ECG etc.

Question 1

P wave is upright in:

Answer 1

I, II, aVF, V4-6

Question 2

What is the PR interval? And how long is it?

Answer 2

The time from the SA node to reach the ventricle muscle fibers.
0.12-0.2 s.

Question 3

QRS length

Answer 3

0.05-0.10 s.

Question 4

Q wave is upright in:

How tall is it?

Answer 4

I, aVL, aVF, V5-6.

1-2 mm.

Question 5

ST elevation and depression:

Answer 5

No more than 2 mm in chest or 1 mm in standard.

No more than 0.5 mm.

Question 6

ST elevation can be indicative of:

Answer 6

Injury or ischemia.

Question 7

ST depression can be indicative of:

Answer 7

Subendocardial injury.

Question 8

T wave is inverted in:

Elelvation:

Answer 8

I, II, aVF, V3-6.

No more than 5 mm in standard and no more than 10 mm in chest.

Question 9

QT duration is:

What can changes in the QT be indicative of?

Answer 9

Length of ventricular systol.

Can be indicative of myocardial ischemia, injury or infarction.

Question 10

Inverted T waves can mean:

Answer 10

Ischemia.

Question 11

Changes in the Q wave can mean:

Answer 11

Necrosis or infarction.

Question 12

P-mitrale

Answer 12

Broad, notched P waves that are taller in lead I than III.

Question 13

P-pulmonale

Answer 13

Flat P wave in I with a tall and pointed P wave in leads II, and III.

Question 14

AV Junctional rhythm

Answer 14

Inverted P waves in leads II and III with short PR interval.

Question 15

Prolonged PR interval can be from (2):

Answer 15

AV block

Hyperthyroidism.

Question 16

Shortened PR interval can be from (5):

Answer 16

Junctional rhythms
Wolff-Parkinson-White syndrome
Lown-Ganong-Levine syndrome
Glycogen storage disease
HTN

Question 17

What are the best leads for reading P waves? (2)

Answer 17

Lead I and V1

Question 18

Each dark line is how long?

Each light line is how long?

Answer 18

0. 2 s

0. 04 s.

Question 19

What can cause a P wave to follow a QRS complex? (2)

Answer 19

SVT

Junctional rhythm

Question 20

No P waves can mean:

Answer 20

AFib, atrial flutter, junctional tachycardia

Question 21

Lateral circumflex a. can be noted in which leads?

Answer 21

I, aVL, V5, V6

Question 22

RCA can be noted in which leads?

Answer 22

II, II, aVF.

Question 23

Septal/LAD can be noted in which leads?

Answer 23

V1, V2

Question 24

Anterior/LAD can be noted in which leads?

Answer 24

V3, V4

Question 25

PAC

Answer 25

Normal and seen in absence of heart disease. Can be aggravated by stress, caffiene, alcohol, etc. See drawing.

Question 26

PVC

Answer 26

Can also be normal or in patients with a history of heart problems (CHF, electrolyte problems, AMI). P wave is absent before a QRS complex that is long and wide. See drawing.

Question 27

MAT - multifocal atrial tachycardia

Answer 27

3 different P waves caused by different atrial foci causing a depolarization. Rate is tachycardic.

Question 28

Supraventricular tachycardia (SVT)

Answer 28

P and T waves are indistinguishable from QRS. Can be in alteration.

Question 29

Vtach

Answer 29

Big, wide QRS complex in rapid succession w/ no identifiable P waves. Rate is tachy.

Question 30

VFib

Answer 30

Peaks/waves are not distinguishable. | Caused by multiple ventricular foci firing without synchronicity.

Question 31

STEMI vs NSTEMI

Answer 31

STEMI s complete blockage of a vessel. | NSTEMI is partial blockage.

Question 32

NSTEMI (3)

Answer 32

ST segment depression. T wave inversion. Elevated cardiac enzymes.

Question 33

NSTE ACS (3)

Answer 33

ST segment depression. T wave inversion. Normal cardiac enzymes.

Question 34

If thinking an MI, what do the T wave, ST elevation and Q wave tell you?

Answer 34

Inverted T wave suggests ischemia. ST elevation suggests injury. Q wave suggests necrosis/infarction.

Question 35

Zones of infarction (3)

Answer 35

Infarction (dead tissue - cannot depolarize): Q wave Injury (poor blood supply - unable to fully depolarize): ST segment Ischemia (poor blood supply - cannot repolarize): T wave

Question 36

What would you expect to see if the MI damage is old?

Answer 36

Return to baseline of the ST segment.

Question 37

When thinking of a posterior wall STEMI, what should you observe?

Answer 37

Reciprocal changes form the anterior wall leads (V1-3)

Question 38

Cardiac biomarker for MI and timeline of its elevation

Answer 38

``` Troponin I 1-4 hrs post event it is detectable. Peaks at 10-24 hrs. Persists for 5-14 days. Renal failure can cause a false positive. ```

Question 39

Lab values for someone w/ AMI (3)

Answer 39

High WBC count High CRP High BNP due to ventricular wall stress due to increased fluid.