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Clinical Decision Making Exam 2 > Name That EKG - Mostly Jaynstein > Flashcards

Name That EKG - Mostly Jaynstein Flashcards

1
Q

steps in EKG interpretation

A

A RARE PQRST

age

rate

axis

rhythm

elements:

p wave

q wave

r wave

st segment

t wave

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2
Q

which leads are used to determine axis

A

I

avF

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3
Q

QRS negative (inverted) in lead I

QRS normal in avF

A

right axis deviation

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4
Q

QRS normal in lead I

QRS negative (inverted) in avF

A

left axis deviation

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5
Q

one small box = __ sec

A

0.04 sec

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6
Q

one big box = __ sec

A

0.20 sec

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7
Q

nl for PR interval

A
  1. 12-0.20 sec → 3 small boxes - 1 big box
    * less than one big box is easier to remember :)*
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8
Q

nl for QRS complex

A

0.12 sec or less → 3 small boxes or less

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9
Q

how many seconds in one 12 lead EKG

A

10 sec

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10
Q

nl for the P wave is __ sec

A

< 0.12 sec → < 3 small boxes

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11
Q

sinus dysrhythmias (4)

A

originate in SA node

sinus tachycardia

sinus bradycardia

sinus arrhythmia

sinus arrest

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12
Q

atrial dysrhythmias

A

originate in atria, but not SA node

Premature Atrial Contraction (PAC)

Wandering Atrial Pacemaker

Multifocal Atrial Tachycardia

Supraventricular Tachycardia (SVT)

Paroxysmal SVT

Atrial Flutter

Atrial Fibrillation

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13
Q

junctional dysrhythmias (3)

A

originate w.in AV node

junctional rhythm

junctional tachycardia

premature junctional contraction

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14
Q

ventricular Dysrhythmias (5)

A

ventricles pace heart

Premature Ventricular Contraction (PVC)

Accelerated Idioventricular Rhythm

Ventricular Tachycardia

Torsades de Pointes

Ventricular Fibrillation

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15
Q

4 types of AV block

A

first degree

second degree → mobitz 1 (wenckebach)

second degree → mobitz 2

third degree

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16
Q

key to differentiating AV blocks

A

PR interval

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17
Q

2 types of BBB

A

right

left

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18
Q

key to differentiating BBB (2)

A

R-R’ in V1 or V6

wide QRS → > 0.12 sec/3 small boxes

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19
Q

R-R’ in V6

wide QRS in V1

A

left BBB

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20
Q

R-R’ in V1

wide QRS in V6

A

right BBB

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21
Q

ST depression and T wave inversion in at least 2 anatomical leads

A

myocardial ischemia

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22
Q

t wave inversion can be normal in __

but is always pathologic in __

A

V1

V3

+/- normal in V2, but VERY uncommon

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23
Q

ST elevation in at least 2 anatomical leads

A

MI

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24
Q

anatomic leads

A
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25
Q

peaked T waves

A

hyperkalemia

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26
Q
A

sinus tachy

rate will not exceed 150

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27
Q
A

sinus brady

< 60

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28
Q
A

sinus arrhythmia

mc cause: afib

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29
Q
A

sinus arrest

irregular rate

changing rhythm

pause > 2 sec between beats

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30
Q
A

premature atrial contraction - bigeminy

single premature beat every second beat

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31
Q
A

premature atrial contraction - trigeminy

single premature beat every third beat

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32
Q
A

wandering pacemaker

rate < 60

at least 3 different p waves within one lead

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33
Q
A

multifocal tachycardia

basically wandering pacemaker with a rate > 100

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34
Q
A

SVT

rate > 160

indistinguishable p waves

narrow QRS

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35
Q
A

paroxysmal SVT

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36
Q
A

atrial flutter

no visible PRI

multiple flutter waves precede each QRS

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37
Q
A

afib

irregularly irregular

chaotic isoelectric line

indiscernible pattern

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38
Q
A

afib w. controlled ventricular response

rate: 70-100

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39
Q
A

afib w. uncontrolled/rapid ventricular response

rate: 120-130

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40
Q
A

junctional rhythm

p wave inverted, under, or after QRS

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41
Q
A

junctional rhythm

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42
Q
A

accelerated junctional

rate: 60-100

inverted p waves

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43
Q
A

junctional tachycardia

rate: > 100

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44
Q
A

junctional tachycardia

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45
Q
A

premature junctional contraction

one inverted premature p wave

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46
Q
A

premature ventricular contraction

single beat, not entire rhythm

no p waves

T wave in opposite direction of wide, bizarre QRS

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47
Q
A

PVC

single beat → T wave in opposite direction of wide, bizarre QRS

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48
Q
A

idioventricular rhythm

rate: 20-40

wide QRS that all look the same

no p wave

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49
Q
A

accelerated idioventricular rhythm

rate: 40-100

no p waves

wide QRS that all look the same

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50
Q
A

v tach

rate: > 100

wide QRS

only QRS is visible

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51
Q
A

v tach

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52
Q
A

torsades de pointes

twisted ribbon

all ventricular beats look different

wide QRS w. alternating amplitude

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53
Q
A

v fib

chaotic rhythm

no p waves

quivering heart

presenting rhythm in 70% of cardiac arrests

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54
Q
A

first degree av block

PRI: consistently >20 sec (1 big box)

EKG normal otherwise

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55
Q
A

1st degree AV block

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56
Q
A

1st degree AV block

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57
Q
A

second degree AV block - Mobitz 1 - Wenckebach

PRI longer and longer until beat is dropped

longer, longer, weeeee(nkebach)

