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GP Final Exam > 12 Lead EKG > Flashcards

12 Lead EKG Flashcards

1
Q

normal PR interval

A

0.12-0.20 (< 1 big box)

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2
Q

normal QRS interval

A

< 0.12 (3 small boxes)

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3
Q
A

sinus rhythm

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4
Q

sinus rhythm rate

A

60-100 bpm

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5
Q
A

Sinus Rhythm with First Degree Block

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6
Q

what is the PR interval in Sinus Rhythm with First Degree Block

A

PR > 0.20 sec

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7
Q

Sinus Rhythm with First Degree Block represents

A

a slowing of conduction through the AV node

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8
Q
A

Sinus Rhythm with Second Degree AV Block - Mobitz type I (Wenckebach)

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9
Q

features of Sinus Rhythm with Second Degree AV Block - Mobitz type I (Wenckebach)

A

increasing PR interval with dropped QRS

P-P interval constant

usually not symptomatic

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10
Q
A

Sinus Rhythm with Second Degree AV Block - Mobitz type II

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11
Q

Sinus Rhythm with Second Degree AV Block - Mobitz type II characteristics

A

PR intervals constant but > .20 seconds

unconducted P waves

usually symptomatic

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12
Q

third-degree AV block represents

A

a complete disassociation between the atria and the ventricles

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13
Q
A

third degree AV block

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14
Q

P waves and QRS waves have nothing to do with each other

A

third degree AV block

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15
Q

is 3rd degree AV block usually symptomatic

A

yes; go get the external pacer

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16
Q
A

third degree AV block

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17
Q
A

third degree AV block

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18
Q
A

third degree AV block

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19
Q

where does QRS originate from in junctional rhythm

A

AV node

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20
Q

QRS rate in junctional rhythm

A

40-60 bpm

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21
Q

are there P waves in junctional rhythm

A

may or may not be present

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22
Q
A

junctional rhythm

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23
Q
A

junctional rhythm

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24
Q
A

accelerated junctional rhythm

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25
Q

where does an accelerated junctional rhythm originate

A

AV node

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26
Q

accelerated junctional rhythm rate

A

greater than 60

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27
Q

accelerated junctional rhythm P waves

A

NONE

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27
Q
A

atrial fibrillation

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28
Q

atrial fibrillation P wave

A

can’t find the P wave

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29
Q

atrial fibrillation rhythm

A

irregular

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30
Q

atrial fibrillation QRS

A

normally still within normal limits

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31
Q

uncontrolled atrial fibrillation

A

> 100 bpm

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32
Q

saw tooth pattern

A

atrial flutter

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33
Q

atrial flutter P waves?

A

present

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34
Q

most common atrial flutter conduction

A

2:1

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35
Q

atrial flutter QRS

A

usually WNL width parameters

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36
Q

almost always occurs in diseased heart

A

atrial flutter

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37
Q
A

supraventricular tachycardia

38
Q

usually regular between 140-220 bpm

A

SVT

39
Q

where are impulses generated during SVT

A

above the AV node

40
Q
A

ventricular tachycardia

41
Q

rate between 100-220 bpm

A

ventricular tachycardia

42
Q

wide and bizarre looking morphology

A

ventricular tachycardia

43
Q

usually symptomatic but not always

A

ventricular tachycardia

44
Q

may progress to v-fib

A

ventricular tachycardia

45
Q
A

ventricular fibrillation

46
Q

no QRS observable

A

ventricular fibrillation

47
Q

chaotic electrical activity

A

ventricular fibrillation

48
Q

failure of primary pacemaker

A

idioventricular rhythm

49
Q

rate usually less than 40 bpm

A

idioventricular rhythm

50
Q

The ventricles “last ditch” attempt to maintain cardiac output

A

idioventricular rhythm

51
Q

inferior leads

A

II, III, aVf

52
Q

lateral leads

A

I, aVL, V5, V6

53
Q

anterior leads

A

V3, V4

54
Q

septal leads

A

V1, V2

55
Q

bipolar leads

A

I, II, III

56
Q

unipolar leads

A

aVL, aVR, aVF

57
Q

axis deviation look at leads

A

I and aVF

58
Q

(Axis Deviation)
up up

A

normal

59
Q

(Axis deviation)
up down

A

left

60
Q

down up

A

right

61
Q

down down

A

extreme right

62
Q

bundle branch blocks look to leads

A

I, V1, V6

63
Q

bundle branch block QRS

A

wide QRS

64
Q

right bundle branch block configuration

A

R, S, R1 configuration in V1

65
Q

left bundle branch block
What do we see in V1?

A

Large wide R, S pattern in V1

66
Q

lead I positive deflection and wide

A

left bundle branch block

67
Q

Usually “bunny ears” in V6

A

left bundle branch block

68
Q

if not bunny ears, a notched QRS somewhere in V leads

A

left bundle branch block

69
Q

ischemia EKG

A

ST depressions and T wave

inversions in consecutive leads

70
Q

acute injury/ infarction EKG

A

ST elevations, peaked T waves , or

T wave inversions in consecutive leads

71
Q

anterior wall supplied by

A

LAD

72
Q

lateral wall is supplied by

A

LAD or obtuse marginal

73
Q

changes seen in I, avL, V5, V6

A

LAD or obtuse marginal

74
Q

inferior wall supplied by

A

RCA

75
Q

seen in Leads II, III, avF

A

inferior wall supplied by RCA

76
Q

posterior wall supplied by

A

PDA

posterior descending artery NOT patent ductus arteriosus

77
Q

depression in V1 and V2

A

posterior wall

78
Q
A

Acute injury patternST Elevations

79
Q

when are Q waves significant

A

if more than 1/3 of the total height of the QRS

wider than 0.03 sec

80
Q

Big R wave in V5 or V6 plus Big S wave in V1

A

Left Ventricle Enlargement

81
Q

rsR’ in V1 and S waves in V5/V6

Right “Strain” Pattern - T wave inversion in the right-sided leads

A

Right Ventricle Enlargement

82
Q
A

monomorphic ventricular tachycardia

83
Q
A

second-degree AV block type I

84
Q
A

third-degree AV block

85
Q
A

unstable SVT

86
Q
A

torsades de pointes

87
Q

ondansetron can cause

A

prolonged QT

88
Q

which leads do you look at for axis deviation

A

Leads I and aVF

89
Q

leads II or V5

A

best to detect ischemia or infarction

90
Q

lead II

A

arrhythmias and inferior wall ischemia

91
Q

lead V5

A

anterior/lateral wall ischemia

92
Q

Signs of Left Bundle Branch Block

A

V1: large, wide R S pattern
I: + deflection, wide QRS
V6: bunny ears
V leads: notched QRS

93
Q

Signs of RV enlargement

A

V1: R S R’
V5 & 6: S wave

Right “strain pattern”: inverted T in V leads

(Do not confuse with RBBB which has R S R1 in V1)

GP Final Exam (3 decks)

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