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Other OSCE Stations > ECG > Flashcards

ECG Flashcards

1
Q

What are the chest leads?

A

V1-V6

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2
Q

What are the limb leads? Which ones are bipolar?

A

I, II, III, aVR, aVL, aVF

I, II and III are bipolar

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3
Q

Inferior leads?

A

II, III, aVF

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4
Q

Anterior leads?

A

V1-V4

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5
Q

Lateral leads?

A

V5, V6, I, aVL

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6
Q

Where are the limb leads and chest leads and rhythm strip on the reading?

A

Limb leads on the left, chest leads on the right, rhythm strip on the bottom.

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7
Q

Which is the rhythm strip if there isn’t actually a rhythm strip?

A

II and V1

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8
Q

What does P wave correspond to?

A

Atrial depolarisation/contraction

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9
Q

What is the PR interval?

A

Distance between P wave and QRS complex

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10
Q

What does QRS complex correspond to?

A

Ventricular contraction (QRS complex hides atrial relaxation

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11
Q

What does T wave correspond to?

A

Ventricular relaxation

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12
Q

What is the QT interval?

A

Distance between Q wave and T wave

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13
Q

First things you do when interpreting ECG?

A

Patient name, DoB and symptoms.
ECG date and time.
Check calibration: paper speed (25mm/s), 1mV calibration (at start of trace) - 2 large squares in height.

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14
Q

How do you work out rate?

A

Number of small sqaures in one R-R interval - divide this into 300.

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15
Q

Rate if RR interval = 3 squares?

A

100bpm

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16
Q

Rate if RR interval = 4 squares?

A

75bpm

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17
Q

Rate if RR interval = 5 squares?

A

60bpm

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18
Q

How to work out rhythm?

A

Mark 4 R peaks on piece of paper and move along trace to confirm consistency.

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19
Q

What are you looking for to confirm sinus rhythm?

A

Regular normal P waves before each QRS complex

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20
Q

No clear P waves and irregular QRS = ?

A

AF

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21
Q

Leads for axis?

A

I and II

22
Q

QRS complexes in I and II are both predominantly…?

A

Positive

23
Q

If I and II R waves point away from each other?

A

LAD (Legs apart)

24
Q

If I and II R waves point towards each other?

A

RAD

25
Q

Cause of left axis deviation?

A

Heart conduction defects

26
Q

Cause of right axis deviation?

A

RVH

27
Q

What are looking for in P waves?

A

Are P waves present?
Do they occur regularly?
Does a P wave precede each QRS complex?
Do the P waves look normal? (Smooth, rounded and upright?)

28
Q

What should the height of the P wave be?

A
29
Q

What do bifid P waves indicate?

A

P Mitrale - left atrial hypertrophy (mitral stenosis)

30
Q

What does peaked P waves indicate?

A

P Pulmonale (right atrial hypertrophy)

31
Q

How long should the PR interval be?

A

3-5 small squares (0.12-0.2 seconds)

32
Q

What does a prolonged PR interval indicate?

A

Heart block

33
Q

What does a reduced PR interval indicate?

A

Accessory conduction pathway (Wolff-Parkinson-White Syndrome)

34
Q

Where should you look when looking at the QRS complex?

A

Rhythm strip

35
Q

Width of QRS complex?

A

3 small sqaures (0.12 seconds)

36
Q

If QRS complex longer than 0.12 seconds…?

A

Complex originated in the ventricles

37
Q

If QRS complex shorter than 0.12 seconds…?

A

The complex is supra-ventricular in origin

38
Q

Where do you look for bundle branch block?

A

V1 and V6

39
Q

QRS in V1 has M pattern and QRS in V6 has W pattern…?

A

RBBB (MaRRoW)

40
Q

QRS in V1 has W pattern and QRS in V6 has M pattern?

A

LBBB (WiLLiaM)

41
Q

Where do you look for R wave progression?

A

Chest leads (V1-V6)

42
Q

What is R wave progression?

A

QRS complexes should progress from mostly negative in V1 to mostly positive in V6

43
Q

Where should you check the ST segment?

A

All leads

44
Q

What constitutes significant elevation or depression?

A

> 1 small square

45
Q

Main cause of ST elevation?

A

MI

46
Q

Main cause of ST depression?

A

Ischaemia

47
Q

Where should you check the T waves?

A

All leads

48
Q

Where is T wave inversion normal?

A

aVR, V1 (right leads)

49
Q

What does T wave inversion indicate?

A

Ischaemia/Post-MI

50
Q

What do tented T waves indicate?

A

Hyperkalaemia

51
Q

What do flat T waves indicate?

A

Hypokalaemia

52
Q

Typical pattern in PE?

A

an S1Q3T3 pattern - a prominent S wave in lead I, a Q wave and inverted T wave in lead III
SINUS TACHY

Other OSCE Stations (7 decks)

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