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58
Q
A

2nd degree AV Block - Mobitz I - Wenckebach

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59
Q
A

second degree AVB - mobitz II

PRI consistent until one drops off

more pathologic than type I

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60
Q
A

second degree AVB - mobitz II

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61
Q
A

third degree AVB

P-P: regular

R-R: regular

no 1:1 ratio

very pathologic

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62
Q
A

third degree AVB

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63
Q
A

right bbb

R-R’ in V1

wide QRS

not always pathologic

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64
Q
A

right BBB

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65
Q
A

left BBB

rabbit ears in V6

wide QRS in V1

always pathologic

66
Q
A

left BBB

67
Q
A

left BBB

68
Q
A

discordant L BBB

QRS and T wave in opposite directions = good

dis good

69
Q
A

concordant QRS and ST elevation

concordant = bad → ischemia or MI

70
Q
A

ischemia

ST depression

T wave inversion

must occur w.in at least 2 anatomical leads

71
Q
A

ischemia

72
Q
A

ischemia

73
Q
A

ST elevation

acute MI

must occur in at least 2 anatomical leads

74
Q
A

MI

75
Q
A

MI w. reciprocal changes

ST elevation in II, III, avF

T wave inversions in other areas

MI and ischemia concurrently

76
Q
A

widowmaker

simultaneous occlusion of LAD and LCX → full LCA occlusion

77
Q
A

upwardly concave = good

upwardly convex = bad

78
Q
A

asystole

complete absence of cardiac activity

79
Q
A

atrial pacemaker

p waves present w. pacer spike before them

80
Q
A

ventricular pacemaker

pacer spike in front of QRS

one spike produces wide QRS

81
Q
A

AV pacemaker

one spike followed by abnormal P followed by second spike producing wide QRS

82
Q
A

prolonged QT

QT > 0.47 (0.500 sec)

always pathologic

83
Q
A

pathologic Q wave

>2mm

prior MI or acute MI

84
Q
A

pathologic Q waves

85
Q
A

HOCM

deep Q waves

increased voltage

inverted T waves

86
Q
A

pericarditis

diffuse ST elevation

87
Q
A

S1Q3T3

PE

S waves in lead I

Q waves in lead III

inverted T waves in lead III

88
Q

31 yo female w. dyspnea

A

sinus rhythm

right axis deviation

otherwise normal

89
Q

54 yo F w. CP

A

borderline right axis deviation

otherwise normal

90
Q

44 yo male w. dizziness

A

SVT

91
Q

27 yo male w. CP

A

NSR

small R’ in VI

92
Q

56 yo M w. CP

A

ischemia anterolateral leads

93
Q

46 yo w. dyspnea and CP

A

NSR

94
Q

54 yo female

pre op EKG

A

NSR

95
Q

65 yo male w. CP

A

AMI

96
Q
A

left BBB

causes: aortic stenosis, dilated cardiomyopathy, AMI, CAD, longstanding HTN, lyme dz, myocarditis

97
Q
A

afib, rate controlled

98
Q
A

sinus brady

causes: SSS, meds, AMI, ICP, hypothyroidism, hypothermia, hypoxia

99
Q
A

SVT

100
Q
A

NSR w. QT prolongation

causes: hypoK, hypoMg, HypoCa, hypothermia, illicit drugs, ICP, congenital

101
Q
A

afib

102
Q
A

SVT

103
Q
A

sinus tachy

104
Q
A

v tach

105
Q
A

third degree AV block

106
Q
A

first degree AV block

107
Q
A

junctional rhythm

108
Q
A

NSR

109
Q
A

second degree AVB type II

110
Q
A

sinus arrhythmia

111
Q
A

sinus tachycardia

112
Q
A

sinus brady

113
Q
A

SVT

114
Q
A

SVT

115
Q
A

torsades

116
Q
A

fib

117
Q
A

Afib

118
Q
A

aflutter

119
Q
A

aflutter

120
Q
A

first degree AVB

121
Q
A

junctional rhythm

122
Q
A

PAC

123
Q
A

PAC

124
Q
A

PVC

125
Q
A

2nd degree AVB type II

126
Q
A

sinus arrhythmia

127
Q
A

sinus brady

128
Q
A

SVT

129
Q
A

third degree AVB

130
Q
A

third degree AVB

131
Q
A

PVC

132
Q
A

first degree AVB

133
Q
A

sinus tachycardia

134
Q
A

right BBB

135
Q
A

inferior STEMI

136
Q
A

left BBB

137
Q
A

septal STEMI

138
Q
A

NSR

139
Q
A

anterior STEMI

140
Q
A

inferior STEMI

141
Q
A

inferior STEMI

142
Q
A

anterior STEMI

143
Q
A

NSR

144
Q
A

mobitz type I - wenckebach

145
Q
A

left BBB

146
Q
A

mobitz type I - wenckebach

147
Q
A

anteoseptal STEMI

148
Q
A

ischemia →

ST depression

149
Q
A

NSR

150
Q
A

AVNRT

151
Q
A

AVRT

152
Q
A

3rd degree AVB

153
Q
A

first degree AVB

154
Q
A

NSR

155
Q
A

hyperkalemia

156
Q
A

pericarditis

157
Q
A

PVC

158
Q
A

paroxysmal SVT

159
Q
A

NSR

160
Q
A

septal STEMI

Clinical Decision Making Exam 2 (10 decks)

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