Cardiology

Question 1

A lesion with occlusion occurying in the LAD artery will typically result in

Answer 1

an Anterior Wall MI

Question 2

When an AWMI extends to the septal and lateral regions as well, the culprit lesion is usually

Answer 2

more proximal in the LAD or even in the left main coronary artery

Question 3

ST segment elevation in the anterior leads (V3 and V4) and sometimes in septal and lateral leads depending on the extent of the myocardial infarction

Answer 3

Anterior Wall MI

Question 4

Septal Leads

Answer 4

V1 and V2

Question 5

Inferior Leads

Answer 5

II, III, avF

Question 6

Laterial Leads

Answer 6

I, avL, V5, V6

Question 7

How to ensure precordial leads have been placed correctly

Answer 7

presence of a negative QRS complex in avR and a positive QRS in Lead I

Question 8

Which lead should be omitted when checking for signs of infact?

Answer 8

avR. It is of no diagnostic value due to the fact that it misrepresents pathological Q waves and obscures them.

Question 9

standard criteria for diagnosing acute miocardial infarction

Answer 9

ST elevation of 1 mm. or more in the presence of pathological Q waves in 2 or more contigous leads

Question 10

abnormal q wave

Answer 10

.04 sec (1mm) wide or greater

depth of q wave is greater than 1/3 height of r wave

Question 11

Cardiac conduction system

Answer 11

SA Node, Internodal Pathways, AV Node, Bundle of His (AV Bundle), Left/Right Bundle Branch, Perkinje Fibers

Question 12

Anterior Leads

Answer 12

V3, V4

Question 13

ST segment elevation in leads II, III and avF

Answer 13

Inferior wall MI

Question 14

MI symptoms with tachycardia

Answer 14

Possible damage to the left Ventricle and an “anterior” or “lateral” infarct.

The Left Circumflex and or Left Descending Coronary Artery may be occluded.

Check for elevation in leads V3, V4, V5, & V6.

Question 15

MI symptoms with bradycardia

Answer 15

Possible damage to the Right Ventricle and an “inferior” or “posterior” infarct.

The Right Coronary Artery may be occluded.
Check for elevations in the Limb Leads: II, III and avF.

Question 16

normal PR interval

Answer 16

.12 - .20 seconds (3-5 small boxes)

Question 17

normal QRS interval

Answer 17

.04 - .12 seconds (not more than 3 boxes)

Some literature states not more than .1 seconds.

Can be shorter for children or after extended periods of exertion.

Question 18

Wide QRS interval can indicate

Answer 18

V-tach
3rd degree heart blocks
Bundle branch blocks
Hyperkalemia
Tricyclic antidepressant overdose.

Question 19

Which lead is the only one used to recognize bundle branch blocks

Answer 19

v1

QS complex = left bundle branch block
rSr complex = right bundle branch block

Question 20

6 Steps to 12 Lead Interpretation

Answer 20

1. Rate and Rhythm
2. Axis Deviation
3. Intervals
4. Morphology
5. ST Elevations - Mimics
6. Ischemia, Injury, Infarct

Question 21

When should nitro be avoided in the presense of acute MI

Answer 21

inferior wall MI, due to possible right ventricle injury

the right ventricle, in the presence of injury, is dependent on preload. Pump action of the right side is significantly diminshed due to injury. Nitro decreases preload.

Hold the nitro and give fluid bolus