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assessment exam 1 > Advanced EKG > Flashcards

Advanced EKG Flashcards

1
Q

ST elevation in leads II, III, aVF

A

Inferior MI; RCA

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2
Q

Reciprocal leads of II, III, AVF

A

I, aVL

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3
Q

ST elevation in leads V1, V2

A

Septal MI; LAD

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4
Q

Reciprocal of V1, V2

A

Posterior wall

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5
Q

ST elevation in leads V3, V4

A

Anterior MI; LAD

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6
Q

Reciprocal of V3, V4

A

II, III, aVF

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7
Q

ST elevation in V5, V6, I, aVL

A

Lateral MI; circumflex

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8
Q

Reciprocal of V5, V6, I, aVL

A

II, III, aVF

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9
Q

ST elevation in V8, V9 R>S in V1

A

Posterior MI; RCA

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10
Q

Reciprocal of V8, V9

A

ST depression in V1-4

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11
Q

ST elevation in V4R

A

Right ventricle infact

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12
Q

I

A

Inferior leads II, III, aVF

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13
Q

S

A

Septal leads V1, V2

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14
Q

A

A

Anterior leads V3, V4

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15
Q

L

A

Lateral leads V5, V6, I, aVL

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16
Q

Wher is the negative electrode in lead I?

A

Under the right clavicle

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17
Q

Where is the negative electrode in lead II?

A

Under the right clavicle

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18
Q

Where is the negative electrode in lead III?

A

Under the left clavicle

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19
Q

What lead is the standard monitoring lead?

A

Lead II

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20
Q

Where do the leads of a 12-lead EKG go

A

V1 on the 4th intercostal space to the right of the sternum, V2 on the 4th ICS to the left of the sternum, V3 in between V2 and V4, V4 on the 5th intercostal space mid-clavicular line, V5 anterior axillary line 5th ICS, and V6 5th ICS mid-axillary line

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21
Q

The precordial leads

A

Are the leads placed on the torso

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22
Q

RSR prime

A

The second time the complex goes above the isoelectric line; indicates a conduction abnormality

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23
Q

Where might you most commonly see an RSR prime?

A

RBBB in V1

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24
Q

What does the J point tell us?

A

It is the point of reference for determining BBBs and measuring ST elevation

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25
Q

How would we determine a rapid axis?

A

Run leads I, II, and III

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26
Q

Normal axis

A

0-90 degrees

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27
Q

Physiologic LAD

A

0 to -40 degrees

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28
Q

Pathologic LAD

A

-40 to -90 degrees

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29
Q

Extreme RAD

A

No man’s land

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30
Q

RAD

A

90-180 degrees

31
Q

Who commonly has physiologic LAD?

A

Athletes and obese people

32
Q

RAD is always

A

Indicative of pathology

33
Q

How do we determine a BBB?

A

QRS must be wider than 0.12s and look in V1

34
Q

Which is worse, LBBB or RBBB?

A

LBBB, because two of the three fascicles are blocked

35
Q

When presenting with a RBBB and _____ put pads on the patient

A

A hemiblock; suspect occlusion of the LAD CA

36
Q

A LBBB has which axis deviation?

A

Left or right depending on degree of blcok

37
Q

Hemiblocks differ from BBBs in that

A

They can have narrow complexes

38
Q

What drugs are contraindicated in bifasicular blocks?

A

Procainamide and lidocaine

39
Q

The RCA supplies blood to what parts of the heart?

A

SA and AV node, inferior wall, posterior wall, right ventricle, and posterior fascicle of the LBB

40
Q

People with RCA occlusion/MIs may present with

A

Abdominal pain/ N/V

41
Q

The LAD supplies blood to what parts of the heart?

A

The anterior wall fo the LV, septal wall, BoH, and bundle brances

42
Q

What is a common symptom of RCA occlusion?

A

Bradycardia

43
Q

What do we worry about with LAD occlusion

A

Myocardial rupture

44
Q

The circumflex artery supplies blood to what parts of the heart?

A

Lateral LV wall, SA and AV nodes, and posterior wall of LV

45
Q

Chest pain on exertion indicates what percentage of occlusion?

A

70-85%

46
Q

Chest pain at rest indicates what percentage of occlusion?

A

90%

47
Q

Chest pain without relief from nitro indicates what percentage of occlusion?

A

100%

48
Q

Absolute contraindications to anti-thrombolytic therapy

A

Sx within past three weeks, recent ICH, ischemic strokes, active bleeds, head trauma

49
Q

Relative contraindications to anti-thrombolytic therapy

A

Age greater than 75, pregnancy

50
Q

Three I’s of infarction

A

Ischemia, Injury, ST depression, Infarction

51
Q

Define ischemia

A

Transient reduction in blood flow to the myocardium

52
Q

Ischemia will show up in a 12-lead by

A

Inverted T waves in 2 or more related leads

53
Q

Injury will show up in a 12-lead by

A

ST elevation in 2 or more related leads; most important thing to look for

54
Q

ST depression shows up in a 12-lead by

A

Reciprocal leads from ST elevation

55
Q

ST depression can indicate

A

Subendocardial injury; drug or electrolyte issue; ischemia

56
Q

What two things commonly cause ST depression?

A

Hypokalemia and dig

57
Q

Infarction shows up on a 12-lead by

A

Pathologic Q waves - > .04s wide or 1/3 depth of R wave height; when seen with ST elevation

58
Q

Infarction indicates

A

Death or necrosis of tissue

59
Q

Why don’t the septal leads have reciprocal leads?

A

No leads for posterior wall

60
Q

Avoid what in an inferior MI?

A

Nitro; manage with fluids instead

61
Q

Most common MI?

A

Inferior

62
Q

Cardiac S/S of inferior MI

A

Bradycardia and HPN; 1st degree heart block or Mobitz I block; N/V

63
Q

50% of patients with inferior MIs also have

A

Posterior and right ventricular involvement

64
Q

What is the most lethal MI?

A

Anterior MI

65
Q

What arrhythmias may suddenly develop with an anterior MI

A

Complete heart block, VF, Vtach

66
Q

Anterior wall MIs also can extend to

A

The septum and lateral parts of the hear

67
Q

Don’t give ______ to patients with an anterior MI

A

Fluids

68
Q

LBBB is considered a _________? Because?

A

Non diagnostic EKG; because the late repolarization of the LV distorts the ST elevation

69
Q

Do not give ________ or ________ to a suspected dissecting thoracic aortic aneurysm?

A

Heparin or NTG

70
Q

Dissecting thoracic aortic aneurysms do not

A

Have reciprocal changes in leads showing ST elevation

71
Q

Pericarditis causes

A

ST elevation in at least 6 leads

72
Q

Pericarditis might give itself away when

A

The patient leans forward to relieve the pain

73
Q

Pericarditis will not

A

Have reciprocal lead changes

assessment exam 1 (5 decks)

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