Unit 6: Monitors and Equipment: Cardiac

Question 1

What does pericarditis do to EKG?

Answer 1

PR-interval depression

Question 2

Q waves on EKG suggest

Answer 2

myocardial infarction

Question 3

What causes peaked T waves on EKG?

Answer 3

1. myocardia ischemia
2. hypERkalemia
3. LV hypertrophy
4. intracranial bleeding

Question 4

What does hypokalemia do to EKG?

Answer 4

1. increased PR interval
2. increased QT interval
3. T wave flattening
4. U ewave

Question 5

What does hypERkalemia do to EKG?

Answer 5

1. Peaked T waves
2. P wave flattening
3. PR prolongation
   4.QRS prolongation
4. ventricular fibrillation

Question 6

Hypercalcemia is associated with a ______ on EKG

Answer 6

short QT interval

Question 7

hypOcalcemia is associated with _____ on EKG

Answer 7

Long QT interval

Question 8

hypERmagnesia is associate with ____ on EKG

Answer 8

heart block and cardiac arrest

Question 9

hypOmagnesia is associated with ____ on EKG

Answer 9

long QT interval (risk of torsades)

Question 10

What are the bipolar leads?

Answer 10

II, II, III

Question 11

what are the limb leads?

Answer 11

aVR, aVL, aVF

Question 12

WHat are the precordial leads?

Answer 12

V1-V6

Question 13

the RCA provides blood to the. ______heart and leads _____ read it

Answer 13

Inferior heart
II, III, aVF

Question 14

the circumflex provides blood to the ______ heart and leads _____ read it

Answer 14

Left lateral heart
I, aVL, V5, V6

Question 15

the LAD supplies blood to the ______ heart and leads ____ supply it

Answer 15

Anterior heart
V1-V4

Question 16

The easiest way to determine axis deviation is to examine lead ______

Answer 16

lead I and aVF

Question 17

What do leads I and aVF look like in nomral axis?

Answer 17

Lead I: +
Lead aVF: +

Question 18

what do leads I and aVF look like in right axis deviation?

Answer 18

Lead I: -
Lead aVF: +

Reaching towards each other

Question 19

What do leads I and aVF look like in left axis deviation?

Answer 19

Lead I: +
Lead aVF: -

Leaving each other

Question 20

what do leads I and aVF look like in extreme axis deviation?

Answer 20

Lead I: -
Lead aVF: -

Question 21

Normal axis deviation degree
L axis deviation degree
R axis deviation degree

Answer 21

Normal: -30 to +90
Left: More negative than -30
Right: More positive than + 90

Question 22

The mean electrical ventricle tends to point towards _______ and away from_______

Answer 22

Towards areas of hypertrophy
Away from areas of myocardial infarction

Question 23

What drug should be used in the setting of beta blockers or calcium channel blocker induced bradycardia

Answer 23

glucagon

Question 24

Mobitz type 1 block: What does it loook like on EKG and what is the treatment

Answer 24

PR progressively longer until p wave does not conduct to the ventricles

long longer longer drop

treatment: atropine if symptomatic

Question 25

Mobitz type II

Answer 25

Some Ps conduct to ventricles while others dont Treatment: pacing (atropine not useful)

Question 26

3rd degree heart block treatment

Answer 26

pacemaker or isoproterenol (chemical pacer)

Question 27

class 1 antiarrhythmic drugs MOA and example

Answer 27

inhibit fast sodium channels example: lidocaine procanamide, phenytoin

Question 28

Class 2 antiarrhythmic drugs MOA and example

Answer 28

decrease rate of depolarization example: propranolol beta blockers

Question 29

Class 3 antiarrythmic drugs MOA and example

Answer 29

inhibit potassium ion channels example: amiodarone bretylium

Question 30

Class 4 antiarrhythmic drug MOA and example

Answer 30

inhibit slow calcium channels example: Verapamil diltiazem

Question 31

adenosine MOA and use

Answer 31

slows conduction via AV node causes potassium efflux, hyperpolarizing the membrane --> slows AV node conduction SVT, WPW with narrow QRS

Question 32

Wolff-Parkinson white defining feature

Answer 32

accessory conduction pathway (Kent's bundle) that bypasses the AV node key diagnostic feature: delta wave

Question 33

Which WPW has a narrow QRS compelx?

Answer 33

Orthodromic - most common

Question 34

WPW orthodromic treatment

Answer 34

Increase the refractory period OF THE AV NODE: 1. vagal 2. amiodarone 3. adenosine 4. beta blockers 5. verapamil 6. cardioversion

Question 35

Which WPW is associated with wide QRS complex?

Answer 35

Antidromic (less common and more dangerous than orthodromic)

Question 36

Antidromic WPW treatment:

Answer 36

Increase the refractory period OF THE ACCESSORY PATHWAY 1. procainamide 2. cardioversion DO NOT GIVE AGENTS THAT INCREASE THE REFRACTORY PERIOD OF THE AV NODE - this will favor conduction through the accessory pathway --> vfib

Question 37

WPW EKG characteristsics

Answer 37

1. delta wave 2. short PR (<0.12 sec) 3. Wide QRS 4. Possible T wave inversion

Question 38

What is failure to capture vs. failure to sense (pacemakers)

Answer 38

Failure to capture: Pacer fires but does not cause QRS complex Failure to sense: Pacer fires when it shouldn't

Question 39

common causes of failure to capture (pacemakers)

Answer 39

1. hyper/o kalemia 2.hypOcapnia 3. hypOthermia 4. MI 5. fibrotic tissue around pacing leads 6. antiarrhythmic medications