Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Health Assessment > Advanced EKG (1) > Flashcards

Advanced EKG (1) Flashcards

1
Q

EKG changes with hyperkalemia:

A

P waves widened and low amplitude d/t slow conduction

QRS widening, loss of ST, tall tented T waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

EKG changes with hypokalemia:

A

ST depression and flattening of T wave

Native T wave

U wave (positive inflection after T wave)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

EKG changes with hypercalcemia:

A

Mild: broad based tall peaking T wave

Severe: Very wide QRS, low R wave, no p wave, tall peaking T wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can cause hypercalcemia?

A

Messing with thyroid/ PTH

Neck surgeries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

EKG changes with hypocalcemia:

A

Narrowing QRS complex
Reduced PR
T wave flattening and inverted
Prolonged QT interval
U wave
ST depression and prolonged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is it common to see a J wave (Osborn wave)?

A

Hypothermia
Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is the J point positive vs negative deflections?

A

Positive deflection in precordial and limb leads

Negative deflections in aVR and V1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the delta wave and what does it mean?

A

Slurred upstroke in QRS (delta wave): related to pre-excitation in the ventricles (EX: WPW)

short PR
Broad QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What med do you want to avoid if EKG has a delta wave?

A

Cardizem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Whats this?

A

Delta wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What patient is at risk for complete heart block?

A

Ventricular disease
Electrolyte abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is the 5 lead better at giving info than the 3 lead?

A

5 lead allows monitoring of 2 or more concurrent leads

3 lead only allows for monitoring in one lead at a time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which lead is a good one to look at for atrial arrythmias?

A

L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which lead is common choice for cardioversion?

A

Lead 2: large upright deflection and ease for “synchronizing” with the R wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a good lead to look at the left ventricle?

A

Lead 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

L1, L2 and L3 should all be __________ deflections

A

Positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How many electrodes used in 12 lead?

A

10 electrodes: 4 limb/ 6 precordial (v leads/MCL leads)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where to place limb leads:

A

Shoulder do NOT count as limbs

place on wrists or ankles–avoid bony prominences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Placement for precordial leads:

A

V1: 4th intercostal space right sternal border

V2: 4th intercostal space left sternal border

V3: sandwich between V2 and V4

V4: 5th intercostal space left of sternum mid clavicular

V5: 5th ICS left sternal anterior axillary line

V6: 5th ICS left sternal mid axillary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Steps to determine where heart issue is occuring:

A

I: inferior (L2, L3, aVF)
See: septal (V1,V2)
All: Anterior (V3, V4)
Leads: Lateral (V5, V6, L1, aVL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

R wave:

A

1st positive deflection after P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Q wave:

A

First negative deflection after p wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

S wave:

A

Negative deflection below baseline after R or Q wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What 2 reasons is the J-point important for?

A

Determining bundle branch blocks

Measuring ST segment elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does RSR complex indicate?

A

classic pattern for right bundle branch block in MCL1 (V1)

26
Q

What complex is this?

A

QS complex: entire complex is below isoelectric line

27
Q

Deflection in a normal axis (0-90):

A

Positive in L1, L2, L#

28
Q

Physiologic let axis (0 to -40) deflections:

A

L1: +
L2: + or split
L3: -

29
Q

Pathologic left axis (-40 to -90) deflections:

A

L1: +
L2: -
L3: -

Anterior hemiblock

30
Q

Right axis (90-180) deflections:

A

L1: -
L2: +/- or half up half down
L3: +

posterior hemiblock

31
Q

Extreme right axis (no mans land) deflections:

A

L1: -
L2: -
L3: -

ventricular origin

32
Q

What is the most common cause of axis deviations?

A

HTN, Hypertrophy–takes longer for muscle to contract

33
Q

What length does the qrs have to be in order for bundle branch dx?

A

Qrs >0.12 or wider than 3 little squares

34
Q

What lead do we look at left turn/right turn signal trick to dx BBB?

A

V1–circle J point then draw line back to the complex

arrow pointing up= R BBB
arrow pointing down= L BBB

35
Q

If someone is having an MI with BBB–how does the BBB affect mortality rate?

A

4x higher mortality rate when bundle branch block present

36
Q

Bifascicular block RBBB + Anterior hemiblock (L axis deviation) increases risk for:

A

high risk for v fib

37
Q

RBBB + posterior hemiblock increases risk for:

A

Not good–probably has LAD occlusion

complete heart block, bradycardia, vfib

38
Q

Bundle branch diagnosis is dependent on ________ whereas hemiblocks are based on _____________.

A

Time
Axis deviation

39
Q

Where does most blood supply for the SA/AV come from?

A

RCA

issues could cause elevated CVP/ JVD

40
Q

Where does the RCA supply blood to?

A

Inferior Wall (LV)
Posterior Wall (LV)
Right Ventricle
SA and AV Node
Posterior fascicle of LBB

41
Q

Where does the LAD supply blood to?

A

“Widow Maker”
Anterior Wall of LV
Septal Wall
Bundle of His and BB

41
Q

Where does the circumflex artery supply blood to?

A

Lateral Wall of LV
SA and AV nodes
Posterior Wall of LV

42
Q

If there is posterior involvement which arteries might be occluded?

A

RCA and circumflex

43
Q

What can we give to interrupt atherosclerotic plaque formation?

A

ASA or heparin

44
Q

If a patient is having back pain with an MI, where might the origin be?

A

Posterior wall

45
Q

Chest pain on exertion represent what % occulsion?

46
Q

Chest pain at rest represent what % occlusion?

47
Q

Chest pain unrelieved by nitro represents what % occlusion?

A

100% – need bypass

48
Q

What is the limitation of 12 lead ekg?

A

Sensitivity: machines ability to “see” the MI

most are 50% sensitive to picking up MIs

Cant rule anything out with just EKG

49
Q

What are the “i’s” of infarction?

A

Ischemia: transient reduction in blood flow to myocardium

Inverted T waves in 2 or more leads

50
Q

Which leads is it normal to have inverted T wave?

51
Q

What can ST depression indicate?

A

Ischemia or subendocardial injury

Could be hypokalemia or digitalis

52
Q

What does a pathological Q wave look like and what does it indicate?

A

Full thickness infarction

Q wave greater than 40ms wide or measures 1/3 height of R wave

Path q wave w/ST elevation= Acute MI

Without acute ST changes= old

53
Q

What artery corresponds with inferior leads?

54
Q

What artery corresponds with septal and anterior leads?

55
Q

What artery corresponds with lateral leads?

A

Circumflex

56
Q

Where is the infarct likely coming from when ST depression is seen in V1-V4?

57
Q

What is the most common MI location? What are S/S?

A

Inferior MI–RCA occlusion

hypotension, JVD, clear lungs

58
Q

What is the most lethal MI location?

A

Anterior MI–LAD

59
Q

What is a common infarction imitator?

A

LBBB: late depolarization makes ST elevation difficult to distinguish
LBBB considered a non-diagnostic ECG

Left vent hypertrophy: won’t have reciprocal changes

Dissecting Thoracic aortic aneurysm:

60
Q

What is going on when there is ST elevation in all leads?

A

Pericarditis (ST elevation in at least 6 leads)

lean pt forward to help with pain

pt may have flu like symptoms

61
Q

What is a distinguishing factor for dissecting thoracic aortic aneurysm compared to acute MI?

A

Dissecting aortic aneurysm can have ST segment elevation but doesnt have reciprocal changes

CXR/CT chest: Widened mediastinum

Health Assessment (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions