Brainscape's Knowledge GenomeTM

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


See full index

Internal Medicine > ECG > Flashcards

ECG Flashcards

1
Q

Normal ECG paper output speed?

A

25 mm per second = 5 large squares = 25 small squares

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

ECG: 1 small square?

A

1 mm = 0.04 seconds

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

ECG: 1 large square?

A

5 small squares = 5 mm = 0.2 seconds

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

ECG: 1mV amplitude?

A

10 mm = 10 small blocks

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

How calculate rate on ECG

A

Number of R waves on rhythm strip (bottom) x 6

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

7 step approach to ECG rhythm analysis?

A

Rate Rhythm I Am pqrst

  1. Rate
  2. rhythm: relationship between P waves and QRS - P before every QRS, AV association/ disassociation., Pr interval
  3. Ischaemia /infarction? St, t wave changes.
  4. Axis
  5. P waves present / absent!!
  6. Pattern of QRS complexes: regular/irregular , QRS morphology: narrow/ wide, qt interval
  7. Individual qrst: q waves present? Poor r wave progression v1-v6?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Interpretation of Narrow complex QRS on ECG? (3)

A

Origin is:

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

Interpretation of wide complex QRS on ECG? (2)

A

Origin is :

  • ventricular or
  • supraventricular with aberrant conduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Differential diagnosis narrow complex tachycardia? (11)

A

= supraventricular origin

Atrial + regular rhythm

  • sinus tachycardia
  • atrial tachycardia
  • atrial flutter
  • inappropriate sinus tachycardia
  • sinus node re-entrant tachycardia

Atrial + irregular

  • Afib
  • atrial flutter with variable block
  • multi focal atrial tachycardia

Atrioventricular

  • AV re-entry tachycardia (AVRT)
  • AV nodal re-entry tachycardia (AVNRT)
  • automatic junctional tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Differential diagnosis broad complex tachycardia (BCT)? (8)

A

Regular rhythm BCT

  • Vtach (all VT until proven otherwise)!
  • antidromic AV re-entry tachycardia (AVRT)
  • any regular supraventricular tachycardia with aberrant conduction eg due to BBB, rate related aberrancy

Irregular

  • Vfib
  • polymorphic VT
  • torsades de pointes
  • AF with Wolff Parkinson White syndrome
  • any irregular supraventricular tachy with aberrant conduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Differential bradycardia with P wave present and every P followed by a QRS (3)

A

= sinus node dysfunction

  • sinus bradycardia
  • sinus node exit block
  • sinus pause/arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Differential bradycardia with P wave present and every P not followed by a QRS (2)

A

= AV node dysfunction

  • AV block second degree
  • AV block third degree (complete heart block)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Differential bradycardia with P wave absent (2)

A

Narrow complex = junctional escape rhythm

Broad complex = ventricular escape rhythm

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

Normal cardiac axis on ECG

A

QRS axis between -30 and +90 (down and slightly left)

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

Define left axis deviation

A

QRS axis less than -30
(Less than -90 to 180 = extreme axis deviation)

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

Define right axis deviation

A

QRS axis more than +90
(More than 180 to -90 = extreme axis deviation)

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

How estimate cardiac axis on ECG (4)

A

Normal axis = 0 - 90 = lead 1 positive (R>S) and lead aVF positive

Left axis deviation = 0 - -90 = lead 1 positive and lead aVF negative (S>R)

Right axis deviation = 90 - 180 = lead 1 negative and aVF positive

Extreme axis deviation = -90 - 180 = lead 1 negative and aVF negative

18
Q

ECG rule of 4s?

A
  • 4 initial features: history , rate, rhythm, axis
  • 4 waves: P wave, QRS complex, T waves, U waves
  • 4 intervals: PR interval, QRS width, ST segment , QT interval
19
Q

Which leads should be mirror images on ECG?

A

aVL and aVR (limb leads)

20
Q

Normal PR interval?

A

3-5 small blocks = 0.12 - 0.2 seconds

21
Q

Cause prolonged/lengthening PR interval?

A

Heart block

22
Q

Cause shortened PR interval? (2)

A
  • WPW syndrome
  • junctional rhythm
23
Q

Normal QRS width?

