Section 4

Question 1

Hyperkalemia

Answer 1

Hyper-K-alemia
High potassium
Caused by renal disease, acidosis, meds

Question 2

Hyperkalemia EKG Progression

Answer 2

1. T waves peak
2. Loss of P wave, further T wave peaking
3. Sine Wave

Question 3

Hypokalemia

Answer 3

Hypo-K-alemia
Low potassium
Caused by dietary deficiency, alkalosis, excess mineralocorticoids, meds

Question 4

Hypokalemia EKG findings

Answer 4

T wave flattening

U wave appears in ONLY the anterior leads (between T and P wave)

Question 5

Hypocalcemia

Answer 5

Low Calcium

Caused by malabsorption, vit d deficiency, hypoparathyroidism

Question 6

Hypocalcemia EKG findings

Answer 6

Prolonged QT interval
Short PR interval
T wave flattening
Risk of V Tach

Question 7

R on T phenomenon

Answer 7

Prolonged QT from hypocalcemia turning into Vtach. T wave encroaches onto the next R wave.

Question 8

Hypercalcemia

Answer 8

High Calcium

Caused by malignancies, granulomatous diseases, medication induced, primary hyperparathyroidism

Question 9

Hypercalcemia EKG findings

Answer 9

Shorted QT inervals

Question 10

Hypothermia

Answer 10

Cold temp

Slows metabolism

Question 11

Hypothermia EKG Changes

Answer 11

Sinus Brady
Prolonged segments
Distinct ST elevation: J Wave or Osborne Wave

Question 12

Digitalis Effect

Answer 12

Drug Digoxin causes it
Normal at therapeutic levels
Slows AV node conduction

Question 13

Digitalis EKG

Answer 13

ST Depression w/ downslope
(Looks like mustache)
T wave flattening or inversion

Question 14

Digitalis Toxicity

Answer 14

Happens at supratherapeutic levels
Sinus Node suppression
AV Conduction blocks
Tachyarrhythmias

Question 15

Paroxysmal Atrial Tach

Answer 15

Enhanced automaticity of ectopic atrial focus
Or from re-entrant circuit in atria
Usually looks like SVT, but can have P waves if slow enough
100-200 BPM
Associated with Digitalis Toxicity

Question 16

PAT

Answer 16

Paroxysmal Atrial Tachycardia
Associated with Dig Toxicity
Usually 2:1 block

Question 17

Acute Pericarditis

Answer 17

Inflammation of Pericardium
Patient recovering from viral infection
Usually presents with chest pain that improved with then lean forward

Question 18

Acute Pericarditis EKG

Answer 18

ST elevations, T wave changes, PR depressions

Question 19

Pericardial Effusion

Answer 19

Heart is rotating freely within fluid

Following an infection

Question 20

Pericardial Effusion EKG

Answer 20

Low voltage: aka little QRS complexes

Question 21

Electrical ALternans

Answer 21

Associated with Pericardial Effusions
Amplitude of the waveform is varying beat to beat
Short-tall-short-tall

Question 22

COPD

Answer 22

Chronic Obstructive Pulmonary Disease
Emphysema
Chronic Bronchitis
Right atrial enlargement common

Question 23

COPD EKG

Answer 23

Low voltage: Little QRS
Right axis deviation
Poor R wave progression
R atrial enlargement

Question 24

Acute Pulmonary Embolism EKG

Answer 24

R ventricular hypertrophy
RBBB: Right bundle branch block
S1, Q3, T3
Tachycardia: Sinus Tach or Afib

Question 25

S1Q3T3

Answer 25

Acute Pulmonary Embolism S1: Large S in Lead 1 Q3: Deep Q in Lead 3 T3: Inverted T in lead 3

Question 26

Brugada Syndrome

Answer 26

Inherited trait, more in men | Causes Syncope

Question 27

Brugada EKG

Answer 27

``` EKG showing RBBB and ST (can look like bunny ears) elevation V1, V2, V3 Risk of Vtach Pointy ST in V1 ```

Question 28

Female presenting with chest discomfort that gets worse when lying on back. Just recovered from infuenza virus

Answer 28

Acute Pericarditis | ST elevations in multiple leads, PR depressions

Question 29

Male with COPD, SOB

Answer 29

Low voltage QRS complexes | Right atrial enlargement: Poor R wave progression and R axis deviation.

Question 30

Female fell in bathroom was there all night

Answer 30

Hypothermia | Osborne Waves: Distinct T waves

Question 31

Patient had facial trauma after fall

Answer 31

Syncopal episode w/o warning so was unable to put hands out to stop fall.

Question 32

Male with CHF on Digoxin

Answer 32

Normal: Digitalis Effect (showing ST depression with T wave flattening) High levels: Tachy arrhythmias

Question 33

Female with thyroidectomy, muscle cramping, tingling in fingers

Answer 33

Hypocalcemia: Prolonged QT with T wave flattening. PR interval shortening

Question 34

Male with Afib on Digoxin, feels fine

Answer 34

Digitalis Effect, normal, Afib with ST depressions