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

Name That EKG - Mostly Jaynstein Flashcards

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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
peaked T waves
hyperkalemia
26
**sinus tachy** rate will not exceed 150
27
**sinus brady** \< 60
28
**sinus arrhythmia** mc cause: afib
29
**sinus arrest** irregular rate changing rhythm pause \> 2 sec between beats
30
**premature atrial contraction - bigeminy** single premature beat every second beat
31
**premature atrial contraction - trigeminy** single premature beat every third beat
32
**wandering pacemaker** rate \< 60 at least 3 different p waves within one lead
33
**multifocal tachycardia** basically wandering pacemaker with a rate \> 100
34
**SVT** rate \> 160 indistinguishable p waves narrow QRS
35
**paroxysmal SVT**
36
**atrial flutter** no visible PRI multiple flutter waves precede each QRS
37
**afib** irregularly irregular chaotic isoelectric line indiscernible pattern
38
**afib w. controlled ventricular response** rate: 70-100
39
**afib w. uncontrolled/rapid ventricular response** rate: 120-130
40
**junctional rhythm** p wave inverted, under, or after QRS
41
**junctional rhythm**
42
**accelerated junctional** rate: 60-100 inverted p waves
43
**junctional tachycardia** rate: \> 100
44
**junctional tachycardia**
45
**premature junctional contraction** one inverted premature p wave
46
**premature ventricular contraction** single beat, not entire rhythm no p waves **T wave in opposite direction of wide, bizarre QRS**
47
**PVC** single beat → T wave in opposite direction of wide, bizarre QRS
48
**idioventricular rhythm** rate: 20-40 wide QRS that all look the same no p wave
49
**accelerated idioventricular rhythm** rate: 40-100 no p waves wide QRS that all look the same
50
**v tach** rate: \> 100 wide QRS only QRS is visible
51
**v tach**
52
**torsades de pointes** twisted ribbon all ventricular beats look different wide QRS w. alternating amplitude
53
**v fib** chaotic rhythm no p waves quivering heart presenting rhythm in 70% of cardiac arrests
54
**first degree av block** PRI: consistently \>20 sec (1 big box) EKG normal otherwise
55
**1st degree AV block**
56
**1st degree AV block**
57
**second degree AV block - Mobitz 1 - Wenckebach** PRI longer and longer until beat is dropped longer, longer, weeeee(nkebach)
58
**2nd degree AV Block - Mobitz I - Wenckebach**
59
**second degree AVB - mobitz II** PRI consistent until one drops off more pathologic than type I
60
**second degree AVB - mobitz II**
61
**third degree AVB** P-P: regular R-R: regular no 1:1 ratio **very pathologic**
62
**third degree AVB**
63
**right bbb** R-R' in V1 wide QRS not always pathologic
64
**right BBB**
65
**left BBB** rabbit ears in V6 wide QRS in V1 **always pathologic**
66
**left BBB**
67
**left BBB**
68
**discordant L BBB** QRS and T wave in opposite directions = good **dis good**
69
**concordant QRS and ST elevation** concordant = bad → ischemia or MI
70
**ischemia** ST depression T wave inversion **must occur w.in at least 2 anatomical leads**
71
**ischemia**
72
**ischemia**
73
**ST elevation** acute MI **must occur in at least 2 anatomical leads**
74
MI
75
**MI w. reciprocal changes** ST elevation in II, III, avF T wave inversions in other areas MI and ischemia concurrently
76
**widowmaker** simultaneous occlusion of LAD and LCX → full LCA occlusion
77
upwardly concave = good upwardly convex = bad
78
**asystole** complete absence of cardiac activity
79
**atrial pacemaker** p waves present w. pacer spike before them
80
**ventricular pacemaker** pacer spike in front of QRS one spike produces wide QRS
81
**AV pacemaker** one spike followed by abnormal P followed by second spike producing wide QRS
82
**prolonged QT** QT \> 0.47 (0.500 sec) **always pathologic**
83
**pathologic Q wave** \>2mm **prior MI or acute MI**
84
pathologic Q waves
85
**HOCM** deep Q waves increased voltage inverted T waves
86
**pericarditis** diffuse ST elevation
87
**S1Q3T3** PE S waves in lead I Q waves in lead III inverted T waves in lead III
88
31 yo female w. dyspnea
sinus rhythm right axis deviation otherwise normal
89
54 yo F w. CP
borderline right axis deviation otherwise normal
90
44 yo male w. dizziness
SVT
91
27 yo male w. CP
NSR small R' in VI
92
56 yo M w. CP
ischemia anterolateral leads
93
46 yo w. dyspnea and CP
NSR
94
54 yo female pre op EKG
NSR
95
65 yo male w. CP
AMI
96
**left BBB** **causes:** aortic stenosis, dilated cardiomyopathy, AMI, CAD, longstanding HTN, lyme dz, myocarditis
97
**afib, rate controlled**
98
**sinus brady** **causes:** SSS, meds, AMI, ICP, hypothyroidism, hypothermia, hypoxia
99
**SVT**
100
**NSR w. QT prolongation** **causes:** hypoK, hypoMg, HypoCa, hypothermia, illicit drugs, ICP, congenital
101
**afib**
102
**SVT**
103
sinus tachy
104
v tach
105
third degree AV block
106
first degree AV block
107
junctional rhythm
108
NSR
109
second degree AVB type II
110
sinus arrhythmia
111
sinus tachycardia
112
sinus brady
113
SVT
114
SVT
115
torsades
116
fib
117
Afib
118
aflutter
119
aflutter
120
first degree AVB
121
junctional rhythm
122
PAC
123
PAC
124
PVC
125
2nd degree AVB type II
126
sinus arrhythmia
127
sinus brady
128
SVT
129
third degree AVB
130
third degree AVB
131
PVC
132
first degree AVB
133
sinus tachycardia
134
right BBB
135
inferior STEMI
136
left BBB
137
septal STEMI
138
NSR
139
anterior STEMI
140
inferior STEMI
141
inferior STEMI
142
anterior STEMI
143
NSR
144
mobitz type I - wenckebach
145
left BBB
146
mobitz type I - wenckebach
147
anteoseptal STEMI
148
**ischemia →** ST depression
149
NSR
150
AVNRT
151
AVRT
152
3rd degree AVB
153
first degree AVB
154
NSR
155
hyperkalemia
156
pericarditis
157
PVC
158
paroxysmal SVT
159
NSR
160
septal STEMI

Clinical Decision Making Exam 2 (10 decks)

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