A

Less than 3 small squares = 0.12 sec

24
Q

Widened QRS meaning?

A

Conduction defect

25
Q

Name 6 types different STEMI patterns on ECG

A
  • septal (V1 V2)
  • anterior (V3-4)
  • lateral (I + aVL, V5-V6)
  • inferior (II,III, aVF)
  • right ventricular (V1, V4R)
  • posterior (V7-9)

SALI RP

26
Q

Normal P wave duration

A

Less than 3 blocks (0.12s)

= atrial depolarization

27
Q

Define sinus P wave (4)

A

Morphology = monophasic in lead 2, biphasic in V1

Axis = upright in leads 1 and 2, inverted in aVR

Duration = less than 3 blocks (0.12 sec)

Amplitude = less than 2.5 mm (0.25mV) in limb leads; less than 1.5 (0.15) in precordial leads

28
Q

How does right atrial enlargement appear on ECG?

A

Lead 2:
Tall P wave > 2.5 mm
Width unchanged (<120 ms)

Lead V1:

Increase height > 1.5 mm in the initial positive portion of the biphasic P wave
P pulmonale ( peaked P)

29
Q

How does left atrial enlargement appear on ECG?

A

Lead 2:

Long duration > 120 ms (3 blocks)
Height unchanged
May have P mitrale (notch)

Lead V1:

Wide > 40ms and deep > 1mm in the terminal negative portion of the biphasic P wave

30
Q

Cause P wave inversion?

A

Ectopic atrial and junctional rhythms

31
Q

Name 6 ECG changes in hyperkalaemia

A
  • peaked T waves (early sign - 5.5-6.5)
  • p wave widening/flattening, PR prolongation (K 6.5-7)
  • bradyarrythmias: sinus bradycardia, high grade AV block with slow junctional and ventricular escape rhythms, slow AF (7-9)
  • conduction blocks: BBB, fascicular blocks (late)
  • QRS widening with bizarre QRS morphology
  • severe >9: sine wave appearance (pre-terminal rhythm), Vfib, PEA (pulse less electrical activity) with bizarre wide complex rhythm, asystole
32
Q

Name 6 ECG features of hypokalaemia

A
  • increased P wave amplitude
  • prolonged PR interval
  • widespread ST depression and T wave flattening/inversion
  • prominent U waves (best seen V2 V3)
  • apparent long QT intervals due to fusion T and U waves (actually long QU interval)

Severe <2.4: frequent supraventricular and ventricular ectopics , supraventricular tachyarrythmias, potential V arrhythmias

33
Q

Define a pathological Q wave

A
  • > 40 ms (1mm) wide
  • > 2 mm deep
  • > 25% depth of the QRS complex
  • seen in leads V1-3 (should be absent in these)
34
Q

What does pathological Q wave indicate

A

Current or prior MI

35
Q

ECG features left ventricular hypertrophy?

A

Tall and thin complexes!

  • R wave in V6 > 25 mm (5 big blocks) or
  • S wave in v1 + r wave in V6 > 35 mm
36
Q

ECG features left BBB?

A

Wide QRs! > 0,12s (3 small blocks)

Also:
- m pattern of QRs in v5
- no septal q waves
- inverted T waves lead 1, avL, V5 - V6

37
Q

Name 4 causes lbbb

A
  • IHD
  • Ht
  • cardiomyopathy
  • idiopathic fibrosis
38
Q

ECG finding pulmonary embolism? (4)

A
  • Sinus tachycardia
  • Rbbb
  • R ventricular strain: inverted T in v1 to V4
  • classical S1 Q3 T3 pattern = rare (deep S wave in lead 1, Q in lead 2, t ware inversion lead 3)
39
Q

ECG findings first degree heart block?

A

Prolonged Pr interval

40
Q

ECG findings second degree heart block?

A

Dropped beats - P wave not followed by QRs

Mobitz 1: Pr interval lengthens with each beat until dropped beat

Mobitz 2: Pr intervals lengthened consistently until beat drop

41
Q

ECG findings third degree heart block?

A

No correlation P and QRs

42
Q

ECG features unstable angina? (3)

A
  • May or may not have St segment depression
  • transient St elevation
  • new t wave inversion

Internal Medicine (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions