemia on an EKG? 1

Prolonged QT interval

10

Characteristics of hypomagnesemia on an EKG? 4

1. Prolonged QT
2. Torsades
3. Frequent PVCs, PACs
4. Ventricular and supraventricular tachyarrhythmias

11

What is a J wave?

The Osborn wave (J wave) is a positive deflection at the J point (negative in aVR and V1)

12

In hypothermia what leads are J waves most prominent?

precordial leads

13

J waves may be seen in a number of other conditions besides hypothermia such as?
5

1. Normal variant
2. Hypercalcemia
3. Medications
4. Neurological insults such as intracranial hypertension, severe head injury and subarachnoid hemorrhage
5. (idiopathic VF)

14

Pulmonary embolus EKG findings?
5

1. Most common finding is sinus tachycardia
2. Ekg changes may include S1Q3T3
3. Right axis deviation
4. Transient RBBB
5. T wave inversions in V1-V4

15

What is the first change that you are going to see on an EKG with a pt with PE? and why?

Most common finding is sinus tachycardia because they are responding to the hypoxia

16

What is S1Q3T3?

prominent S wave in I
Prominent Q wave in III
inverted T wave in III