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MS4 - Dermatology > ECG > Flashcards

ECG Flashcards

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Dermatology Board Prep flashcards
1
Q

System to analyse ECG

A

Rate

Rhythm

Axis

P wave

P-R

QRS length

QT

T wave

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2
Q

How to calculate rate

A

300 divided by big squares between 2 QRS

OR

count 30 large boxes (6seconds)

count the no. of R-R interval

Multiply by 10

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3
Q

How to tell axis on ECG

A

Leaving- LEFT axis deviation

Reaching- RIGHT axis deviation

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4
Q

P wave normal measurements

A

<2.5 squares high

<3 small squares wide

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5
Q

Normal PR length

A

3-5 small squares

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6
Q

QRS normal length

A

<3 small squares

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7
Q

How to tell if it is a Q wave

A

negative deflection before an R wave

If no R wave, assume it is S wave

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8
Q

Q wave a sign of

A

cardiac damage - prvs MI

normal in limb leads

Should be less than a quarter of depth of QRS otherwise pathological

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9
Q

How to tell if Q wave pathological

A

normal in limb leads

Should be less than a quarter of depth of QRS otherwise pathological

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10
Q

ST elevation a sign of

A

infarction if more than 1mm

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11
Q

ST depression a sign of

A

ischaemia if > 0.5mm

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12
Q

Where to expect downward T waves

A

aVR

V1

sometimes III

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13
Q

Normal amplitude of T wavs

A

<5 mm in limbs

<10 in chest leads

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14
Q

Peaked T wave a sign of

A

hyperkalaemia

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15
Q

T wave inversion a sign of

A

Ischaemia

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16
Q

What is a prolonged QT

A

>440 in men

>460 mm in women

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17
Q

What does a QT of >500 ms increase the risk of

A

torsades de pointes

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18
Q

Causes of prolonged QTc

A

Low K, Ca, Mg

Low Temp

Drugs

MI

congenital

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19
Q

U wave

A

small deflection after T

delayed repolarisation of Purkinjee fibres

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20
Q

How big is a prominent U waves

A

>1mm or >25% of T wave

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21
Q

Causes of prominent u wave

A

Low HR, K, Temp

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22
Q

Inverted U wave causes

A

ischaemia

CAD

HTN

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23
Q

Regions associated with ECG leads

A
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24
Q

Lateral heart supplied by

A

LCX

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25
Q

Inferior heart supplied by

A

LCS or RCA

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26
Q

Septal/anterior heart supplied by

A

LCS

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27
Q

Reperfusion (PCI) criteria

A

ischaemic sx +

ST elevation >2 mm in 2 x contiguous chest leads

or

ST elevation >1mm in 2 x contiguous limb leads

or

New LBBB

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28
Q

Left vs right BBB

A

Left bundle: WiLLiaM

W shape in V1

M shape in V6

Right bundle: MaRooN

M shape in V1

N shape in V6

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29
Q

Posterior STEMI

A

V 1-3 ST depression

looking at ECG upside down = STEMI

30
Q

Progression of STEMI

A
31
Q

T wave inversion or flattening

A

At least 1 mm deep

Present in ≥ 2 continuous leads that have upright QRS complexes

32
Q

Narrow complex tachyarrhythmias

A

AF

Atrial flutter

Re-entrant tachycardia (AVNRT)

33
Q

Broad complex tachyarrhythmias

A

VT

Torsades de pointes

VF

34
Q

pathophysiology of Atrial flutter

A

Re-entry circuit within the right atrium.

Regular atrial activity, ventricular rate can be regular or irregular.

