12 Lead Peer Quiz Flashcards
What are the two main reasons for the need to put the limb leads on the limbs.
Angle and Amplitude
Angle and size
Amplitude and area
Time and rate
Angle and Amplitude
If lead I is positive, Lead II is negative and Lead III is negative, what is the axis and if there is a block what type is it? Left axis, Anterior Hemiblock Right axis, posterior Hemiblock. Extreme right axis, no block Left axis, no block
Left axis, Anterior Hemiblock
For each point increase in HR the heart requires 2 times the amount of oxygen.
True
False
True
Under what circumstances should we consider a DeBakey 1 aneurysm
patient with a history of hypertension, with elevation in inferior, right and posterior leads
What condition cause not only RAD, but physical abnormalities of the heart?
dextrocardia
True or false: RBBB is a bifascicular block
False
Difference between monitoring and assessing?
Monitor for changes and changes prompt assessment
Monitor vitals and changes prompt treatment
12 lead monitor and treat the changes
Monitor changes and treatment
Monitor for changes & changes prompt assessment
Where do limb leads go?
Hands and feet
Wrist andankles
Forearm and calf
Shoulder and thighs
Shoulder & thighs
Right ventricle myocardial infarction does not get? Aspirin Nitro Oxygen Normal Saline
Nitro
What patients are always sicker than they appear? Pt with past cardiac hx Diabetics Pt > 65 yr Females
Diabetics
For every 1 beat increase in heart rate how many oxygen demand does it require? 1 oxygen demand increase 2 oxygen demand 5 oxygen demand 10 oxygen demand
2 oxygen demand
If there is greater elevation in lead III than lead II what is suspected? Posterior involvement Right sided involvement Inferior stemi Pericarditis
Right sided involvement
A QRS complex in lead v1 greater than \_\_\_\_\_ is a sign of a left branch bundle block? 100 ms 120 ms 140 ms 160 ms
120 milliseconds
Which of the following v1 morphology criteria proves ventricular tachycardia? Big mountain, little mountain Steeple sign Firemans hat All of the above
All of the above
Normal axis deflection in leads 1,2, and 3 is read as? Up down down Down down down Up up up Up, ½ way, down
Up up up
You have a positive deflection in leads I, II, and III. Your lead 12-lead gives you a QRS axis of 45. What is the axis of the heart? Normal axis Physiological left axis Pathological left axis Extreme right axis
Normal axis
You have a supraventricular QRS complex greater than 0.12 seconds wide. Using the “Turn Signal Criteria”, what lead will you look at to determine the type of Bundle Branch Block? I II III V1
V1
You obtain a 15 lead ECG. What do you relabel v4, v5, and v6? V4r, v5r, v6r V4r, v8, v9 V7, v8, v9 You do not relabel
V4r, v8, v9
With elevation in leads v4r, v8, v9, and a medical history of hypertension. You should have a high index of suspicion that your patient may have an: Dissecting aortic aneurysm Pulmonary embolism Pericarditis Cardiac tamponade
Dissecting aortic aneurysm
A hemiblock is characterized by a block of one of the fascicles in the? Left Bundle Branch Right Bundle Branch AV Node SA Node
Left Bundle Branch
While looking at the 12 lead ECG the QRS must be longer than ___ to determine a bundle branch block. Any 2 block in the conduction system is a contraindication for what class of medication?
- 12, antiarrhythmic
- 12 antiemetic
- 08 beta-blocker
- 08 anti-cholinergic
0.12, antiarrhythmic
What is the QTc duration cut off for giving medication or synchronized cardioversion?
- 420 s
- 450 s
- 460 s
- 640 s
0.460 s
What leads do you have to move to perform a right sided ECG? V1 v2 v3 V4 v5 v6 RA RL LA All of them
V4 v5 v6
A tear/aneurysm in the aorta that activates the RCA is classified as… Lefort I Debakey I Mobitz I DM type I
Debakey I
An upward deflection in lead I with negative deflection in lead II and lead III is what type of hemiblock? Anterior hemiblock Posterior hemiblock Ventricular in origin No hemiblock
Anterior hemiblock
A QRS complex greater than 120 ms is a sign of? Bundle Branch Block 2nd degree AV block type 2 SVT Normal Sinus
Bundle Branch Block
What is a contraindication in lidocaine that was discussed in Bob Pages lecture? Heart block Cardiac arrest Frequent PVCs Allergic to contrast dye
Heart block
What do you need to do before giving Nitro to a pt with an inferior MI?
Put the patient on a 15 lead to rule out right sided involvement
Establish an IV just in case
Do a 12 lead to rule out right sided involvement
Put the pads on pt for when he goes into shock and cardiac arrest
Put the patient on a 15 lead to rule out right sided involvement
What is the treatment for right sided MI? Lidocaine Thrombolytics Liter of fluid Nitro
Liter of fluid
If the QRS axis is -50 what does this indicate? Right axis deviation Normal axis Physiological left axis deviation Pathological left axis deviation
Pathological left axis deviation
It is not important for the limb leads to be attached to the limbs, they can be placed on the torso and still give an accurate reading.
True
False
False
Pathological left axis deviation is a sign of what block? LBBB RBBB Anterior Hemiblock Posterior Hemiblock
Anterior Hemiblock
What lead is used to assess for “Turn Signal Criteria?” II V6 V1 aVL
V1