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Year 4 Gen Med > Cardio ECG > Flashcards

Cardio ECG Flashcards

1
Q

what does the p wave represent

A

atrial depolarisation

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2
Q

how long is the p wave (seconds and squares)

A

0.08-0.1s 2 small squares

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3
Q

how long is the qrs wave (seconds and squares)

A

<0.12s <3 small squares

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4
Q

how long is the pr interval (seconds and squares)

A

0.12-0.2s 3-5 small squares

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5
Q

what does the qrs wave represent

A

ventricular depolarisation

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6
Q

what does the t wave represent

A

ventricular repolarisation

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7
Q

what does the pr interval represent

A

av nodal delay

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8
Q

st

A

systole

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9
Q

tp

A

diastole

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10
Q

1 small box =

A

0.04s

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11
Q

1 large box =

A

0.2s

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12
Q

if heart rate regular

A

300/ no large squares between r-r

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13
Q

if heart rate irregular

A

Count the number of QRS complexes in 30 large squares, and then multiply by ten.

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14
Q

normal axis deviation shown on ecg

A

lead 1 and avf are upright

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15
Q

right axis deviation axis deviation shown on ecg

A

lead 1 down avf up

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16
Q

left axis deviation shown on ecg

A

axis deviation shown on ecg

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17
Q

what criteria diagnoses st elevation

A

• Greater than or equal to 1mm ST Elevation in 2 adjacent limb leads • Greater than or equal to 2mm ST Elevation in at least 2 contiguous precordial leads • New onset bundle branch block

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18
Q

how do you analyse an ecg in an osce

A
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19
Q

what are the 3 leads of an ecg

A

lead 1 = right arm left arm

lead 2 - right arm left leg

lead 3 - left arm left leg

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20
Q

inferior mi effects which arteries

A

left or right ca

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21
Q

anterior mi effects which arteries

A

LAD

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22
Q

what ecg changes could happen on the first day of a stemi

A

ST Elevation – first few hours

T wave inversion – first day

Q waves – first day

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23
Q

how would you calculate a regular heart rate on a patient with tachycardia?

A

1500/ small squares between two r waves

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24
Q

what are the 3 most common tracing problems

A

ac interference

muscle tremor

baseline wandering

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25
Q

what are the 6 key rhythm questions

A
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26
Q

if a signal travels toward a lead it will be

A

+ve

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27
Q

if a signal travels away from a lead it will be

A

-ve

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28
Q

5 large boxes =

A

1s

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29
Q

how to calculate the corrected qt interval?

A

qt/square root of rr

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30
Q

the p wave is normally inverted in lead

A

avr

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31
Q

r wave amplitude should ……….. from v1-6

A

increase

32
Q

what is the general rule of t waves

A

should not be more than half the size of the qrs

33
Q

what does prwp stand for?

A

poor r wave progression

34
Q

how do you calculate corrected qt?

A

QT (in milliseconds)/ square root of R-R (IN SECONDS)

35
Q

WHAT IS THE NORMAL QT?

A

400ms (0.4s)

36
Q

in axis deviation, if both lead one and avl are down then the axis would be

A

indeterminate

37
Q

which wave grows across chest leads v1-6? what is this called?

A

r wave = r wave progression

38
Q

which leads are good at helping you determine rhythm and by looking at the p waves?

A

lead 2 or V1

39
Q

when you are describing rhythm what would you say?

A

not regular or irregular – you would say sinus rhythm/ sinus tachycardia/ atrial flutter etc

40
Q

how do you treat heart block

A

pacemaker

41
Q

which one could get you in legal shit if you miss on an ecg

A

heart block

42
Q

which types of heart block may be normla

A

1st degree and mobitz type 1

43
Q

what are escape beats

A

come late because you didnt get a normal beat (back up rhythm)

44
Q

what are ectopic beats

A

beats that arrive early

45
Q

what is the definition of sinus rhythm

A

each p wave precedes a qrs and each qrs follows a p wave

46
Q

at what rate do the atria usually beat in atrial flutter? what does this mean for the ventricular beat?

A

usually atria go at 300bpm

ventricles usually beat at a derivative of this (so 100 75 150 etc)

47
Q

how can you slow the heart rate down in svt in order to see the rhythm properly?

A

vagal maneuvres

adenosine

48
Q

what is a delta wave?

A

slurred upstroke on the r wave seen in WPW

49
Q

How do you determine if there is BBB and if so which type?

A

step 1 - is the qrs broad? qrs >120ms (cannot be narrow needs to be broad)

step 2 - is it right bbb? (RSR pattern in V1 up down up / or M pattern)

step 3 - if answer to above qs is no - – left bbb

50
Q

if you have a lbbb or rbbb with a tachycardia

A

broad complex tachycardia (vtach or a narrow complex tachy with aberancy)

51
Q

what does monomorphic mean

A

all look the same in teh tachy

52
Q

what does polymorphic mean?

A

v tachy all looking different ie torsades de pointes

53
Q

if you have an irregualr broad complex tachy you need to check that its not

A

AF with aberancy

54
Q

what does abberancy mean?

A

problem in heart conducting system - change in length of beat with no change in refractory period

55
Q

t wave inversion in what lead is normal

A

lead 3

56
Q

treat tachy

A
  1. vagal manoevre
  2. adenosine
  3. cardiovert
57
Q

treat vtach

A

amiodarone

cardiovert

58
Q

dont give adenosine in ……. - you should give …….

A

WPW/ AF

shock q

59
Q

st depression

A

ischaemia

60
Q

what is seen in cocaine

A

st depression

61
Q

ectopic beats can cause

A

vtachy

62
Q

a normal ecg does not exclude

A

coronary artery disease

63
Q

inferior - artery

A

rca

64
Q

anterior - artery

A

LAD

65
Q

lateral - artery

A

circumflex

66
Q

signs of a posteiror infarction

A

t wave inversion

v1-3

normal v4-6

67
Q

treat MI

A

mona + t

IV unfractionated heparin 5000 units

cath lab (if far from hospital then thrombolysis)

68
Q

what is hypertrophy

A

increase in mass not volume

69
Q

most common cause of hypertrophy

A

hypertension

70
Q

how to diagnose hypertrophy

A

-ve sv2 + +ve RV5 >7 boxes

71
Q

ST depression and hypertension

A

may not be ischaemia may be LVH with strain

72
Q

if qrs is broad think

A

bbb

73
Q

st elevation with pr depression

A

pericarditis

74
Q

treat pericarditis

A

nsaids but check troponin just in case

75
Q
A

Year 4 Gen Med (26 decks)

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