Others

Question 1

Diffuse T wave peaking and prolonged PR interval that eventually disappears followed by QRS waves that merge with T waves is diagnostic of

Answer 1

Hyperkalemia

Question 2

Hyperkalemia can cause…

Answer 2

V-fib & Death

Question 3

ST segment depression
Flattening of Twave
and U waves are diagnostic of

Answer 3

Hypokalemia

Question 4

Hypocalcemia does what to the QT interval?

Answer 4

Prolongs QT Interval

Question 5

Hypercalcemia does what to the QT interval?

Answer 5

Shortens the QT Interval

Question 6

Hypocalcemia can lead to what arrhythmia?

Answer 6

Torsades de pointes

Question 7

What are the usual causes of hypomagnesemia?

Answer 7

GI or renal losses

Question 8

What electrolyte disorder can cause hypokalemia, ventricular arrhythmias w/acute MI, digoxin toxicity, worsens hypocalcemia, and torsades de pointes?

Answer 8

Hypomagnesemia

Question 9

Severe hypermagnesemia shows what EKG changes

Answer 9

Prolonged PR and QRS intervals

Question 10

What are J waves (Osborn waves)

Answer 10

See an abrupt ascent at J point and then a sudden plung to baseline

Question 11

Prolonged intervals and segments and appearance of J waves are diagnostic of

Answer 11

Hypothermia

Question 12

Asymmetric ST segment depression and flattening/inversion of T waves is seen in

Answer 12

Therapeutic digitalis levels

Question 13

When using digitalis _____ is more likely seen in patients with sick sinus syndrome

Answer 13

sinus node suppression

Question 14

Which is a more significant measure of potassium levels: EKG or serum levels?

Answer 14

EKG changes are more significant

Question 15

A dialysis patient comes to the ER and voices that they skipped their last two dialysis appointments. What EKG changes might you expect to see on the EKG?

Answer 15

Hyperkalemia:
Diffuse t wave peaking
PR interval prolonging
QRS widening- sine wave pattern

Question 16

What are common causes to hypermagnesemia?

Answer 16

Renal failure or excessive intake

Question 17

What can hypermagnesemia cause

Answer 17

cardiac arrest

Question 18

Are U waves diagnostic of hypokalemia?

Answer 18

No, may be seen in other conditions and those with normal hearts

Question 19

In general, if a T wave is upright, a following U wave is_____

Answer 19

Also upright

-usually same axis

Question 20

When is digitalis most effective at slowing HR?

Answer 20

When sitting or lying, commonly lost during exertion

Question 21

What can digitalis toxicity cause?

Answer 21

First, Second, and Third Degree Heart Block
PAT and PVC most common tachyarrhythmias
PAT w/second degree AV block is most common

Question 22

What is the most common cause of PAT w/block

Answer 22

Digitalis toxicity

Question 23

What body temp brings about EKG changes in hypothermia?

Answer 23

<30C

Question 24

What mimics atrial flutter in hypothermia?

Answer 24

muscle tremor artifact

Question 25

What is the most common arrhythmia seen during hypothermia?

Answer 25

slow atrial fibrillation

Question 26

At what percent QT lengthening do you d/c drug that causes QT interval lengthening

Answer 26

Prolonged more than 25% from pts baseline

Question 27

Therapeutic digitalis changes best seen in what leads?

Answer 27

V5 V6

Question 28

What things can prolong the QT interval?

Answer 28

``` Inherited Disorders Many antiarrhythmics Tricyclic antidepressants Phenothiazines Erythromycin Quinolone antibiotics Various antifungals ```

Question 29

Two most common tachyarrhythmias in digitalis toxicity

Answer 29

PAT and PVCs

Question 30

What cardiac cause shows dampening of electrical output shown in all leads?

Answer 30

Effusion, from pericarditis possibly

Question 31

Diffuse ST elevation that after returning to baseline shows T wave inversion Sometimes with PR interval depression is diagnostic of

Answer 31

Pericarditis

Question 32

What is electrical alternans?

Answer 32

Heart is rotating within its fluid filled sac from excess effusion EKG axis varies with each beat

Question 33

Patients with inherited QT intervals should be restricted from what?

Answer 33

Competitive sports and meds that prolong interval

Question 34

Patients with inherited QT intervals often treated with

Answer 34

Beta blockers and implantable defibrillators

Question 35

Correct QTc most accurate with what heart rates

Answer 35

50-120 bpm

Question 36

Specific or nonspecific: Flattening of T waves

Answer 36

nonspecific

Question 37

Specific or nonspecific: tented T waves

Answer 37

specific- hyperkalemia

Question 38

Specific or nonspecific: slightly inverted t waves

Answer 38

nonspecific

Question 39

Specific or nonspecific: deep t wave inversions

Answer 39

specific- usually ischemia

Question 40

What differentiates pericarditis from MI?

Answer 40

Diffuse in pericarditis T wave inversion only after ST segments back to baseline in pericarditis No Q waves in pericarditis PR depression in pericarditis

Question 41

A patient with hypertrophic obstructive cardiomyopathy may have

Answer 41

LVH left axis deviation Q waves laterally and occasionally inferiorly

Question 42

Myocarditis can cause

Answer 42

conduction blocks | -esp bundle branch blocks & hemiblocks

Question 43

What is myocarditis?

Answer 43

Diffuse inflammatory process of the myocardium

Question 44

COPD can show what EKG changes

Answer 44

low voltage right axis deviation poor R wave progression in precordials

Question 45

COPD can cause/lead to

Answer 45

chronic cor pulmonale right sided CHF and will show right atrial enlargement (P pulmonale) RVH with repolarization abnormalities

Question 46

S1Q3T3 pattern is diagnostic of

Answer 46

Pulmonary Embolism

Question 47

What EKG changes can be seen in acute pulmonary embolism?

Answer 47

Pattern of RVh w/repolarization changes RBB S1Q3T3 arrhythmias

Question 48

What are the most common arrhythmias seen in PE?

Answer 48

sinus tachycardia &atrial fibrillation

Question 49

Diffuse deep symmetrical T wave inversion and prominent U waves are diagnostic of

Answer 49

Subarachnoid bleed or cerebral infarction

Question 50

What is the most common cause of sudden cardiac death?

Answer 50

Coronary artery disease/atherosclerosis causing an infarction or arrhythmia

Question 51

What types of drug abuse can cause sudden cardiac death?

Answer 51

Cocaine and amphetamines

Question 52

What is commotion cordis?

Answer 52

blunt force to the chest causing v-fib possibly leading to sudden cardiac death ie- baseball player with healthy heart that gets a ball directly to the chest

Question 53

What is constriction of the artery by surrounding tissue exacerbated by increased myocardial contractions during exercise causing v-fib?

Answer 53

Anomalous origin of the coronary arteries | -can cause sudden cardiac death

Question 54

What genetic mutation affects voltage dependent sodium channels during repolarization commonly seen in men in 20s and 30s?

Answer 54

Brugada Syndrome

Question 55

What EKG changes are diagnostic of Brugada Syndrome?

Answer 55

RBB | BST segment elevation in V1-V3

Question 56

When is sudden death most likely to occur in patients with Brugada Syndrome?

Answer 56

during sleep

Question 57

What can Brugada syndrome cause

Answer 57

Ventricular arrhythmias that can cause sudden death | -commonly fast polymorphic v-tach that looks like torasades

Question 58

In athletes hearts, are the most common causes of heart disorders?

Answer 58

Heart muscle disorders and sudden ventricular arrhythmias

Question 59

True or False: Athletes are at an increased risk for sudden cardiac death compared to non-athletes

Answer 59

True