Saw tooth

35
Q

Commonest cause of atrial flutter

A

IHD

36
Q

Wolff-Parkinson-White syndrome ecg changes

A
  • ST Segment and T wave opposite direction
  • delta waves in the inferior / anterior leads (“pseudo-Q waves”),
  • a prominent R wave in V1-3 (mimicking posterior infarction)
37
Q

VT ECG

A

Broad QRS

AV dissociation

Tachy

38
Q
A

Ventricles rapidly attempt to contract (up to 500bpm)

39
Q

Shockable rhythms

A

VF

VT

40
Q

Non shockable rhythms

A

Asystole

Pulseless electrical activity

41
Q

Causes of Cardiac arrest

A

4 H + 4 T

Hypoxia

Hypovolemia

High K, Low K, glucose, Ca

Hypothermia

Thrombosis

Tension pneumothorax

Tamponade

Toxins

42
Q

Whats the ECG showing

A

1st degree heart block

prolonged PR

43
Q

Causes of 1st degree heart block

A

increased vagal tone (eg due to athletic training)

inferior MI

myocariditis

44
Q

Whats the ECG showing

A

2nd degree HB - Mobitz T1

Progressive prolongation of PR interval- leads to non conducted P waves

45
Q

another name for Mobitz T1 HB

A

Wenkebach phenomenon

46
Q

Management of Mobitz T1 HB

A

if asymptomatic none

If sx-> atropine

47
Q

Whats the ECG showing

A

Mobitz T2 HB

intermittent non conductive P

No PR prolongation

48
Q

Causes of Mobitz T2 HB

A

Anterior MI (sepetal infarct)

Idiopathic fibrosis

Inflammatory conditions (Lyme disease, rheumatic fever, myocarditis)

Autoimmune (SLE, systemic sclerosis)

49
Q

Mangament of Mobits T2

A

Temporary pacing

PPM

50
Q

Causes of Mobits T1 vs T2

A

T1 due to functional suppression, eg drugs or ischaemia

T2 due to structural damage eg infarct, fibrosis

51
Q

Whats this

A

3rd degree HB

No AV conduction

dissociation between atrial and ventricular activity

52
Q

Hyperkalaemia on ECG

A

Tall tented T waves

Prolonged PR interval (or loss of P wave)

Wide QRS complexes

53
Q

whats this

A

hyperkalaemia

54
Q

Hypokalaemia on ECG

A

T wave inversion

Prominent U waves

Long QU interval

ST depression

55
Q

Main effect of Ca level on ECG

A

low-> long QT

high-> short QT

56
Q

PE ECG findings

A

Sinus Tachycardia (most common!)

RBBB

Right Axis Deviation

Right atrial enlgargement (P pulmonale)

S1Q3T3

Right ventricular strain – TWI V1-V4 + inferior leads

57
Q

S1 Q3 T3

A

Deep S wave in lead I, Q wave in III, inverted T wave in III

58
Q

ECG of

A

PE

RBBB

Extreme right axis deviation (+180 degrees)

S1 Q3 T3

T-wave inversions in V1-4 and lead III

59
Q

Pericarditis ECG

A

Concave ST elevation

PR depression

Sinus tachy

60
Q

ECG of

A

pericarditis

61
Q

Premature ventricular complex

A

ectopic beat:

Broad QRS

Premature — i.e. occurs earlier than would be expected for the next sinus impulse

Discordant ST segment and T wave changes

Usually followed by a full compensatory pause

62
Q

Bigeminy

A

premature ventricular complex every other beat

63
Q

Trigeminy

A

premature ventricular complex every third beat

64
Q

Pulseless electrical activity

A

clinical features of cardiac arrest

ECG shows normal rhythm

cardiac contractions absent despite electrical activity

65
Q

Describe ECG

A

Asystole

66
Q

Describe ECG

A

VT

67
Q

Describe ECG

A

Supravebtricular tachy (AV node re-entry)

68
Q

Describe ECG

A

Atrial flutter

69
Q

Describe ECG

A

prvs STEMI

70
Q

Describe ECG

A

Posterior STEMI

71
Q

Describe ECG

A

ANTERO-SEPTAL STEMI

72
Q

Drugs causing sinus bradycardia

A

Beta-blockers

Ca channel blocker (verapamil & diltiazem)

Digoxin

Central alpha-2 agonists (clonidine & dexmedetomidine)

Amiodarone

Opiates

GABA-ergic agents (barbiturates, benzodiazepines, baclofen, GHB)

Organophosphate poiso

MS4 - Dermatology (3 decks)

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