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MBChB OSCE > ECG > Flashcards

ECG Flashcards

(72 cards)

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1
Q

What 2 things do you do when checking the calibration of an ECG?

A
  • Ensure 10mm = 1mV
  • Ensure paper speed is 25 mm/sec
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2
Q

What does a small box representon an ECG?

A

0.04 secs or 40 ms

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3
Q

What do the larger boxes on an ECG represent?

A

5 small boxes = 1 big box

0.2 secs or 200 ms

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4
Q

How do you determine the HR (ventricular rate)?

A

300 / number of big squares between R waves

(calculated in standard lead II)

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5
Q

Describe a normal P wave

A
  • Height < 0.25 mV
  • Width < 110 msec (3 small boxes)
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6
Q

What is a normal PR interval?

A

120 to 200 msec (0.12 to 0.2 secs)

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7
Q

What does a prolonged PR interval suggest?

A

Heart block (primary, secondary or tertiary)

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8
Q

What is a normal QRS complex?

What is a wide QRS complex?

A

Normal < 120 msec

Wide > 120 msec

(120 msec = 3 small boxes)

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9
Q

What is the normal axis of an ECG reading?

A

-30 to +90 degrees

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10
Q

In what leads is T wave usually inverted?

A
  • Standard lead aVR
  • Chest lead V1
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11
Q

In what leads would it be abnormal for a T wave to be inverted?

A

I, II and V4 to V6

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12
Q

What does a tall/peaked T wave suggest?

A

Hyperkalaemia

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13
Q

Where is the QT interval measured between?

A

From start of QRS to end of the T wave

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14
Q

What does QT vary with?

A

Heart rate

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15
Q

How do you calculate the corrected QTc interval?

A

QTc = QT / √RR

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16
Q

What is the normal range for QTc?

A

380 to 420 msec (0.38 to 0.42 secs)

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17
Q

What degrees of the hexaxial diagram does aVR sit at?

A

-150 degrees

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18
Q

What degrees of the hexaxial diagram does aVL sit at?

A

-30 degrees

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19
Q

What degrees of the hexaxial diagram does I sit at?

A

0 degrees

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20
Q

What degrees of the hexaxial diagram does II sit at?

A

+60 degrees

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21
Q

What degrees of the hexaxial diagram does aVF sit at?

A

+90 degrees

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22
Q

What degrees of the hexaxial diagram does III sit at?

A

+120 degrees

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23
Q

What does P in the ECG represent?

A

Atrial depolarisation

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24
Q

What does T represent in the ECG?

A

Ventricular repolarisation

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25
What does Q represent in the ECG?
Septum depolarisation
26
What does R represent in the ECG?
Ventricular (main) depolarisation
27
What does S represent in the ECG?
Base of heart depolarisation
28
What are the inferior leads?
III, aVF, II
29
What are the left lateral leads?
aVL, I, V6, V5
30
What are the front leads?
V2, V3, V4
31
What are the chest leads?
V1 - V6
32
What are the limb leads?
aVL, aVR, aVF, II, III
33
Describe the order of conduction?
SAN -\> AVN -\> Bundle of His -\> R and L Bundle Branches Left Bundle Branch -\> Anterior and Posterior Fascicles
34
What are Einthoven's labelling rules for the QRS?
* First positive is an R * Any negative preceding an R is a Q * Negative following an R is an S * Any further positive following an S is called R1 (R prime)
35
What are the characteristics of right bundle branch block?
* M pattern in V1 to V3 * Rabbit ears * W pattern in V6
36
State 2 signs of myocardial ischaemia?
* ST depression * T wave inversion
37
Comment on the ECG
NORMAL
38
Comment on the ECG
ST DEPRESSION
39
Comment on the ECG
T WAVE DEPRESSION
40
What do you use to determine if there is left ventricular hypertrophy (LVH)?
Sokolow-Lyon criteria
41
What is sokolow-lyon criteria?
Sum of the height of the R wave in leads V5 or V6 plus the depth o the S wave in lead V1 \> 35 mm = LVH
42
What signs on the ECG would suggest Right Ventricular Hypertrophy?
* R wave in V1 greater than 7mm * Right axis deviation * S waves in V5-V6
43
What are the different types of Acute Coronary Syndrome?
* Unstable angina * Non-ST segment elevation MI * ST segment elevation MI
44
What would be the signs on an ECG of NSTEMI?
* No ST elevation * Troponin elevated
45
What does Troponin \< 14 ng/L signify?
* Troponin negative * Unstable angina
46
What does a troponin between 14 and 99 ng/L suggest?
Myocardial infarction
47
What does a troponin greater than 99 ng/L suggest?
Myocardial infarction
48
What are the inferior leads?
II, III, aVF
49
What are the lateral leads?
V5-V6, I and aVL
50
What are the anterior leads?
V2-V5
51
What are the signs on an ECG that may suggest a PE?
S1 Q3 T3 pattern Inverted Ts V1-V4
52
What are the ECG signs of hyperkalaemia?
* Tall T waves * Prolonged PR * Widened QRS * Arrhythmias
53
What are the signs of hypokalaemia?
* Flattened T wave * Depressed ST * Tall U waves * Prolonged QT * Arrythmias
54
What is the normal height/amplitude of a T wave?
1/3 to 2/3 of the corresponding R wave
55
How does hypercalcaemia show on an ECG?
Short QT interval
56
How does hypocalcaemia show on an ECG?
* Long QT interval * Small T waves
57
What does DIGOXIN do to a patients ECG?
* Shortened QT interval * Characteristic down-sloping ST depression * "Reverse tick" * Arrythmias
58
First degree heart block?
Delayed PR interval
59
2nd-degree heart block Mobitz type 1 (wenckenbachs)?
Signals are delayed more and more until the heart skips a beat then resets
60
2nd degree heart block Mobitz type 2?
Some electrical signals don't reach the ventricles
61
Third-degree heart block?
No electrical signals reach the ventricles
62
Where do you find the apex beat?
* Left 5th ICS * Mid-clavicular line
63
What is a thrill? What does it indicate?
* Palpable vibration caused by turbulent blood flow * Aortic stenosis
64
What is a heave? What does it indicate?
Vibration felt on the heel of the hand * Caused by left atrial hypertrophy * mitral stenosis * mitral regurgitation
65
What can the tricuspid valve be auscultated?
* Left 4th ICS * Sternal edge
66
What can the pulmonary valve be auscultated?
* 2nd left ICS * Lateral to sternum
67
What can the aortic valve be auscultated?
* Right 2nd ICS * Lateral to sternum
68
What are the shockable rhythms?
* Ventricular fibrillation * Pulseless ventricular tachycardia
69
What drugs should you administer intermittently for shockable rhythms?
* Adrenaline 1mg IV * Amiodarone 300mg IV
70
What should the minimum power be for a first shock?
150J
71
What are the non-shockable rhythms?
* Pulseless electrical activity (PEA) * Asystole
72
What drug should you administer intermittently for non-shockable rhythms?
Adrenaline 1mg IV

MBChB OSCE (14 decks)

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