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AFN Principles II Coop > ECG Basics > Flashcards

ECG Basics Flashcards

1
Q

Resting EKG is normal in ___-___% of patients who have CAD who have not had a prior MI

A

25-50%

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2
Q

(t/f) Precordial leads do not need augmentation

A

True

*they are close to the heart

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3
Q

In what 4 leads are all waveforms expected to have postitive deflections?

A

I,II,III,aVF

*just think about the location of these leads and the conduction pathway of the heart

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4
Q

aVR- all waveforms are __________

A

negative

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5
Q

aVL, P and T are ________, but QRS is _________

A

negative

biphasic

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6
Q

Precordial leads-

P and T are ________

QRS starts ________ & ends ________

A

positive

negative

positive

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7
Q

V2 goes at ___ IC space left sternal border

A

4th

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8
Q

V4 goes at ________ at the 5th IC space

A

midclav

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9
Q

V6 horizontal to V5 at ________ _____

A

midax line

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10
Q

What 2 leads best for overall monitoring

A

II, V5

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11
Q

Consider using ___ and II for detecting supply ischemia/transmural injury

A

V3

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12
Q

Lead __ for rhythm assessment (p-wave analysis)

A

II

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13
Q

Lead ___ if anticipated change is depression (subendo injury/ischemia)

A

V5

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14
Q

Lead ____ for RV ischemia

A

V4

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15
Q

V4 + V5 = ___% sensitivity for detecting ischemia

A

90%

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16
Q

In diagnostic mode w/ ECG the frequency filter range is set to __-__hz

A

0.05-100hz

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17
Q

In monitor mode w/ ECG the frequency filter range is set to __-__hz

A

0.5-40hz

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18
Q

How many seconds (miliseconds) is one tiny box on EKG strip

A

0.04sec (40ms)

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19
Q

One small box on EKG strip is ___mV

A

0.1mV

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20
Q

Normal QRS duration

A

0.08-0.12sec

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21
Q

Normal PRI

A

0.05-0.12sec (mund)

Real = 0.12-0.2

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22
Q

QTc >____sec = Increased susceptibility to life-threatening dysrhythmias

A

0.44sec (440ms)

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23
Q

Absolute refractory period is where on the ECG?

A

Beginning of QRS to first 1/2 of T-wave

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24
Q

Relative refractory period is where on the ECG?

A

2nd 1/2 of T-wave

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25
Q

Negative ___ wave may sig LAD occlusion, ischemia , AR/MR, increased afterload

A

U wave

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26
Q

_________ waves are positive deflections at the J-point usually d/t severe hypothermia

(looks similar to infarction elevations but more isolated at the j-point)

A

Osborne waves

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27
Q

“_______ rhythm and greater than ___ PVCs on resting EKG were independent predictors of increased perioperative risk after noncardiac surgery”

A

nonsinus rhythm

5

28
Q

Mobitz 1 (Wenckebach)
is due to pathology at the level of the ______ _______

A

AV node

29
Q

(t/f) Mobitz I (Wenckebach) has a high chance of progressing to CHB

A

False

30
Q

What MI location could cause mobitz I

A

Inferior MI

31
Q

Mobitz II
pathology is located ________ in the _____ _______ system

A

infranodal

His-Purkinje

32
Q

(t/f) Mobitz II has a high chance of progressing to CHB

A

True

33
Q

Mobitz II is ALWAYS associated with significant ______

A

CAD

34
Q

What MI could cause Mobitz II

A

Anteroseptal MI

35
Q

(t/f) W/ CHB you should cancel case if able

A

True

36
Q

In RBBB you see an RSR’ configuration in leads ___ and ___

A

V1 and V2

37
Q

In LBBB you see an RSR’ configuration in leads ___ and ___

A

V5 and V6

38
Q

Preexisting _____ can mask
ischemia, impending infarction, &
Left ventricular hypertrophy

A

LBBB

39
Q

LBBB under anesthesia : ominous sign of _______________

A

ischemia/infarction

40
Q

Bifascicular block is a
__BBB in combination with a block of one of the __ branches

A

RBBB w/ 1 Left branch

41
Q

Trifascicular block is a
__________ block and a prolonged _____

A

Bifascicular

PRI

42
Q

Which one progresses to CHB, bifascicular or trifascicular block

A

Trifascicular

43
Q

______ is an independent predictor of perioperative risk after noncardiac surgery

A

LVH

44
Q

W/ LVH what will you see on EKG

A

Strain pattern

45
Q

Hypercalcemia and hypermagnesemia cause _________ QTc

A

shortened QTc

46
Q

Hypocalcemia and hypomagnesemia __________ QTc

A

Prolonged QTc

47
Q

What pathology?

Low voltage, r-axis deviation, poor R-wave progression in the precordial leads

Due to lung hyperinflation and RV enlargement

A

COPD

48
Q

What pathology?

RBBB, RV strain, ST and/or AF

NOT very specific or sensitive

A

Pulm embolism

49
Q

Criteria for ischemia on EKG:

> __mm horizontal ST depression
__mm upsloping or downsloping depression measured ____ ms from J-point
__mm ST elevation

A

All are >1mm

1.5ms from J-point

50
Q

Combination of ST ________ and T wave ________ = high incidence of LM dz and death

A

ST depression

T-wave inversion

51
Q

ST depression + T-wave inversion = ____ disease

A

Left main (LM/LCA)

52
Q

______sloping ST depression is associated with an increased number of diseased coronary arteries and an increased mortality

A

Downsloping ST Depression

53
Q

______sloping more often benign especially if less than 2 mm

A

Upsloping

54
Q

ST ________ may represent acute myocardial ischemia (preinfarction), coronary vasospasm, epicardial ischemia

A

elevation

55
Q

Which lead will t-waves be normally inverted?

A

aVR

56
Q

Inverted t-waves in the inferior (II, III, aVF) or anterolateral (I, aVL, V3-6) leads may be seen in ________

A

MVP (papillary muscle ischemia)

57
Q

What leads & vessels effected for inferior MI?

A

II,III,aVF

RCA/PDA

58
Q

What leads & vessels effected for lateral MI?

A

I,aVL,V5,V6

LCx

59
Q

What leads & vessels effected for septal MI?

A

V1,V2

LAD (some LCx)

60
Q

What leads & vessels effected for anterior MI?

A

V3,V4

LAD/Diagonals

61
Q

What leads & vessels effected for posterior MI?

A

Reciprocal V1,V2

PDA (80%RCA, 20%LAD)

62
Q

A significant Q wave in leads I & AVL is called an “______ ______ ______ _____”,

A

old high lateral MI

63
Q

Inferior MI can cause _______ complex dysrhythmias

A

Narrow

64
Q

Anterior MI can cause _______ complex dysrhythmias

A

wide

65
Q

What MI can cause these:

-Profound sinus bradycardia

-Junctional

-3rd degree with junctional escape rhythm

A

Inferior MI

66
Q

What MI can cause these:

-Mobitz II

-3rd degree with ventricular escape rhythm

A

Anterior MI

AFN Principles II Coop (1 decks)

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