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Neet Rank 8 > Ecg > Flashcards

Ecg Flashcards

1
Q

Absent P waves

Normally 2&1/2 small sq

A

Junctional rhythm
Dyselectrolytemia- Hyper K
Arrhythmia - Afib and PSVT

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2
Q

Tall P waves

P Pulmonale

A

RAH

TS, TR, RVH, cor pulmonale (PAH)

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3
Q

Wide P waves

P mitrale

A

LAH

MS, MR, LVF, systemic HTN

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4
Q

Prolonged PR interval

Normally 2&1/2 small sq

A 
AVN block 
Drugs - digoxin, verapamil and diltiazem, BB 
Hyper or Hypo K+
AVN inflammatory edema - ARF
AVN infiltration- amyloidosis
AVN calcification
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5
Q

Short PR interval

A

Accessory pathways

  1. James pathway
  2. Bundle of Kent
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6
Q

Lawn ganong Levine syndrome

A

James pathway activates BOH so both ventricles contract simultaneously

ECG - short PR interval and normal QRS

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7
Q

WPW

A

Bundle of Kent directly excites LV and causes it to contract before RV

ECG - PR shortening + Wide QRS 💀 + Delta wave

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8
Q

QRS pathologies

2&1/2 small sq

A

Wide
Morphology
Axis

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9
Q

Wide QRS

A 
Both ventricles aren’t contracting simultaneously AVN#
1. Idioventricular rhythm 
2. LBBB RBBB 
3. WPW 
4. Inf wall MI 
5. HKMALT 
High K 
Hyper Mg 
Adrenal insufficiency 
Low thyroid
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10
Q

Morphology of QRS

A
  1. RVH
  2. LVH
  3. RBBB
  4. LBBB
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11
Q

QRS in RVH

A

H/o PS, PAH

V1
R wave > 1 large box

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12
Q

QRS in LVH

A

H/o systemic HTN, AS

V5/6
R wave > 25mm

Or

V5/6 R wave ➕ V1 S wave > 35mm

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13
Q

RBBB QRS

A

H/o RV strain - PE

Rabbit ear pattern
rSr’ pattern

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14
Q

LBBB QRS

A

LV wall MI

rR’ pattern (M pattern)

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15
Q

QRS axis probs

A

LAD (I and III away each other)
RAD (I and III towards each other)
Extreme axis (dextrocardia)

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16
Q

Arrhythmias

A

Brady
Sinus
AV block

Tachy
Supra vent (above BOH)
Ventricular (below)

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17
Q

Sinus Brady

A

HR<60

Each P followed by QRS

18
Q

Sinus arrest

A

No P wave
Junctional rhythm

Normal QRS
HR 40-60

Symptomatic = Sick sinus syndrome
Rx artificial pacemaker

19
Q

AV blocks types

A

Primary
Secondary
Tertiary

20
Q

Primary AV block

A

PR prolonged + each O followed by QRS
(Slow cond from atria to vent but ALL impulses conducted)

Rx underlying cause

21
Q

Secondary AV block

A

2 types
Mobitz 1
Mobitz 2

Intermittent failure of atria to conduct to ventricle
Each P NOT followed by QRS

22
Q

Mobitz 1

A

Progressive PR prolonging till one P not followed by QRS
⬇️
Wenkebach phenomenon

Rx digoxin (NO PACEMAKER NEEDED)

23
Q

Mobitz 2

A

Fixed PR interval (normal or prolonged) with alternate Absent QRS

P:QRS = 2:1
Atrial rate = 80
Vent rate = 40

Rx AVN ischemia give PACEMAKER +

24
Q

Tertiary AV block

A

Complete failure of atrioventricular cond

Idioventicular rhythm starts

Wide QRS + QRS independent of P
HR = 40

Rx pacemaker

25
Q

Tachyarrythmias

A

SAN 1
Atria 3
AVN 1

26
Q

SAN origin

Sinus tachycardia

A

Increase SAN automaticity

HR>100
Each P followed by QRS

Rx thyrotoxicosis, fever

27
Q

Atrial origin tachy

A

Atrial tachycardia
Atrial flutter
Atrial fibrillation

28
Q

Atrial tachycardia

A

> 3 ectopics Away from SAN at HR = 100-250

Atrial rate = vent rate 
Each P (abnormal and negative) followed by QRS 
If P has different morphology - multifical atrial tachycardia

Rx COPD hypoxia

29
Q

Atrial flutter

A

Sync depolarisation at 250-350 due to RE ENTRY in RA

Ratio 2:1 fixed
Vent rate < atrial rate
SAW TOOTH P waves and each P not followed by QRS

30
Q

Rx Atrial flutter stable

A

Control vent rate BB

Definitive Rx - RFA

31
Q

Rx Atrial flutter unstable

A

DC shock

Stop all pathways and re start only SAN

32
Q

Atrial fibrillation

A

Async atrial rate > 350
Due to stretching of atria in LAE

small amp p fibrillations and absent P with AV block
Irregularly irregular

33
Q

Atrial fibrillation Rx stable

A

Control rate BB

Convert AF into sinus “Cardioversion”
Doc - ibutilide
DC shock

Maintenance doc - Amiodarone

Do TEE to rule out thrombus before DC

34
Q

Unstable atrial fibrillation

A

DC shock

35
Q

PSVT

A

AV re entry

Absent P wave and HR >100 regular

Rx stable
Carotid massage
Doc IV adenosine

Unstable DC shock

36
Q

VTachy

A

> 3 vent ectopics at 100-250 and Endo to epi rule broken

Absent P wave + Wide QRS + T opp to QRS

37
Q

Variant of VT with different QRS morphology

A

Polymorphic VT

Torsades de pontes

38
Q

V flutter

A

Sync vent depolarisation at >250

Wide QRS and p waves

Rx DC shock
Doc - iv amiodarone > ligno

39
Q

V fibrillation

A

Asynchronous vent depolarisation

No definitive QRS

Rx DC shock
Doc - iv amiodarone > ligno

40
Q

Sustained VT

A

> 30 sec always unstable

Rx DC shock
Doc - iv amiodarone > ligno

41
Q

Non sustained VT

A

<30 sec

Oral amiodarone prophylaxis

Neet Rank 8 (30 decks)

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