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MD2 Foundation > ECG, IHD, cardio exam, HTN > Flashcards

ECG, IHD, cardio exam, HTN Flashcards

1
Q

which lead is used as rhythm strip usually

A

II

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2
Q

what is sinus arrhythmia

A

a normal variation where heart rate changes with respiration

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3
Q

what is a premature atrial complex

A

an atrial ectopic.

an early beat generated in the atria with a normal QRS

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4
Q

what is a premature ventricular complex? how would it look on ECG?

A

a ventricular ectopic beat. broad QRS in absence of P wave.

a ventricular extra beat

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5
Q

how does atrial fibrillation appear on ecg?

A

absence of p waves

irregularly irregular rhythm

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6
Q

how does atrial flutter appear on ECG?

A

saw tooth appearance of p waves.

too many p waves.

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7
Q

normal p wave length

A

<120ms (3 small squares)

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8
Q

what does the PR interval indicate

A

AV conduction time

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9
Q

what is first degree AV block

A

gradually increasing PR interval and eventually a non conducted P wave

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10
Q

normal QRS length

A

100ms

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11
Q

what causes right axis deviation

A

right ventricular hypertrophy

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12
Q

lateral ECG leads

A

V5 V6

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13
Q

inferioir ECG leads

A

2, 3, aVF

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14
Q

high lateral ECG leads

A

1, aVL

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15
Q

pronounced Q wave is indicative of

A

prior infarct

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16
Q

how long does ST elevation last in STEMI

A

only 48 hours

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17
Q

horizontal ST depression indicates

A

significant myocardial

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18
Q

3 types of ST depression

A

downgoing
horizontal
upgoing (might be ok)

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19
Q

atrial fibrillation on ECG

A

no p waves

irregularly irregular

20
Q

what is torsades de pointes

A

QT lengthening can lead to this abnormal ecg that can cause vtachycardia and sudden death

21
Q

how is hypokalaemia reflected on ECG

A

dampened t waves

22
Q

definition of acute myocardial infarction. 3 features it includes

A

symptoms (chest pain, SOB etc)
change in ECG
elevation of cardiac markers

23
Q

in AMI, is primary percutaenous intervention or fibrinolysis preferred?

A

primary percutaneous intervention (clot retrieval)

24
Q

4 medications you will be put on after an AMI

A

beta blockers (reduce recurrency, reduce angine, reduce arrhythmias)
aspirin (antiplatelet therapy important for future prevention)
ACEI
statin

25
Q

what do you need to clarify about when a patient says they have “palpitations”

A

fast beats? missed beats? irregular? forceful?

26
Q

possible diagnoses of “palpitations”

A

sinus tachycardia
atrial fibrillatoin
supraventricular tachycardia
ventricular tachycardia

27
Q

investigations to be completed for palpitations

A

ECG is needed most importantly but can be difficult. may need implantable monitor.

also echocardiogram for underlying strucutral disease of the heart

maybe UEC to determine if there is electrolyte imbalance

28
Q

2 mechanisms of tachycardia

A

single group of cells firing rapidly (the nodes)
or
re-entry

29
Q

mechanism of re-entry

A

2 electrical paths around an area of scar, one path becomes unable to conduct and then the other path can go around the scar, go up the other path, and may get past the block and then create a circular electrical circuit

30
Q

what is atrial flutter

A

re-entry tachycardia within the atria leading to sawtooth ecg

31
Q

what are premature ventricular complexes

A

ectopic depolarisation within the ventricle that bypasses the his-purkinje system to cause slow depolarisation within ventricles
usually benign

32
Q

treatment for atrial fibrillation

A

often want to control the rate instead of the rhythm
beta blockers, digoxin

and then want to control stroke risk vs bleeding risk (aspirin? warfarin?)

and if nothing works then may need catheter ablation of pulmonary veins

33
Q

first degree AV block

A

PR interval > .2 seconds

34
Q

second degree AV block

types 1 and 2

A 
1 = gradually increasing PR interval until a p isnt conducted
2 = intermittently blocked p waves
35
Q

third degree av block

A

dissociation of atrial and ventricular activity

36
Q

diagnosing hypertension

A

BP > 140/90 on 2 separate measurements

37
Q

what level does Hb have to be for conjunctival pallor

A

less than 80

38
Q

what causes cyanosis

A

deoxy Hb (as opposed to anemia)

39
Q

what does JVP tell us

A

the filling pressure of the right side of the heart

40
Q

how to tell if it is JVP vs carotid

A 
cant feel it pulsing
double wave
hepatojugular reflux
inhalation changes
occlude it
varies with position
41
Q

what is kussmauls sign

A

JVP rising with inspiration

indicative of constrictive pericarditis

42
Q

what does S3 indicate?

A

turbulence during early ventricle filling
voume overload (aortic or mitral regurge)
dilated cardiomyopathy

43
Q

what does S4 indicate?

when is it?

A

before S1.

indicates turbulence duering atrial contractoin in stiff ventricle (HTN, aortic stenosis, Hypertrophic cardiomyopathy)

44
Q

aortic stenosis murmur?

A

crescendo-decrescendo

45
Q

mitral regurgitation murmur ?

A

pansystolic

MD2 Foundation (10 decks)

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